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Phase 2 > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

Describe the components of a paediatric clinical history

A

Name
Age
PC
HPC - origin, duration, progress
Birth hx - full term, normal delivery, weight, SCBU
Feeding hx - breast/bottle, weaned, weight gain
Immunisation hx - up to date
Developmental hx - milestones, concerns, school performance
SH - nursery/school, home environment, travel
FH - conditions, genogram, consanguinity

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2
Q

Describe relevant questions in a systems review

A

Cardioresp - tachypnoea, grunting, wheeze, cyanosis, smokers in family, cough (barking/whooping)
GI - appetite, vomiting, feeding, jaundice, bleeding, weight, passed meconium
Genitourinary - wet nappies, smell, haematuria
ENT - noisy breathing, ear infections, hearing
Skin - rash, birthmarks

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3
Q

Describe the components of a paediatric examination

A

Vital signs - temp. O2 sats, HR, RR, cap. refill,

Plot and interpret growth chart

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4
Q

Describe the components of a paediatric respiratory examination

A

Observation - respiratory distress (nasal flaring, recession, accessory muscle use, wheeze, stridor, grunting), restless, drowsy, cyanosis, finger clubbing
Palpation - expansion, trachea (central), apex beat, chest deformity, percussion
Auscultation - air entry, breath sounds, expiratory wheeze, transmission of upper airway sounds

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5
Q

Describe the components of a paediatric ENT examination

A

Ear - grey, shiny/red, bulging/dull, retracted
Nose - inflammation, obstruction, polyps
Throat - enlarged, red tonsils

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6
Q

Describe the components of a paediatric cardiology examination

A

Observation - central cyanosis, breathless/pale/sweaty, finger clubbing, failure to thrive
Palpation - apex beat, RVH, thrills, hepatomegaly, pulse (radial/femoral)
Auscultation - murmurs (diastolic = pathological), BP, CRT

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7
Q

Describe the components of a paediatric abdominal examination

A

Observation - nutritional status (BMI, upper arm circumference), jaundice, pallor, abdominal distension, wasting of buttocks (coeliac), genitalia (hypospadias, undescended testes, hydrocele, hernia)
Palpation - tenderness, organomegaly (spleen, kidneys), masses
Auscultation - bowel sounds

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8
Q

Describe the components of a paediatric neurological examination

A

Observation - conscious level, posture, movement, gait, limb deformity, contractures, growth, head circumference, shoes (unequal wear)
Tone - hypotonia, spasticity (toe walking)
Power
Sensation
Reflexes - *plantar reflex is up until ~8mo
Coordination
Developmental exam

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9
Q

Describe the NICE guidelines on fever in children

A

Green = normal colour, responds normally to social cues, smiles, stays awake, not crying/strong cry. normal skin and eyes, moist mucous membranes

Amber = pale, not responding normally to social cues, no smile, wakes only with prolonged stimulation, decreased activity, nasal flaring, tachypnoea, tachycardia, CRT >3s, dry mucous membranes, poor feeding, low urine output, temp. >38, rigors, fever >5 days, non weight bearing limb

Red = pale/mottled/ashen/blue, no response to social cues, appears ill to HCP, does not wake, weak high pitched continuous cry, grunting, reduced skin turgor, age <3mo with temp. >38, non blanching rash, bulging fontanelle, neck stiffness, focal neurology

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10
Q

Define the terms prematurity, extremely premature, low birth weight, very low birth weight, extremely low birth weight and small for gestational age

A 
Prematurity = <37 weeks
Extremely premature = <28 weeks
Low birth weight = <2.5kg
Very low birth weight = <1.5kg
Extremely low birth weight <1kg
SGA = <10th centile
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11
Q

List risk factors for prematurity

A

Maternal - smoking, alcohol, pre-eclampsia, young age
Uterine - structural abnormality, cervical incompetence
Fetal - multiple, distress, infection, chromosomal abnormality
Placental - praevia, abruption, insufficiency

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12
Q

Describe the APGAR score

A

Appearance - pink/blue/white (2/1/0)
Pulse - >100/<100/absent
Grimace (reflex to suction) - cough or sneeze/grimace/none
Activity (floppy) - good flexion/some flexion/limp
Respiration - strong cry/irregular/absent
*normal score at 1 min = 7/10

