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PAEDIATRICS Flashcards

1
Q

what are the clinical features of hypogammaglobulinaemia?

A
  • recurrent infections
  • infections with S.pneumoniae and haemophilia
  • failure to thrive
  • diarrhoea
  • pallor
  • lymphadenopathy and hepatosplenomegaly
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2
Q

how is hypogammaglubulinaemia diagnosed?

A

-reduced or absent serum IgG, IgM or IgA

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3
Q

how is hypogammaglobulinaemia managed?

A
  • Offer early antibiotic treatment in infections
  • Give IVIG in all primary immunodeficiency syndromes except IgA deficiency
  • Offer TNF inhibitors for granulomatous diseases in patients with CVID
  • Live vaccines are contraindicated
  • Offer bone marrow transplant for Severe Combined Immunodeficiency
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4
Q

what are the clinical features of Gaucher’s disease?

A
  • hepatosplenomegaly
  • corneal clouding
  • neurodevelopmental delay
  • cataract
  • failure to thrive
  • eye movement disorder
  • joint contracture
  • depression
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5
Q

what are the clinical features of MPS?

A
  • hepatosplenomegaly
  • corneal clouding
  • large head circumference
  • neurodevelopmental delay
  • cataract
  • hearing impairment
  • joint contracture
  • spinal gibbus
  • hydrocephalus
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6
Q

what are the clinical features of Fabry’s disease?

A
  • skin rash and cutaneous lesions
  • corneal clouding
  • hearing impairment
  • cataract
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7
Q

what are the clinical features of Pompe’s disease?

A
  • hepatosplenomegaly
  • fatigue
  • cataract
  • failure to thrive
  • joint contracture
  • depression
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8
Q

what are the clinical features of Tay-Sachs disease?

A
  • depression
  • failure to thrive
  • dementia
  • ataxia
  • optic atrophy/retinitis pigments
  • hyperacusis
  • macular cherry red spot
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9
Q

what are the clinical features of Niemann-Pick disease?

A
  • hepatosplenomegaly
  • neurodevelopmental delay
  • eye movement disorder
  • dementia
  • ataxia
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10
Q

what are the clinical features of GH deficiency?

A
  • Short stature
  • Poor growth velocity
  • Short for target height
  • Absent pubertal growth spurt
  • Delayed puberty
  • Mid-facial hypoplasia
  • Delayed dentition
  • Frontal bossing
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11
Q

how is GH deficiency diagnoseD?

A
  • Wrist xray: delayed bone age

- Low IGF1 and IGFBP3

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12
Q

how is GH deficiency managed?

A

-somatotropin

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13
Q

what are the clinical features of biliary atresia?

A
  • Neonatal jaundice with pale stools, persisting beyond 14 days of life
  • Dark urine
  • Bruising
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14
Q

how is biliary atresia diagnosed?

A
  • raised serum bilirubin
  • high GGT
  • Hepatobiliary scintigraphy: no tracer excretion into bowel within 24 hours
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15
Q

how is biliary atresia managed?

A
  • Offer hepatoportoenterostomy before 45 to 60 days of life
  • Give ursodeoxycholic acid to facilitate bile flow
  • If hepatoportoenterostomy is unsuccessful, offer liver transplant
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16
Q

what are the clinical features of a haemangioma?

A
  • Pink, red or blue lesion
  • Rapid growth
  • Variable compressibility
  • Flat or nodular character
  • Islands of normal skin
  • Ulceration and bleeding
  • Warmth
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17
Q

how is a haemangioma managed?

A
  • Offer propranolol for infantile haemangiomas
  • Offer surgical excision
  • If there is ulceration, offer barrier protection and topical antibiotics such as metronidazole
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18
Q

what are the clinical features of congenital torticollis?

A
  • Head tilt
  • Head rotated with decreased active rotation to affected side
  • Decreased head righting to contralateral side
  • Sternocleidomastoid mass
  • Ipsilateral shoulder elevation
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19
Q

what are the risk factors for congenital torticollis?

A
  • Plagiocephaly
  • Complicated birth
  • Non-varied supine sleep and resting position
  • Decreased prone awake time
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20
Q

how is congenital torticollis managed?

A
  • For children under 5 months, offer massage and myofascial release physiotherapy
  • Offer cranial moulding orthosis for children with plagiocephaly
  • Offer BOTOX injection into the sternocleidomastoid or upper trapezius
  • As a last resort, offer sternocleidomastoid muscle release surgery
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21
Q

what are the risk factors for faecal incontinence in children?

