Paediatrics Flashcards
When should a babby be able to raise their head to 45 degrees when in prone position?
6-8 weeks
When should a baby be able to sit without support? When should it be able to crawl?
6-8 months to sit
8-9 months to crawl
When should a baby be walking unsteady by?
should start at 12 months
>18 months is abnormal
When should a child be able to walk steady? when for run and jumping?
steady walking should be around 15months
running and jumping at 2.5 years
Describe 3 of the vision and fine motor development milestones
- at 6 weeks should follow objects/ face by turning head
- at 4 months should reach out for toys
- palmar grasp at 4-6 months
- pincer grip at 10 months
many many bricks should a 1.5,2 and 2.5 year old be able to stack?
3 bricks- 18 months
6 bricks- 2 years
8 bricks- 2.5 years
3 year old should be able to build a bridge from a model
How is a childs fine motor development assessed from ages 2-4?
Drawing line= 2 yrs circle= 3 yrs cross= 3.5 yrs square= 4 years
When should a baby start making noises?
3-4 months
When should the child start saying words like mamma and dadda
7-10 months
when should a child be able to make simple phrases? eg ‘give me teddy’
20-24 months
What is are the 4 main things drs are looking for in the 6 week baby check?
- congential heart disease (cyanosis, head, resp distress, murmers)
- developmental dysplasia of the hip (length discrepancy, barlow test)
- congenital cateracts (external exam, red reflex)
- undescended testes
- a general abdo, resp, growth, tone–> bruises SAFEGUARDING
What are the 4 categories of child abuse?
- physical abuse
- emotional abuse
- sexual abuse
- neglect
Give 4 signs of child neglect
- absent from school frequently
- lacks needed medical care, denal care, immunisations or glasses
- consistantly dirty or poor body odour
- complain of hunger and looks malnourished
Give 2 signs of emotional abuse
- extremes in behaviour
- delayed physical, emotional or intellectual development
- finds it hard making friends
- bed wetting or soiling in school age
- seem gloomy or depressed
What is the normal resp rate for a 1 year old?
<40 breaths per min
<60 for 0-5 months and <50 for 6-12 months
What is normal HR for child <1, 1-2 and 2-4?
<1= <160 bpm 1-2= <150bpm 2-4= <140bpm
What are signs of meningitis in child?
- fever
- neck stiffness
- bulging frontanelle
- decrease consciousness
- epilepsy
- non blanching rash
- prolonged cap refill
- signs other than fever may not be present in infants
What tool can be used for assessment of feverish child with no localising symptoms? How does the system work?
Traffic light system
- if no amber or red signs they are not at high risk of serious illness
- if they do they should be sent straight to hospital
Describe amber signs on the traffic light system for a feverish child? (Give 5)
- pallor
- not responding normally to social queues, not smiling, wakes with only prolonged stimulation, decreased activity
- nasal flaring, highresp rate for age, sats less than 95%
- high hr for age, cap refill longer than 3
- dry mucous membranes, reduced urine output
- age 3-6 months temp >39
- fever >5 days
- joint or limb swelling
- other localising symptoms and signs
Give 5 high risk signs for a feverish child
- pale/ mottled/ ashen/ blue
- no response to social cues
- appears ill
- does not wake
- weak high pitches continious cry
- grunting
- rr>60
- moderate or severe chest indrawing
- reduced skin turgor
- age more than 3 months with fever greater than 38
- non blanching rash
- bulging frontanelles
- neck stiffness
- status epilepticus
- focal neuro signs or seizures
How should you measure the temperature of a child younger than 4 weeks?
Electronic thermometer in axilla
How does infectious mononucleosis present?
- usually in college age students
- low grade fever
- fatigue and prolonged malaise (can persist for months after acute infection)
- sore throat: tonsils enlargement with exudate, palatial petechia and uvulas odema
- fine macular and non pruritic rash which rapidly dissapears
- lyphadenopathy common
- later signs inc mild hepatomegaly and splenomegaly and jaundice (
How can infective mononucleosis be diagnosed?
IM heterophile antibodies on blood test- monospot test
EBV specific antibodies if suspect false negative heterophile antibody test
What disease are associated with infectious mononucleosis
- burkitts lymphoma
- b cell lymphomas in immunosurpressed pts
- undifferentiated carcinomas
- Duncan’s syndrome
- multiple sclerosis
How is infectious mononucleosis managed?
Avoid contact sports for 3 weeks
Avoid alcohol
Paracetamol for analgesia and fever control
Can go to school/ work
Steroids can be used if develop haemolytic anaemia, CNS involvement or extreme tonsillar enlargement
Send to hospital if need iv fluids
Give 3 complications of infectious mononucleosis
Extreme tonsillar enlargement blocking airway Myocarditis Splenic rupture Haemolytic anaemia Thrombocytopenia ATN and GN prolonged fatigue and depression