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13
Q

List and describe the management of some common newborn respiratory problems

A

TTN - often in C-section baby –> dry and give oxygen
RDS - surfactant deficiency, ground glass appearance on CXR –> dexamethasone, surfactant
Apnoea - not breathing for >20s –> caffeine
Bronchopulmonary dysplasia - chronic oxygen requirement for >28 days or 36 weeks corrected
Meconium aspiration syndrome - seen on Xray –> suction

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14
Q

List and describe the management of some common newborn cardiac problems

A

PDA –> NSAIDs (indomethacin), ligation

Hypotension –> ITU

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15
Q

List and describe the management of some common newborn haematology problems

A

Anaemia - iatrogenic (multiple blood tests), underdeveloped kidneys producing low EPO –> iron tablets, transfusions

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16
Q

List and describe the management of some common newborn gastrointestinal problems

A

NEC - breast milk is protective, abdominal distension, bloody stools –> ABx, NBM, surgery if perforated
Inguinal hernia –> surgery due to strangulation risk

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17
Q

Describe causes and management of neonatal jaundice

A

<24h - Rh/ABO incompatibility, G6PD, spherocytosis, sepsis
24h-2 weeks - breastfeeding, physiological, dehydration
>2 weeks - biliary atresia, hypothyroidism, pyloric stenosis
Mx = watch and wait/phototherapy/exchange transfusion (*risk of kernicterus)

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18
Q

What precautions must be taken when a neonate undergoes phototherapy

A

Cover eyes

Ensure adequate fluids (IV)

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19
Q

Describe the clinical presentation and management of biliary atresia

A

CFs - jaundice, yellow urine, chalky, white stool, splenomegaly
Ix - HIDA scan
Mx - surgery (Kasai procedure), liver transplantation

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20
Q

List different causative agents for neonatal infection

A 
Early onset (<48h) - GBS, listeria (maternal infection/PROM)
Late onset (>48h) - staph aureus, E. coli (central line, catheter infection)
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21
Q

List and describe the management of some common newborn endocrine/metabolic problems

A

Jaundice
Hypoglycaemia (BM <2.6) –> IV 2mls/kg of 10% dextrose
Thermoregulation –> incubator box
Osteopenia

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22
Q

List and describe the management of some common newborn neurological problems

A 
Intraventricular haemorrhage (IVH) - cranial USS, increased cerebral palsy risk
Hypoxic ischaemic encephalopathy - cord blood pH <7.0 --> therapeutic hypothermia (cooling to 33.5 for 72h)
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23
Q

Describe causes and management of retinopathy of the newborn

A

Screen neonates <1.5kg or born <32 weeks
Caused by high oxygen - keep neonate at <92% sats
Mx = laser ablation

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24
Q

List benefits of breastfeeding

A

Maternal - bonding, lower risk of PPH (oxytocin release), lowers risk of breast/ovarian cancer, contraceptive effect, low cost
Fetal - receive maternal IgG, lowers risk of NEC, long term health benefits

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25
Q

List some negatives of breastfeeding

A

Cracked nipples
Increased sodium loss –> dehydration
Higher costs (formula)

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26
Q

List contraindications of breastfeeding

A

HIV +ve mother
Active TB (+ treatment)
Illicit drug use

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27
Q

List medications that are contraindicated in breastfeeding

A 
Amiodarone
Antineoplastic (e.g. methotrexate)
Chloramphenicol
Lithium
Tetracyclines
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28
Q

List signs of a healthy breastfed baby

A

Wet nappies
Pooing regularly
Gaining weight (30-40g/day)

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29
Q

What is the NIPE?

A

Newborn and Infant physical examination - performed within 72h of delivery
General - weight, length, head circumference, tone, reflexes
Skin - jaundice, pallor, cyanosis, erythema toxicum rash, birthmarks
Head - anterior fontanelle, chignon
Eyes - red reflex, jaundice, coloboma
Mouth - cleft lip/palate, tongue tie
Chest - heart murmur, respiratory distress
Abdomen - distention, defects, organomegaly
Hips/limbs - pulses, barlow & ortolani, clubfoot
Genitalia/anus - ambiguity, undescended testes
Spine - spina bifida

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30
Q

Describe clinical presentation, investigations and management of bronchiolitis

A

<1 year, viral (RSV, parainfluenza, rhinovirus), lasts 7-10 days
CFs - wheeze, crackles, fever, poor feeding, <92% sats
Ix - CXR (hyperinflation, collapse/consolidation)
Mx - supportive (oxygen, feeding)

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31
Q

List the admission criteria for bronchiolitis

A

Apnoea
<92% sats
RR >70
Decreased oral intake

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32
Q

Describe the clinical presentation, management and long term advice given in cystic fibrosis