A
  • Chronic constipation
  • Male sex
  • Diet lacking in fibre
  • Inadequate fluid intake
  • Delayed or inadequate toilet training
  • Anorectal malformations
  • Hirschsprung’s disease
  • Spinal abnormalities
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22
Q

what are the clinical features of DiGeorge’s syndrome?

A
  • Cyanosis, signs of heart failure and a heart murmur associated with tetralogy of fallot, truncus arteriosus, interrupted aortic arch and VSD
  • Bulbous nose tip and prominent ears
  • Cleft lip and palate
  • Growth failure
  • Feeding difficulty
  • Speech delay
  • Non-verbal learning disorder
  • Frequent infection
  • Schizophrenia
  • Seizures
  • Hypoparathyroidism
  • CHARGE syndrome: coloboma of the eye, heart defects, atresia of the nasal choanae, retardation of growth, genital or urinary abnormalities and ear abnormalities and deafness
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23
Q

what are the clinical features of Dubin-Johnson Syndrome?

A
  • Intermittent jaundice
  • Lack of pruritus
  • Triggered by intercurrent illness, infection, stress, pregnancy or medication including oral contraceptives
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24
Q

what is seen on investigation in suspected Dubin-Johnson syndrome?

A
  • elevated bilirubin, with more than half conjugated
  • all other bloods normal
  • Liver biopsy: coarsely granulated pigment in the hepatocyte lysosomes with normal liver histology
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25
Q

how is Dubin-Johnson syndrome managed?

A

-no treatment needed

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26
Q

what are the risk factors for SIDS?

A
  • Side, prone or inclined position at last sleep
  • Bed-sharing/co-sleeping
  • Soft sleeping surface
  • Maternal smoking
  • Increasing number of smokers in house
  • Smoking in the same room as the child
  • Non-use of dummy
  • Premature birth
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27
Q

what are the clinical features of cryptorchidism?

A
  • Malpositioned or absent testis
  • Palpable cryptorchid testis
  • Non-palpable testis
  • Testicular asymmetry
  • Scrotal hypoplasia or asymmetry
  • Retractile testis
  • Ascending cryptorchidism
  • Hypospadias
  • Micropenis
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28
Q

how is cryptorchidism diagnosed?

A
  • Perform USS: Testis can be identified within the inguinal canal or as it emerges into the superficial inguinal pouch
  • Perform MRI: testis identifiable along normal path of descent
  • Perform hormonal evaluation with hCG stimulation test: no increased in testosterone after hCG, in conjunction with elevated basal rates of LH and FSH signifies that the testes are absent
  • Measure Mullerian inhibiting substance, inhibin B and FSH: anorchia if MIS and inhibin B undetectable with raised FSH
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29
Q

when should bilateral undescended testes detected at birth be referred?

A

-within 24 hours

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30
Q

when should bilateral undescended testes detected at 6-8 weeks be referred?

A

-urgently to be seen within 2 weeks

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31
Q

how should a suspected unilateral undescended testis be managed according to time of detection?

A
  • At birth — re-examine the infant at 6–8 weeks of age. If both testes are normally descended, no further action is required.
  • At 6–8 weeks of age — re-examine the infant at 4–5 months of age.
  • At 4–5 months (corrected for gestational age), if the testis remains undescended, arrange referral to paediatric surgery or urology to be seen by 6 months of age.
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32
Q

define enuresis

A

-normal micturition that occurs at an inappropriate or socially unacceptable time or place.

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33
Q

what are the clinical features of enuresis?

A
  • Increased fluid intake at night
  • Urinary frequency
  • Constipation
  • Caffeine
  • Urinary urgency
  • Abnormal voiding habits
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34
Q

how is enuresis managed?

A
  • appropriate fluid intake and voiding
  • reward chart
  • enuresis alarm
  • desmopressin
  • anticholinergic with desmopressin
  • imipramine
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35
Q

what are the clinical features of glycogen storage disorders?

A
  • Frequent feeding
  • Hepatomegaly
  • Distended abdomen
  • Hypernoea
  • Failure to thrive
  • Lethargy
  • Hypotonia
  • Bleeding tendency
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36
Q

what is seen on blood tests in glycogen storage disorders?

A
  • glucose: low
  • bicarbonate: raised
  • lactic acid: raised
  • uric acid: raised
  • triglycerides: raised
  • LFTs: raised AST and ALT
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37
Q

how are glycogen storage disorders managed?

A
  • Orally administered uncooked cornstarch is the mainstay of therapy from early childhood and through adulthood.
  • Treat hypoglycaemia as indicated
  • Give a xanthine oxidase inhibitor such as allopurinol for hyperuricaemia
  • Give fenofibrate for hyperlipidaemia
  • Liver transplant may be required for hepatic dysfunction
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38
Q

what are the clinical features of meconium aspiration?

