Paediatrics - toddlers and children Flashcards
Typical walking milestone?
19 months however earlier at
10-14 months is common
general rule for milestones for babies born prematurely at 35 weeks?
add 5 weeks to milestones
gross motor skill milestones for babies at 3 months?
- lying supine with head in midline
- no head lag when pulling from supine to sitting
- lift head when on tummy
when would it be expected for a baby to be crawling?
10-12 months
when would it be expected for a baby to be cruising on furniture?
1 year
fine motor skills at 3 months?
- hands in mouth
- holding things without realising
fine motor skills at 6 months?
- reaching/grasping objects and putting in mouth
- transferring things from one hand to the other
- poking and pointing with index finger (6-12)
when would it be expected for a baby to make coo noises
6 weeks
when would it be expected for a baby to be very vocal?
3 months
when would it be expected for a baby to start using words
9-10 months
Visual concerns: When to refer baby?
- cannot see things or white/cloudy eyes
- squints a lot after 3 months
- baby not interested with whats going on around them
hearing concerns - when to refer:
- not responding to sounds
- not interested in whats going on around them
MSK concerns when to refer:
- not moving both arms and legs
- not sitting by self by 10 months
- not WB by 1 year
- not holding head up on tummy at 3-4/12
What is a primitive reflex?
are the first part of the brain and CNS to develop that are normal in infants but not in adults
What causes primitive reflexes to be suppressed?
frontal lobe development as baby grows
what reflexes replace primitive reflexes?
postural reflexes
List the primitive reflexes?
Rooting: cheek Moro: startle Walking/stepping Babinski Tonic neck reflex Galant: hip swing (stroke back) Grasp
general rule to treating retained primitive reflexes?
fatigue the reflex
- repetition > intensity
What is plagiocephaly?
assymetrical or misshapen head
when to be concerned about plagiocephaly?
if head doesnt go back to normal within 6 weeks
treatment for plagiocephaly?
- counterpositioning
- increased tummy time
- corrective helmets
Genu Varus?
Bow legs
Genu valgus?
knock knees
At what age would a waddling type gait be an abnormal finding?
over 3 years old
Osteosarcoma?
type of cancer that produces immature bone. Most common form of bone cancer and is usually found at the end of long bones usually around the knee
typical features of an osteosarcoma
- common in ages 10-25
- pain and swelling over bone or joint
- bone that breaks for no reason
Ewings sarcoma:
Type of cancer that forms in bone or ST. SSx: - swelling and pain at tumour site - fever - fracture
where do ewings sarcomas usually form (general)
bone marrow and bone shaft
common features of ewings sarcoma:
- age 10-25
- pain and swelling - worse at night
- soft warm lump in legs, chest, arms
- fever, tiredness, weight loss
Acute lymphoblastic leukemia definition.
cancer that is characterised by an overproduction of immature WBcs.
Acute lymphoblastic leukemia SSx
features include by slow healing, infections, unexplained bleeding or bruising.
anaemia
Rhabdomyosarcoma definition
an aggressive, highly malignant form of cancer that develops from skeletal muscle cells that have failed to fully differentiate
Rhabdomyosarcoma SSx
lump or swelling that keeps getting bigger.
bulging eye, HA, difficulty urinating or bowel movements
Often found in head, neck, trunk, extremities and GU system
what is the difference between osteomyelitis and septic arthritis?
OM is an infection in the bone marrow
SA is an intraarticular infection
What features would lead to suspicion of transient synovitis?
- limp
- recent history of viral URTI
- decreased hip ROM especially IR
- able to walk but painful
What is perthes disease?
occurs when blood supply to the femoral head is interrupted. This leads to avascular necrosis of the femoral head.
SSx of perthes disease?
gradual onset of pain in the hip +/- knee with limping, slow joint movements and wasting of thigh muscles
Slipped capital femoral epiphysis?
when the epiphyseal plate on femur slips down and backwards.
what demographic is associated with SCFE?
boys
obesity
SSx of SCFE?
slowly developing symptoms.
mimic a pulled muscle in the groin, hip, thigh or knee.
Apperent shortening of the femur
Juvenile Arthritis:
umbrella term used to describe the many AI conditions that develop in children under 16
SSx of juvenile arthritis?
- joint pain
- swelling
- eye/skin/muscle/GI symptoms
management for growing pains?
heat pack, panadol, massage