A

Cystic fibrosis = genetic disorder causing defect in CFTR chloride channel –> thick mucus
CFs - Guthrie heel prick (screening), sweat test (>60mmol/L Cl-), meconium ileus, failure to thrive, (recurrent chest) infections
Ix - CXR (overinflation, hilar enlargement, ring shadows)
Mx - ABx, steroid therapy, nebulised DNAse, regular bronchodilators, chest physiotherapy
Long term advice - prophylactic ABx, immunisations (pneumococcal, influenza)

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33
Q

List common organs affected in cystic fibrosis

A

Lungs - recurrent infections
Pancreas - malabsorption, pancreatic failure (requires vitamins ADEK, pancreatic enzymes), diabetes
Liver - cirrhosis
Gallbladder - biliary disease
Reproductive - sub fertility (absence of vas deferens in men)

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34
Q

Describe clinical presentation, investigations and management of croup

A

Croup = swelling of trachea
6mo-6 years, viral (RSV, parainfluenza)
CFs - seal like barking cough, stridor, sternal recession, agitation, lethargy, coryza illness, usually self limiting
Mx = dexamethasone oral/IV

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35
Q

Describe clinical presentation, investigations and management of epiglottitis

A

Epiglottitis = inflammation of epiglottis
1-6 years, haemophilus influenza B bacteria (*immunisation history)
CFs - 4Ds (drooling, dysphonia, dyspnoea, distress)
Ix - DO NOT EXAMINE
Mx - intubate, IV ABx, steroids

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36
Q

Describe clinical presentation, investigations and management of tonsilitis

A

Tonsilitis = inflammation of tonsils
Often viral (adenovirus, rhinovirus), bacterial (group A b-haemolytic streptococcus)
CFs - sore throat, red swollen tonsils, odynophagia, fever, malaise, lymphadenopathy
Mx - supportive (paracetamol, ibuprofen) or ABx (penicillin V), tonsillectomy

37
Q

Describe the Fever PAIN score

A 
Predicts likelihood of strep. throat:
Fever in past 24h
Purulent tonsils (exudate)
Attend rapidly (symptoms <3 days)
Inflamed tonsils
No cough
0-1 = no ABx
2-3 = delayed ABx\
>4 = ABx
38
Q

Describe the NICE guidelines regarding tonsillectomy

A

Sore throat is due to acute tonsillitis
The episodes of sore throat are disabling and prevent normal functioning
>7 in one year OR 5 in two years OR 3 in three years

39
Q

Describe clinical presentation, investigations and management of whooping cough

A

Whooping cough = highly infectious bacterial (bordella pertussis) infection *infants not fully vaccinated
CFs - paradoxical coughing spasms during expiration followed by a sharp intake of breath, apnoea
Ix - mostly clinical, lymphocytosis, nasal swab culture
Mx - supportive, ABx (erythromycin)
*advise cough may continue for months

40
Q

List cyanotic heart defects

A

Transposition of the Great Arteries (TGA)

Tetralogy of Fallot (ToF)

41
Q

List acyanotic heart defects

A

VSD
PDA
Coarctation of the aorta (CoA)

42
Q

Describe clinical presentation, investigations and management of Transposition of the Great Arteries

A

TGA = two parallel unconnected circulations (*only viable if ASD/PDA/VSD = bidirectional shunting)
CFs - cyanosis in 24h, tachypnoea, tachycardia, failure to thrive (3-6 weeks), prominent right ventricular heave, systolic murmur (if VSD), no respiratory distress
Ix - blood gas (metabolic acidosis, lactate), ECHO, CXR (egg on a string = narrowed mediastinum, cardiomegaly)
Mx - PG infusion (keeps duct patent), correct metabolic acidosis, surgery (<4 weeks)

43
Q

List some maternal risk factors for fetal TGA

A 
Age >40 
Diabetes mellitus
Rubella infection
Poor nutrition
Alcohol
44
Q

Describe clinical presentation, investigations and management of Tetralogy of Fallot

A

ToF = VSD + pulmonary stenosis + RVH + overriding aorta
CFs - asymptomatic until age 1-3 (mild), cyanosis, respiratory distress recurrent chest infections, failure to thrive (moderate - severe), marked respiratory distress, cyanosis (extreme), central cyanosis, clubbing, thrill/heave, murmur, hepatosplenomegaly
Ix - ECG (RAD, RVH), CXR (boot shaped heart), ECHO
Mx - squatting, PG infusion, definitive surgery (3mo-4years)

45
Q

Describe clinical presentation, investigations and management of VSD

A

VSD = hole in the septum separating left and right ventricles
CFs - exercise intolerance, dizziness, chest pain, blue-ish complexion, clubbing, undernourished, sweaty, tachypnoea, blowing pan systolic murmur
Ix - ECG, bloods, CXR, ECHO
Mx - diuretics, ACEi, surgical repair

46
Q

What is Eisenmenger’s syndrome?