A
  • Tachypnoea
  • Cyanosis
  • Chest wall asymmetry with decreased air entry
  • Barrel shaped chest
  • Grunting
  • Chest retractions
  • Tachycardia
  • Hypotension
  • Crackles
  • Meconium stained liquor
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39
Q

what are the risk factors for developing meconium aspiration?

A
  • Gestational age >42 weeks
  • Foetal distress
  • Oligohydramnios
  • Thick meconium
  • Apgar score <7
  • Chorioamnionitis
  • Caesarean delivery
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40
Q

what is seen on chest x-ray in meconium aspiration?

A
  • irregular pattern
  • patchy infiltrations
  • atelectasis
  • hyperexpanded lung fields
  • consolidation
  • may show pleural effusion, pneumothorax, or pneumomediastinum
  • cardiomegaly may be seen
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41
Q

what are the clinical features of infant colic?

A
  • Generally well and thriving
  • Normal urine
  • Absence of vomiting
  • Absence of diarrhoea
  • Normal temperature
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42
Q

what are the clinical features of kwashiorkor?

A
  • Low weight for height
  • Low height for age
  • Low mid upper arm circumference
  • Bilateral pitting oedema
  • Hair discolouration
  • Dermatosis/ulceration
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43
Q

how is kwashiorkor managed?

A
  • Offer community based therapy with ready to use therapeutic food if the child can eat 30g of RUTF in 15 minutes or less
  • If the child cannot eat 30g RUTF in less than 15 mins, inpatient care with regular milk based liquid food is required
  • Manage electrolyte imbalances as indicated
  • Treat dermatosis with potassium permanganate wash and topical zinc oxide
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44
Q

what are the clinical features of lead toxicity?

A
  • Cognitive impairment
  • Behavioural changes
  • Headaches
  • Clumsiness and agitation
  • Loss of appetite
  • Constipation
  • Somnolence
  • Cerebellar signs
  • Seizures
  • Coma
  • Colicky abdominal pain
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45
Q

how is lead poisoning diagnosed?

A
  • Measure whole blood lead level: blood lead >0.4micromoles/L in children or >1.2micromoles/L in adults
  • Perform FBC: microcytic, hypochromic anaemia
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46
Q

how is lead poisoning managed?

A
  • Separate from source of exposure

- Offer chelation therapy with DMSA (Dimercaptosuccinic acid, succimer), sodium calcium edetate or d-penicillamine

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47
Q

what are the clinical features of Lesch-Nyhan Disease?

A
  • Orange sand crystals in nappy
  • Kidney stones
  • Pyramidal signs
  • Spasticity and hyper-reflexia
  • Testicular atrophy
  • Males
  • Developmental delay
  • Involuntary movements
  • Generalised hypotonia
  • Self injurious behaviour
  • Cognitive disturbances
  • Growth retardation
  • Action dystonia
  • Gout
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48
Q

how is Lesch-Nyhan diagnosed?

A
  • Measure hypoxanthine-guanine phosphoribosyltransferase gene analysis: mutation in the coding region of the HPRT gene
  • Measure HPRT enzyme activity: reduced
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49
Q

what are the clinical features of Trisomy 18, Edwards syndrome?

A
  • low birthweight
  • prominent occiput
  • small mouth and chin
  • short sternum
  • flexed overlapping fingers
  • rocker bottom feet
  • cardiac and renal malformations
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50
Q

what are the clinical features of Trisomy 13, Patau’s syndrome?

A
  • structural brain defects
  • scalp defects
  • small eyes
  • cleft lip and palate
  • polydactyly
  • cardiac and renal malformations
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51
Q

define kernicterus

A

-encephalopathy resulting from the deposition of unconjugated bilirubin in the basal ganglia and brainstem nuclei

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52
Q

what are the causes of jaundice in a <24 hour old?

A
  • haemolytic disorders

- congenital infection

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53
Q

what are the causes of jaundice in a 2 day to 2 week old?

A
  • physiological
  • breast milk
  • dehydration
  • infection
  • crigler najjar
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54
Q

what are the causes of jaundice in a >2 week old?

A
  • biliary atresia
  • breast milk
  • infection
  • congenital hypothyroidism
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55
Q

how is Noonan syndrome inherited?

A

-autosomal dominant

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56
Q

what are the clinical features of Noonan syndromes?

