Paeds Flashcards
how is congenital toxoplasmosis caused? What can it cause in the baby?
Congenital toxoplasmosis is due to transplacental spread from the mother.
The presence of chorioretinitis, intracranial calcifications, and hydrocephalus is considered the classic triad of congenital toxoplasmosis.
Some infected children without overt disease as neonates may escape serious sequelae of the infection; however, a significant number (14 to 85%) develop chorioretinitis, strabismus, blindness, hydrocephalus or microcephaly, cerebral calcifications, developmental delay, epilepsy, or deafness months or years later.
differentials for eye pain in children
Allergies
Eye infection
Eye inflammation
conjunctivitis
A foreign object in the eye
Contact lens irritation
An eye injury
A stye
blepharitisdifferentials for transient altered vision in children
migraine (+/- aura)
occipital lobe epilepsy
psychogenic visual loss
what are the 2 broad types of seizures and give further examples and classifications of each.
Generalised – discharge arises from both hemispheres. They may be – absence, myoclonic, tonic, tonic-clonic and atonic
Focal – where seizures arise from one or part of one hemisphere. Consciousness may be retained or lost. Presentation -
Frontal seizures – involve the motor or premotor cortex. May lead to clonic movements, which may travel proximally (Jacksonian march). Asymmetrical tonic seizures can be seen, which may be bizarre and hyperkinetic and can be mistakenly dismissed as non-epileptic events. Atonic seizures may arise from mesial frontal discharge.
Temporal lobe seizures, the most common of all the epilepsies – may result in strange warning feelings or aura with smell and taste abnormalities and distortions of sound and shape. Lip-smacking, plucking at one’s clothing and walking in a non-purposeful manner (automatisms) may be seen, following spread to the pre-motor cortex. Déjà-vu and jamais-vu are described (intense feelings of having been, or never having been, in the same situation before). Consciousness can be impaired and the length of event is longer than a typical absence.
Occipital seizures – cause distortion of vision.
Parietal lobe seizures – cause contralateral dysaesthesias (altered sensation), or distorted body image.
What are the 4 fields of development?
- gross motor
- fine motor and vision
- hearing, speech and language
- social, emotional and behavioural
How should you adjust developmental milestones for prematurity?
Age correct up to 2 years of age
median age vs limit age with respect to developmental milestones?
The median age is the age when half of a standard
population of children achieve that level.
Limit ages are the age by which they should have
been achieved.
what is the limit age for walking unsupported?
18 months
by what action do most babies achieve mobility?
crawling.
in what order to crawlers, bottom shufflers and commando crawlers learn to walk unsupported?
The limit age of 18 months for walking applies predominantly to children who have had crawling as their early mobility pattern. Children who bottom
-shuffle or commando crawl tend to walk later than crawlers.
What are the primitive reflexes?
The primitive reflexes present at birth gradually disappear as postural reflexes develop. they are - Moro grasp rooting stepping asymmetric tonic neck reflex
When should the primitive reflexes have diminished by?
4-6 months
If they haven’t – could be a sign of cerebral palsy
limit age for head control?
4 months
limit age for sitting unsupported?
9 months
limit age for standing unsupported?
12 months
limit age for walking unsupported?
18 months
limit age for fixing and following visually
3 months