A

Pressure in RV > LV –> shunt reversal –> cyanotic patient

47
Q

List some maternal risk factors of fetal VSD

A 
Maternal diabetes
Rubella
Alcohol
FH
(Fetal Down's syndrome/trisomy 18)
48
Q

Describe clinical presentation, investigations and management of PDA

A

PDA = ductus arteriosus fails to close after birth (common in preterm babies - prevent with indomethacin, *associated with IVH, NEC)
CFs - systolic/continuous machinery like murmur, full bounding pulses
Ix - ECHO, CXR (cardiomegaly)
Mx - ibuprofen, surgical closure

49
Q

Describe clinical presentation, investigations and management of Coarctation of the Aorta

A

CoA = narrowing of descending aorta
CFs - shock (if closure of PDA), weak/absent femoral pulses, BP in arms > legs
Mx - PGs (keep duct open), surgical repair

50
Q

Describe clinical presentation, investigations and management of gastro-oesophageal reflux disease

A

GORD = passage of gastric contents into the oesophagus causing symptoms or complications
CFs - distressed behaviour, feeding difficulties, chronic cough, pneumonia, faltering growth, alleviated when held upright
Mx - reassurance (*usually resolves by 1 year of age), alginate (Gaviscon) + water, lower feed volume and higher frequency, feed thickener/alginate added to formula, PPI (omeprazole), H3 antagonist (ranitidine), domperidone, fundoplication

51
Q

List reasons neonates are more likely to experience GORD

A

Lower tone of lower oesophagus
Short narrow oesophagus
Delayed gastric emptying
High ratio of gastric volume:oesophageal volume

52
Q

List some risk factors of GORD

A 
Prematurity
Obesity
Hx of congenital diaphragmatic hernia
Hx of oesophageal atresia
Neurodisability
53
Q

Describe clinical presentation, investigations and management of cow’s milk protein intolerance/allergy

A

IgE (acute, rapid onset, skin signs, angioedema) vs non IgE (non acute, delated onset, faltering growth) mediated allergy
Ix - clinical, IgE blood test (RAST)
Mx - cow’s milk avoidance (baby + mother) for >6mo, nutritional counselling, growth monitoring, extensively hydrolysed formula/amino acid formula
*NOT soya based formula due to oestrogenic effects

54
Q

List some risk factors for CMPI

A

Atopy (asthma, eczema, allergic rhinitis, other food allergies)
FH of atopy

55
Q

Describe clinical presentation, investigations and management of Coeliac Disease

A

CD = lifelong gluten (wheat, barley, rye) sensitive autoimmune disease
CFs - failure to thrive, abdominal distension, buttock wasting, diarrhoea, anaemia, osteoporosis, dermatitis herpetiformis
Ix (if on gluten diet) - serology testing, duodenal biopsy
Mx - gluten free diet, iron supplementation

56
Q

What is the diagnostic criteria of Coeliac Disease?

A

Positive serology - IgA for anti-endomyseal, anti TTG
On biopsy - increased intraepithelial lymphocytes, villous atrophy, crypt hypertrophy
Resolution of symptoms on gluten free diet and catch up growth

57
Q

List some risk factors for Coeliac Disease

A

Autoimmune conditions (T1DM, thyroid, RA), Down’s syndrome, Turner’s syndrome

58
Q

Describe clinical presentation, investigations and management of gastroenteritis

A

Viral (rotavirus, norovirus, adenovirus) or bacterial (campylobacter, E.coli)
CFs - sudden onset diarrhoea +/- vomiting, abode pain, mild fever, dehydration
Ix - stool sample, bloods (Na+/K+, urea, creatinine, glucose)
Mx - continue feeds, encourage fluid intake, offer rehydration solution (if dehydrated), oral therapy or NG tube
*IV therapy if shock/red flags/lots of vomit