A
  • Short stature
  • Dysmorphic facial features: wide spaced and down slanting eyes with vivid blue or green irides; low-set posteriorly rotated ears; inverted, triangular shaped face with small chin; a broad or webbed neck
  • Cryptorchidism
  • Cardiac anomalies: pulmonary valve stenosis/dysplasia, septal defects, hypertrophic cardiomyopathy
  • Delayed puberty
  • Easy bruising or bleeding
  • Lymphoedema
  • Pigmentary anomalies: café au lait, lentigines, nevi, keratosis
  • Sparse or absent eyebrows and lashes
  • Splenomegaly
  • Chest deformity: pectus carinatum and excavatum
  • Developmental delay
  • Cubitus valgus; short fingers with blunt fingertips; joint hyperextensibility; talipes equinovarus; joint contractures; scoliosis; radioulnar synostosis
  • Muscle weakness
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57
Q

how is phenylketonuria inherited?

A

-autosomal recessive

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58
Q

what are the clinical features of phenylketonuria?

A
  • Intellectual disability
  • Microcephaly
  • Eczema
  • Light pigmentation of eyes and hair
  • Seizures
  • Musty odour of urine
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59
Q

how is phenylketonuria managed?

A

-lifelong dietary phenylalanine restriction

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60
Q

what are the criteria for a diagnosis of Reye’s syndrome?

A
  • an acute, non-inflammatory encephalopathy with either sterile CSF containing <9 WBC/mL or cerebral oedema without inflammatory cell infiltrate
  • hepatic dysfunction documented by either a threefold elevation of serum transaminases and/or serum ammonia, or liver biopsy demonstrating fatty infiltration
  • there is no other diagnosis to account for the cerebral and hepatic derangement.
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61
Q

what are the clinical features of Reye’s syndrome?

A
  • Vomiting
  • Altered mental status
  • Hyperventilation
  • Hepatomegaly
  • Abnormal pupillary response
  • Hyper/areflexia
  • Diminished pain response
  • Seizures
62
Q

what is seen on blood gas in Reye’s syndrome?

A

-mixed metabolic acidosis and respiratory alkalosis

63
Q

what is seen on LFTs in Reye’s syndrome?

A
  • elevated transaminase and aminotransferase

- bilirubin mildly elevated

64
Q

what is seen on EEG on Reye’s syndrome?

A

-generalised slowing and flattening of waves

65
Q

how is Reye’s syndrome managed?

A
  • anti-emetics
  • furosemide
  • IV fluids and vasopressors
  • IV bicarbonate
  • lactulose
66
Q

how is Wiskott-Aldrich syndrome inherited?

A

-X-linked recessive

67
Q

what are the clinical features of Wiskott-Aldrich syndrome?

A
  • Easy bruising and petechiae
  • Recurrent infections
  • Eczema
  • Lymphadenopathy
  • Serious bleeding
  • Autoimmunity
68
Q

how is Wiskott-Aldrich syndrome diagnosed?

A
  • thrombocytopenia
  • WASp analysis: low or absent
  • WASp gene mutation analysis: mutation present
69
Q

how is Wiskott-Aldrich syndrome managed?

A
  • prophylactic co-trimoxazole and azithromycin
  • IVIG
  • bone marrow transplant
  • splenectomy
  • rituximab
70
Q

what are the clinical features of a hydrocele?

A
  • Scrotal mass
  • Transillumination
  • Enlargement of scrotal mass following activity
  • Variation in scrotal mass during the day
71
Q

when should a child with a hydrocele be referred to a paediatric surgeon?

A
  • There is an underlying pathology.
  • Concomitant inguinal hernia is suspected — an incarcerated hernia may be difficult to distinguish from a hydrocele.
  • The hydrocele is localized to the spermatic cord.
  • There is also a palpable abdominal mass (suggesting an abdomino-scrotal hydrocele).
  • A simple, non-communicating hydrocele either is not decreasing in size, or is still present after 2 years of age.
72
Q

what are the clinical features of oesophageal atresia and trachea-oesophageal fistula?

A
  • Inability to swallow secretions
  • Inability to pass an NG tube
  • Laboured respiration
  • Coughing
  • Choking
73
Q

what are the clinical features of turner’s syndrome?

A
  • Poor growth
  • Short stature
  • Delayed/absent pubertal development
  • Primary amenorrhoea
  • Congenital heart defects: coarctation of the aorta, bicuspid aortic valve
  • Skeletal abnormalities: cubitus valgus, short fourth metacarpals or metatarsals, prominent distal ulnar and scoliosis
  • Webbed neck
  • Secondary amenorrhoea
  • Multiple melanocytic naevi
  • Recurrent/severe otitis media
74
Q

what are the clinical features of severe combined immunodeficiency syndrome?

A
  • Recurrent and unusually severe infections
  • Chronic diarrhoea
  • Failure to thrive
  • Absent lymphoid tissue
75
Q

how is severe combined immunodeficiency diagnosed?

