Paediatrics Flashcards
At 3-4 months of age, what gross motor, fine motor, speech and social development should have occurred?
Gross motor:
- Prone position: lifts head and shoulders with weight in forearms.
- Pull to sit: no head lag
Fine motor
- Grasping and reaching: Holds a rattle and shakes purposefully.
Speech:
- Expressive: vocalises (ooh, aah)
- Receptive: responds to voices, startles
Social:
- laughing out loud
At 5 months, what gross motor, fine motor, speech and social development should have occurred?
Gross motor: -
Fine motor:
- Grasping and reaching: Reaches for object.
- Manipulation: Whole hand grasp
Speech: -
Socail: -
At 6-8 months, what gross motor, fine motor, speech and social development should have occurred?
Gross motor:
- Prone: arms exten ded supporting chest off couch
- sitting: curved back needs support from adult
- Standing/walking: stands with support
Fine motor:
- Grasping and reaching: Transfers objects from hand to hand (6 months)
- Finger feeds (7 months)
Speech/language:
- Expressive: double babble (dada, mama, baba) (8 months)
- receptibe responds to name
Social:
- stranger anxiety (7 months)
- rapid increase in development of primary attachment, with emergence of separation anxiety.
At birth, what gross motor, fine motor, speech and social development should have occurred?
Gross motor:
- prone: flexed position
- pull to sit: complete head lag
At 6 weeks, what gross motor, fine motor, speech and social development should have occurred?
Gross motor:
- prone: pelvis flatter (frog position)
- Pull to sit: head control developing
- Sitting: curved back needs support from adult
Personal/social:
- Social: smile
At 9-10 months, what gross motor, fine motor, speech and social development should have occurred?
Gross motor:
- Sitting: gets into sitting position alone
- Standing/walking: pulls to standing and stands holding on.
Fine motor:
- manipulation: Immature pincer grasp (9m)
- points to bead (10m)
Social:
- ‘peek a boo’, waves bye bye. object constancy, intersubjectivity
At 12 months, what gross motor, fine motor, speech and social development should have occurred?
Gross motor:
- standing/walking: stands with one hand held
Fine motor:
- Building blocks: give bricks to examiner
- manipulation: mature pincer grasp
Speech/language:
- expressive: 1-3 words with meaning
Personal/social:
- stranger anxiety
At 15 months, what gross motor, fine motor, speech and social development should have occurred?
Gross motor:
- Standing/walking: walks independently and stoops to pick up objects.
Fine motor:
- Building bricks: buidling tower of two cubes
Personal/social:
- Social: points
- Personal: drinks from cup
At 18 months - 2 years, what gross motor, fine motor, speech and social development should have occurred?
Fine motor:
- Building blocks: builds tower of three to four cubes
- Pencil skills: scribbles with a pencil
Speech:
- 10 words (18m)
- links 2 words (2y)
Personal:
- Spoon feeds (18m)
Parallel play (2y)
At 3 years, what gross motor, fine motor, speech and social development should have occurred?
Fine motor:
- Pencil skills: draws a circle
Speech:
- Full sentences, talks incessantly
Personal/ Social:
- Cooperative play
- toilet trained by day
- dresses
What vaccines are given at birth?
- Hep B
What vaccines are given at 2 months?
- Hep B, diphtheria, tetanus, acellular pertussis, Haemophilus influenzae type b, inactivated poliomyelitis (hepB-DTPa-Hib-IPV)
- Pneumococcal conjugate
- Rotavirus
What vaccines are given at 4 months?
- Hep B, diphtheria, tetanus, acellular pertussis, Haemophilus influenzae type b, inactivated poliomyelitis (hepB-DTPa-Hib-IPV)
- Pneumococcal conjugate
- Rotavirus
What vaccines are given at 6 months?
- Hep B, diphtheria, tetanus, acellular pertussis, Haemophilus influenzae type b, inactivated poliomyelitis (hepB-DTPa-Hib-IPV)
- Pneumococcal conjugate
- Rotavirus
What vaccines are given at 12 months?
- Haemophilus influenzar type b and meningococcal C (Hib-MenC)
- Measles, mumps, rubella and varicella (MMRV)
What vaccines are given at 18 months?
- Diphtheria, tetanus, acellular pertussis (DTPa)
- Measles, mumps, rubella and varicella (MMRV)
What vaccines are given at 4 years?
- Diphtheria, tetanus, pertussis and inactivated poliomyelitis (DTPa-IPV)
- Measles, mumps and rubella (only to be given if MMRV was not given at 18 months)
What vaccines are given at 10-15 years?
- Diphtheria, tetanus, pertussis
- Varicella
- HPV
What are the red flags for child abuse on physical examination?
Brusing patterns.
- Any bruising in infants younger than six months of age
- More than one bruise in a pre-mobile infant and more than two bruises in a crawling child
- Bruises located on the torso, ear, neck, or buttocks
- Bruises with a pattern of the striking object (eg, slap, belt, or loop marks; spoons; spatulas; or other objects)
- Human bite marks
What are the red flags for child abuse on physical examination?
Oral injuries.
- Lip lacerations or bruising, especially in nonambulatory infants
- Lingual or labial frenulum tears, especially in nonambulatory infants
- Tongue lacerations, especially in nonambulatory infants
- Bruising or wounds of the buccal mucosa, gums, or palate, especially in nonambulatory infants
- Missing or fractured teeth with an absent or implausible history
- Maxillary or mandibular fractures with an absent or implausible history
- Bruising, lichenification, or scarring at the corners of the mouth from being gagged
What are the red flags for child abuse on physical examination?
Burns
- Scalds in children <5 years of age that do not fit an unintentional spill pattern
- Scalds from hot tap water due to immersion, demonstrating a sharp upper line of demarcation (“high tide mark”), affecting both sides of the body symmetrically, or involving the lower extremities and/or perineum
- Burns that have a sharply demarcated edge in the shape of the burning object (eg, clothing iron, spatulas, spoons, grates, metal hairdryer grids, curling irons, or the metal tops of butane cigarette lighters)
- Cigarette burns that appear as discreet circular burns 8 to 12 mm in diameter and are deep (eg, third degree burns)
What are the red flags for child abuse on physical examination?
Fractures
- Metaphyseal corner fractures
- Rib fractures
- Fractures of the sternum, scapula, or spinous processes
- Long bone fracture in a nonambulatory infant
- Multiple fractures in various stages of healing
- Bilateral acute long-bone fractures
- Vertebral body fractures and subluxations in the absence of a history of high force trauma
- Digital fractures in children younger than 36 months of age
- Epiphyseal separations
- Severe skull fractures in children younger than 18 months of age
What are the red flags for child abuse on physical examination?
Serious injury without explanation.
- Subdural hematoma or retinal hemorrhage in a young child, without a significant public trauma such as a fall out a tall building window or a car crash
- Other intracranial injury without a clear trauma history
- Abdominal injury (perforation or hematoma of the bowel, pancreas, or bladder; solid organ [eg, liver, spleen, or kidney] hematoma or laceration)
Describe the different types of clubbed feet?