59
Q

List some complications of gastroenteritis

A

Haemolytic uraemic syndrome
Toxic megacolon
Acquired lactose intolerance

60
Q

State the paediatric maintenance fluid calculation formula

A

1st 10kg - 100ml/kg/day
2nd 10kg - +50ml/kg/day
>20kg - +20ml/kg/day

61
Q

Calculate the maintenance fluids of a 35kg child

A

1800ml/day

62
Q

State how to correct for dehydration in children

A

%dehydration x 10 x weight

63
Q

Describe clinical presentation, investigations and management of Hirshsprung’s Disease

A

HD = absence of ganglionic cells from plexuses in large bowel, association with trisomy 21
CFs - no meconium >48h, obstruction, abdominal distension, bilious vomit, chronic constipation, faltering growth
Ix - full thickness rectal biopsy, barium enema
Mx - rectal washout, anorectal pullthrough

64
Q

Describe clinical presentation, investigations and management of intussusception

A

= telescoping of one part of bowel into another, 3mo-2 years, commonly ileum –> caecum, caused by enlarged lymphatics (post viral, polyp, lymphoma)
CFs - episodic abdo pain, screaming, drawing up legs, pallor, passage of blood/mucus (red current jelly stool), palpable sausage mass
Ix - AXR (rounded edge of intussusception against gas filled lumen, proximal bowel obstruction), abdominal USS (target/doughnut sign)
Mx - fluid, IV ABx, reduction enema, laparotomy

65
Q

Describe clinical presentation, investigations and management of mesenteric adenitis

A

= inflammation of intraabdominal lymph nodes following URTI/gastroenteritis
CFs - abdo (RIF) pain, no peritonism/guarding, evidence of infection
Mx - analgesia (normally self limiting), otherwise appendicectomy

66
Q

Describe clinical presentation, investigations and management of Meckel’s diverticulum

A

= congenital out-pouching leftover from umbilical cord releases acid, rule of twos (2% population, 2% symptomatic, 2 inches, 2 feet from ileocaecal valve) *intussusception risk, appendicitis risk, volvulus risk
Ix - AXR, USS, faecal sample, Meckel’s scan, laparoscopy

67
Q

Describe clinical presentation, investigations and management of malrotation

A

= failure of duodenojejunal flexure to rotate around superior mesenteric vessels –> mesentery is not fixed, presents in first few days of life
CFs - obstruction +/- ischaemic bowel, blood stained bilious vomit
Ix - upper GI contrast study (corkscrew sign)
Mx - surgical correction

68
Q

Describe clinical presentation, investigations and management of pyloric stenosis

A

= hypertrophy of pylorus muscle, 2-8 weeks, first born male
CFs - non bilious projectile vomiting (immediately after feed), constipation, hungry baby, failure to thrive, prominent peristaltic wave, palpable epigastric mobile mass
Ix - USS (thickened, elongated pyloric muscle), bloods (hypochloraemic hypokalaemia metabolic acidosis)
Mx - rehydration + correction of electrolytes/acidosis), Ramstedt’s pyloromyotomy

69
Q

Describe clinical presentation, investigations and management of congenital diaphragmatic hernia

A

CFs - respiratory distress in neonate, not responsive to resuscitation, displaced apex beat, poor air entry to left lung
Ix - X-ray (bowel loops in chest)
Mx - NG with suction (to decompress bowel), intubation, surgical repair

70
Q

Describe clinical presentation, investigations and management of tracheoesophageal fistula/oesophageal atresia

A

CFs - polyhydramnios, not feeding, cyanosis on feeding
Ix - CXR (air in stomach)
Mx - NG with suction, surgical repair

71
Q

List some causes of nephritic syndrome

A

= inflammation –> haematuria
Post streptococcal glomerulonephritis - red cells, casts, HTN, group A strep, 1-2 weeks post throat/2-6 weeks post skin, penicillin 10 day course
Vasculitis - SLE, Wegener’s granulomatosis, HSP
IgA nephropathy (Berger’s disease)
Goodpasture’s syndrome (anti GBM)
Alport’s syndrome (X-linked recessive, sensorineural deafness + ESRD)
Sickle cell disease
PCKD (recessive –> infancy, dominant –> adolescence)

72
Q

List some causes and complications of nephrotic syndrome

A

= inflammation –> proteinuria, oedema, hypoalbuminaemia, hyperlipidaemia
Minimal change glomerulonephritis - oedema, URTI hx, fluid restriction, low salt diet, steroids (renal biopsy +/- cyclophosphamide if steroid resistant), penicillin (pneumococcal peritonitis risk)
Focal segmental glomerulosclerosis - rule of 1/3 (resolve/infrequent relapse/frequent relapse)
Complications - hypovolamia, thrombotic disease, hypercholesterolaemia