A
  • absolute lymphocyte <3000cells/mm3
  • absence or reduced total number of T cells in flow cytometry
  • absent or low immunoglobulins
76
Q

what are the causes of hypoxic-ischaemic encephalopathy?

A
  • excessive or prolonged uterine contractions
  • placental abruption
  • ruptured uterus
  • shoulder dystocia
  • cord prolapse
  • inadequate maternal placental perfusion
  • maternal hypotension or hypertension
77
Q

what are the clinical features of mild HIE?

A
  • irritability
  • responds excessively to stimulation
  • staring of the eyes
  • hyperventilation
  • impaired feeding
78
Q

what are the clinical features of moderate HIE?

A
  • marked abnormalities of tone and movement
  • cannot feed
  • seizures
79
Q

what are the clinical features of severe HIE?

A
  • no normal spontaneous movements or response to pain
  • tone fluctuates between hyper and hypotonia
  • prolonged seizures refractory to treatment
  • multi-organ failure
80
Q

what causes retinopathy of prematurity?

A

-uncontrolled use of high concentrations of oxygen

81
Q

what is bronchopulmonary dysplasia?

A

-Infants who still have an oxygen requirement at a post- menstrual age of 36 weeks

82
Q

what is seen on chest xray in bronchopulmonary dysplasia?

A
  • widespread areas of opacification

- cystic changes

83
Q

what are the clinical features of alcohol poisoning in children?

A
  • hypoglycaemia
  • respiratory failure
  • coma
84
Q

what are the clinical features of acid and alkali poisoning in children?

A

-inflammation and ulceration of upper GI tract leading to stenosis

85
Q

what are the clinical features of digoxin poisoning in children?

A
  • arrhythmias

- hyperkalaemia

86
Q

what are the clinical features of battery poisoning in children?

A
  • mild GI symptoms
  • oesophageal stricture
  • corrosion of gut wall and perforation
87
Q

what are the clinical features of iron poisoning in children?

A
  • vomiting
  • diarrhoea
  • haematemesis
  • melaena
  • acute gastric ulceration
  • drowsiness
  • coma
  • shock
  • liver failure with hypoglycaemia and convulsions
  • gastric strictures
88
Q

what are the clinical features of paracetamol poisoning in children?

A
  • gastric irritation

- liver failure

89
Q

what are the clinical features of petroleum poisoning in children?

A

-aspiration causing pneumonitis

90
Q

what are the clinical features of salicylate poisoning in children?

A
  • tinnitus
  • deafness
  • nausea
  • vomiting
  • dehydration
  • hyperventialtion causing respiratory alkalosis followed by metabolic acidosis
  • hypoglycaemia
91
Q

what are the clinical features of tricyclic poisoning in children?

A
  • sinus tachycardia
  • conduction disorders
  • dry mouth
  • blurred vision
  • agitation
  • confusion
  • convulsions
  • hypotension
  • respiratory depression
92
Q

where do brain haemorrhages typically occur in neonates?

A

-germinal matrix above the caudate nucleus

93
Q

how is neonatal brain haemorrhage diagnosed?

A

-cranial ultrasound

94
Q

how does caput succedaneum present?

A
  • bruising and oedema of the presenting part extending beyond the margins of the skull bones
  • resolves in a few days
95
Q

how does a cephalhaematoma present?

A
  • haematoma from bleeding below the periosteum, confined within the margins of the skull sutures.
  • usually involves the parietal bone.
  • The centre of the haematoma feels soft.
  • It resolves over several weeks
96
Q

how does a chignon present?

A

-oedema and bruising from Ventouse delivery

97
Q

how does a subaponeurotic haemorrhage present?

A
  • diffuse, boggy swelling of scalp on examination

- blood loss may be severe and lead to hypovolaemic shock and coagulopathy

98
Q

what is seen on chest x-ray in transient tachypnoea of the newborn?

A

-fluid in the horizontal fissure

99
Q

what are the clinical features of diaphragmatic hernia in neonates?

A
  • failure to respond to resuscitation
  • respiratory distress
  • apex beat and heart sounds displaced to the right
100
Q

what are the causes of microcephaly?

A
  • familial
  • autosomal recessive conditions
  • congenital infection
  • Acquired after an insult to the developing brain, e.g. perinatal hypoxia, hypoglycaemia or meningitis, when it is often accompanied by cerebral palsy and seizures
101
Q

what are the causes of macrocephaly?

A
  • tall stature
  • familial macrocephaly
  • raised ICP
  • Hydrocephalus
  • chronic subdural haematoma
  • cerebral tumour
  • neurofibromatosis
  • cerebral gigantism
  • CNS storage disorders
102
Q

what are the clinical features of necrotising enterocolitis?

A
  • infant stops tolerating feeds
  • milk is aspirated from the stomach
  • bile-stained vomit
  • distended abdomen
  • bloody stool
  • shock
103
Q

what is seen on abdominal x-ray in necrotising enterocolitis?

A
  • distended loops of bowel
  • thickening of the bowel wall with intramural gas
  • gas in the portal tract
104
Q

how is necrotising enterocolitis managed?

A
  • Stop oral feeding and pass an NG tube to decompress the bowel
  • Give IV fluids, TPN and IV antibiotics for 10-14 days.
  • Ampicillin/gentamicin or cefotaxime plus metronidazole or clindamycin
  • Artificial ventilation and circulatory support are often needed.
  • Surgery is performed for bowel perforation.
105
Q

what are the clinical features of neonatal sepsis?

A
  • fever or temperature instability
  • poor feeding
  • vomiting
  • apnoea and bradycardia
  • respiratory distress
  • abdominal distension
  • jaundice
  • neutropenia
  • hypo/hyperglycaemia
  • shock
  • irritability
  • seizures
  • lethargy and drowsiness
106
Q

what are the clinical features of neonatal hypoglycaemia?

A
  • jitteriness
  • irritability
  • apnoea
  • lethargy
  • drowsiness
  • seizures.
107
Q

what are the clinical features of respiratory distress syndrome?

A
  • within 4 h of birth
  • tachypnoea >60 breaths/min
  • laboured breathing with chest wall recession (particularly sternal and subcostal indrawing) and nasal flaring
  • expiratory grunting in order to try to create positive airway pressure during expiration and maintain functional residual capacity
  • cyanosis if severe.
108
Q

how is respiratory distress syndrome managed?

A
  • raised ambient oxygen or CPAP
  • surfactant therapy
  • ventilation
109
Q

what are the clinical features of homocystinuria?

A
  • developmental delay
  • subluxation of the ocular lens (ectopia lentis)
  • progressive learning difficulty
  • convulsions
  • psychiatric disorders
  • fair complexion with brittle hair
110
Q

how is homocystinuria managed?

A
  • pyridoxine

- low methionine diet supplemented with cysteine and betaine

111
Q

what are the clinical features of galactosaemia?

A
  • lactose containing milk feeds started
  • poor feeding
  • vomiting
  • jaundice
  • hepatomegaly
  • hepatic failure
112
Q

what are the social and emotional milestones at 2 months?

A
  • Begins to smile at people
  • Can briefly calm himself (may bring hands to mouth and suck on hand)
  • Tries to look at parent
113
Q

what are the language/communication milestones at 2 months?

A
  • Coos, makes gurgling sounds
  • Turns head toward sounds
  • Baby raising head and chest when lying on stomach
114
Q

what are the cognitive milestones at 2 months?

A
  • Pays attention to faces
  • Begins to follow things with eyes and recognize people at a distance
  • Begins to act bored (cries, fussy) if activity doesn’t change
115
Q

what are the movement milestones at 2 months?

A
  • Can hold head up and begins to push up when lying on tummy

- Makes smoother movements with arms and legs

116
Q

what are the social and emotional milestones at 4 months?

A
  • Smiles spontaneously, especially at people
  • Likes to play with people and might cry when playing stops
  • Copies some movements and facial expressions, like smiling or frowning
117
Q

what are the language/communication milestones at 4 months?

A
  • Begins to babble
  • Babbles with expression and copies sounds he hears
  • Cries in different ways to show hunger, pain, or being tired baby on floor with toy
118
Q

what are the cognitive milestones at 4 months?

A
  • Lets you know if she is happy or sad
  • Responds to affection
  • Reaches for toy with one hand
  • Uses hands and eyes together, such as seeing a toy and reaching for it
  • Follows moving things with eyes from side to side
  • Watches faces closely
  • Recognizes familiar people and things at a distance
119
Q

what are the movement milestones at 4 months?

A
  • Holds head steady, unsupported
  • Pushes down on legs when feet are on a hard surface
  • May be able to roll over from tummy to back
  • Can hold a toy and shake it and swing at dangling toys
  • Brings hands to mouth
  • When lying on stomach, pushes up to elbows
120
Q

what are the social and emotional milestones at 6 months?

A
  • Knows familiar faces and begins to know if someone is a stranger
  • Likes to play with others, especially parents
  • Responds to other people’s emotions and often seems happy
  • Likes to look at self in a mirror
121
Q

what are the language/communication milestones at 6 months?