73
Q

List different causes of UTI in a child

A 
Pelviureteric obstruction - due to abnormal tissue/external compression at point of renal pelvis joining ureter
Vesicoureteric reflux (VUR) - retrograde flow of urine from bladder into ureters due to abnormally short and straight insertion of ureters into bladder, Mx - monitor, ABx prophylaxis
74
Q

List some causes of anaemia in a child

A

Impaired RBC production:
- Red cell aplasia - parvovirus B19, leukaemia, aplastic anaemia
- Ineffective erythropoiesis - chronic renal failure, folic acid deficiency
- Iron deficiency anaemia - blood cells, malabsorption, low intake
Increased RBC destruction:
- Haemolytic anaemia (hereditary sperocytosis, G6PD, sickle cells)
Blood loss:
- ITP - post viral infection, mucocutaneous bleed, Mx = steroid)
- Haemophilia A - joint bleeds, F8 deficiency, raised APTT
- DIC - raised D dimer, PT/APTT, trauma, metastatic cancer, sepsis
- von Willebrand’s - raised APTT, mucosal bleeding, Mx = desmopressin

75
Q

Describe the features of Kawasaki Disease

A 
Conjunctivitis
Rash
Adenopathy (cervical)
Strawberry tongue
Hand/feet reddening 
Fever for >5 days 
*risk of coronary artery aneurysms
76
Q

Describe the features of Henloch Shonlich Purpura (HSP)

A

Rash on buttocks, extensor surfaces
Arthralgia
Abdo pain
Nephritis (haematuria/proteinuria)

77
Q

Describe risk factors, investigations and management of Developmental Dysplasia of the Hip (DDH)

A

= abnormal relationship of femoral head to acetabulum
RFs - female, FHx, breech, oligohydramnios, positive screening (Barlow&Ortolani)
CFs - painless limp
Ix - USS if <6mo/XR hip if >6mo
Mx - pavlik harness if <6mo, closed reduction if >6mo, ORIF if unsuccessful

78
Q

Describe clinical presentation, investigations and management of septic arthritis

A

CFs - hot, swollen, painful joint +/- erythema, severely reduced ROM, non weight bearing
Ix - USS joint (effusion) *never aspirate
Mx - urgent IV ABx, surgical washout

79
Q

Define Kocher’s criteria

A 
Likelihood of septic arthritis
WBC >12
ESR >40
Temp >38.3
Non weight bearing
80
Q

Describe clinical presentation, investigations and management of transient synovitis

A

Similar to septic arthritis but inflammatory markers normal, hx of viral illness
Self limiting
*if >18mo = septic arthritis

81
Q

Describe clinical presentation, investigations and management of Perthes’ disease

A

= idiopathic osteonecrosis of femoral head, peak 4-7 years
CFs - painless limp *rule out sickle cell
Ix - radiography/MRI
Mx - symptom control, surgery –> THR in adult life

82
Q

Describe clinical presentation, investigations and management of SUFE

A

= salter halter 1 fracture, adolescents, overweight/obese
CFs - gradual onset groin/knee pain
Ix - X-ray hip + frog leg lateral
Mx - surgical (prophylaxis vs. damage control)

83
Q

List red flags for a limping child

A 
Child <3y
Unable to weight bear
Fever
Systemic illness
>9y with a hip problem
84
Q

List red flags for development

A 
Regression
Plateau
Hyper/hypotonia
Not holding an object by 5mo
Can't sit unsupported by 10mo
No speech by 18mo
Not pointing by 2y
85
Q

List red flags of gross motor development

A

Primitive reflexes >6mo
Unable to sit unsupported >10-12mo
Can’t walk >18mo

86
Q

List red flags for fine motor development

A

Hand preference <6mo

87
Q

List red flags for speech and language development

A

No sounds >10mo
<6 words at 18mo
Not responding to commands >2y

88
Q

List red flags for social development

A

Not smiling responsively >10weeks

Little interest in others >6mo

89
Q

List important development milestones

A

4-6 weeks - fixes to face, smiles responsively
6-7 months - sits unsupported
9 months - gets to sitting position
10 months - pincer grasp, waves bye bye
12 months - walks unsupported, 2-3 words
18 months - feeds self with spoon, throws a ball
2y - 2-3 word sentences, runs, kicks a ball

Phase 2 (11 decks)

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