A
  • Responds to sounds by making sounds
  • Strings vowels together when babbling (“ah,” “eh,” “oh”) and likes taking turns with parent while making sounds
  • Responds to own name
  • Makes sounds to show joy and displeasure
  • Begins to say consonant sounds (jabbering with “m,” “b”) mother enjoying 7 month old infant
122
Q

what are the cognitive milestones at 6 months?

A
  • Looks around at things nearby
  • Brings things to mouth
  • Shows curiosity about things and tries to get things that are out of reach
  • Begins to pass things from one hand to the other
123
Q

what are the movement milestones at 6 months?

A
  • Rolls over in both directions (front to back, back to front)
  • Begins to sit without support
  • When standing, supports weight on legs and might bounce
  • Rocks back and forth, sometimes crawling backward before moving forward
124
Q

what are the social and emotional milestones at 9 months?

A
  • May be afraid of strangers
  • May be clingy with familiar adults
  • Has favourite toys
125
Q

what are the language/communication milestones at 9 months?

A
  • Understands “no”
  • Makes a lot of different sounds like “mamamama” and “bababababa”
  • Copies sounds and gestures of others
  • Uses fingers to point at things
  • Doctor holding little boy
126
Q

what are the cognitive milestones at 9 months?

A
  • Watches the path of something as it falls
  • Looks for things he sees you hide
  • Plays peek-a-boo
  • Puts things in her mouth
  • Moves things smoothly from one hand to the other
  • Picks up things like cereal o’s between thumb and index finger
127
Q

what are the movement milestones at 9 months?

A
  • Stands, holding on
  • Can get into sitting position
  • Sits without support
  • Pulls to stand
  • Crawls
128
Q

what are the social and emotional milestones at 1 year?

A
  • Is shy or nervous with strangers
  • Cries when mom or dad leaves
  • Has favourite things and people
  • Shows fear in some situations
  • Hands you a book when he wants to hear a story
  • Repeats sounds or actions to get attention
  • Puts out arm or leg to help with dressing
  • Plays games such as “peek-a-boo” and “pat-a-cake”
129
Q

what are the language/communication milestones at 1 year?

A
  • Responds to simple spoken requests
  • Uses simple gestures, like shaking head “no” or waving “bye-bye”
  • Makes sounds with changes in tone (sounds more like speech)
  • Says “mama” and “dada” and exclamations like “uh-oh!”
  • Tries to say words you say
  • Toddler sitting with mom playing xylophone
130
Q

what are the cognitive milestones at 1 year?

A
  • Explores things in different ways, like shaking, banging, throwing
  • Finds hidden things easily
  • Looks at the right picture or thing when it’s named
  • Copies gestures
  • Starts to use things correctly; for example, drinks from a cup, brushes hair
  • Bangs two things together
  • Puts things in a container, takes things out of a container
  • Lets things go without help
  • Pokes with index (pointer) finger
  • Follows simple directions like “pick up the toy”
131
Q

what are the movement milestones at 1 year?

A
  • Gets to a sitting position without help
  • Pulls up to stand, walks holding on to furniture (“cruising”)
  • May take a few steps without holding on
  • May stand alone
132
Q

what are the social and emotional milestones at 18months?

A
  • Likes to hand things to others as play
  • May have temper tantrums
  • May be afraid of strangers
  • Shows affection to familiar people
  • Plays simple pretend, such as feeding a doll
  • May cling to caregivers in new situations
  • Points to show others something interesting
  • Explores alone but with parent close by
  • Toddler eating you from a blue bowl
133
Q

what are the language/communication milestones at 18months?

A
  • Says several single words
  • Says and shakes head “no”
  • Points to show someone what he wants
134
Q

what are the cognitive milestones at 18months?

A
  • Knows what ordinary things are for; for example, telephone, brush, spoon
  • Points to get the attention of others
  • Shows interest in a doll or stuffed animal by pretending to feed
  • Points to one body part
  • Scribbles on his own
  • Can follow 1-step verbal commands without any gestures; for example, sits when you say “sit down”
135
Q

what are the movement milestones at 18 months?

A
  • Walks alone
  • May walk up steps and run
  • Pulls toys while walking
  • Can help undress herself
  • Drinks from a cup
  • Eats with a spoon
136
Q

what are the social and emotional milestones at 2 years?

A
  • Copies others, especially adults and older children
  • Gets excited when with other children
  • Shows more and more independence
  • Shows defiant behavior (doing what he has been told not to)
  • Plays mainly beside other children, but is beginning to include other children, such as in chase games
137
Q

what are the language/communication milestones at 2 years?

A
  • Points to things or pictures when they are named
  • Knows names of familiar people and body parts
  • Says sentences with 2 to 4 words
  • Follows simple instructions
  • Repeats words overheard in conversation
  • Points to things in a book
  • 2 year old playing with big ball
138
Q

what are the cognitive milestones at 2 years?

A
  • Finds things even when hidden under two or three covers
  • Begins to sort shapes and colours
  • Completes sentences and rhymes in familiar books
  • Plays simple make-believe games
  • Builds towers of 4 or more blocks
  • Might use one hand more than the other
  • Follows two-step instructions such as “Pick up your shoes and put them in the closet.”
  • Names items in a picture book such as a cat, bird, or dog
139
Q

what are the movement milestones at 2 years?

A
  • Stands on tiptoe
  • Kicks a ball
  • Begins to run
  • Climbs onto and down from furniture without help
  • Walks up and down stairs holding on
  • Throws ball overhand
  • Makes or copies straight lines and circles
140
Q

what are the social and emotional milestones at 3 years?

A
  • Copies adults and friends
  • Shows affection for friends without prompting
  • Takes turns in games
  • Shows concern for crying friend
  • Understands the idea of “mine” and “his” or “hers”
  • Shows a wide range of emotions
  • Separates easily from mom and dad
  • May get upset with major changes in routine
  • Dresses and undresses self
  • Toddler hugging doll
141
Q

what are the language/communication milestones at 3 years?

A
  • Follows instructions with 2 or 3 steps
  • Can name most familiar things
  • Understands words like “in,” “on,” and “under”
  • Says first name, age, and sex
  • Names a friend
  • Says words like “I,” “me,” “we,” and “you” and some plurals (cars, dogs, cats)
  • Talks well enough for strangers to understand most of the time
  • Carries on a conversation using 2 to 3 sentences
142
Q

what are the cognitive milestones at 3 years?

A
  • Can work toys with buttons, levers, and moving parts
  • Plays make-believe with dolls, animals, and people
  • Does puzzles with 3 or 4 pieces
  • Understands what “two” means
  • Copies a circle with pencil or crayon
  • Turns book pages one at a time
  • Builds towers of more than 6 blocks
  • Screws and unscrews jar lids or turns door handle
143
Q

what are the movement milestones at 3 years?

A
  • Climbs well
  • Runs easily
  • Pedals a tricycle (3-wheel bike)
  • Walks up and down stairs, one foot on each step
144
Q

what are the social and emotional milestones at 4 years?

A
  • Enjoys doing new things
  • Plays “Mom” and “Dad”
  • Is more and more creative with make-believe play
  • Would rather play with other children than by himself
  • Cooperates with other children
  • Often can’t tell what’s real and what’s make-believe
  • Talks about what she likes and what she is interested in
145
Q

what are the language/communication milestones at 4 years?

A
  • Knows some basic rules of grammar, such as correctly using “he” and “she”
  • Sings a song or says a poem from memory such as the “Itsy Bitsy Spider” or the “Wheels on the Bus”
  • Tells stories
  • Can say first and last name
  • Child throwing ball
146
Q

what are the cognitive milestones at 4 years?

A
  • Names some colours and some numbers
  • Understands the idea of counting
  • Starts to understand time
  • Remembers parts of a story
  • Understands the idea of “same” and “different”
  • Draws a person with 2 to 4 body parts
  • Uses scissors
  • Starts to copy some capital letters
  • Plays board or card games
  • Tells you what he thinks is going to happen next in a book
147
Q

what are the movement milestones at 4 years?

A
  • Hops and stands on one foot up to 2 seconds
  • Catches a bounced ball most of the time
  • Pours, cuts with supervision, and mashes own food
148
Q

what are the social and emotional milestones at 4 years?

A
  • Wants to please friends
  • Wants to be like friends
  • More likely to agree with rules
  • Likes to sing, dance, and act
  • Shows concern and sympathy for others
  • Is aware of gender
  • Can tell what’s real and what’s make-believe
  • Shows more independence (for example, may visit a next-door neighbour by himself [adult supervision is still needed])
  • Is sometimes demanding and sometimes very cooperative
  • 5 year old playing guitar
149
Q

what are the language/communication milestones at 4 years?

A
  • Speaks very clearly
  • Tells a simple story using full sentences
  • Uses future tense; for example, “Grandma will be here.”
  • Says name and address
150
Q

what are the cognitive milestones at 4 years?

A
  • Counts 10 or more things
  • Can draw a person with at least 6 body parts
  • Can print some letters or numbers
  • Copies a triangle and other geometric shapes
  • Knows about things used every day, like money and food
151
Q

what are the movement milestones at 4 years?

A
  • Stands on one foot for 10 seconds or longer
  • Hops; may be able to skip

-Can do a somersault
Uses a fork and spoon and sometimes a table knife

  • Can use the toilet on her own
  • Swings and climbs

FINALS (18 decks)

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