Paeds milestones and neurology Flashcards
What are the paediatic milestones for social and play at 6 weeks?
6 weeks: Smiles
3 months: Laughs, friendly handling
6 months: Not shy
9 months: Shy, takes everything to mouth, plays peekaboo
12 months: Bye-bye, pat-a-cake
18 months: Plays alone well
2 years: Plays near others
4 years: Plays with others
What are the paediatic milestones for social and play at 3 months?
6 weeks: Smiles
3 months: Laughs, friendly handling
6 months: Not shy
9 months: Shy, takes everything to mouth, plays peekaboo
12 months: Bye-bye, pat-a-cake
18 months: Plays alone well
2 years: Plays near others
milestones for social and play at 6 months?
6 weeks: Smiles
3 months: Laughs, friendly handling
6 months: Not shy
9 months: Shy, takes everything to mouth, plays peekaboo
12 months: Bye-bye, pat-a-cake
18 months: Plays alone well
2 years: Plays near others
What are the paediatic milestones for social and play at 9 months?
6 weeks: Smiles
3 months: Laughs, friendly handling
6 months: Not shy
9 months: Shy, takes everything to mouth, plays peekaboo
12 months: Bye-bye, pat-a-cake
18 months: Plays alone well
2 years: Plays near others
What are the paediatic milestones for social and play at 12 months?
6 weeks: Smiles
3 months: Laughs, friendly handling
6 months: Not shy
9 months: Shy, takes everything to mouth, plays peekaboo
12 months: Bye-bye, pat-a-cake
18 months: Plays alone well
2 years: Plays near others
What are the paediatic milestones for social and play at 18 months?
6 weeks: Smiles
3 months: Laughs, friendly handling
6 months: Not shy
9 months: Shy, takes everything to mouth, plays peekaboo
12 months: Bye-bye, pat-a-cake
18 months: Plays alone well
2 years: Plays near others
What are the paediatic milestones for social and play at 2 years?
6 weeks: Smiles
3 months: Laughs, friendly handling
6 months: Not shy
9 months: Shy, takes everything to mouth, plays peekaboo
12 months: Bye-bye, pat-a-cake
18 months: Plays alone well
2 years: Plays near others
What are the paediatic milestones for social and play at 4 years?
6 weeks: Smiles
3 months: Laughs, friendly handling
6 months: Not shy
9 months: Shy, takes everything to mouth, plays peekaboo
12 months: Bye-bye, pat-a-cake
18 months: Plays alone well
2 years: Plays near others
4 years: Plays with others
What are the gross and fine motor skills seen between 3 months and 1 year
Gross // Fine
3m: lifts head // reaches
6m: Sits up // Grabs
9m: Crawls // Points
12m: Stands // Pincer
What are the gross and fine motor skills between 15m and 5 years
Gross // Fine
15m: Walks // 2 bricks + pats book
18m: Squats // 3 bricks + flicks pages + scribble circle
2y: Runs, stairs supported // 6 bricks + turns pages + vertical lines
3y: Stairs alone // 9 bricks + draws circle
4y: Draws cross
5y: Draws triangle/square
Outline speecha and hearing from 3 months to 1yr
Speech // hearing
3m: Squeals // parents voice, turns to sound
6m: Double syllables
9 months: mama, dada // understands no
12 months: Responds to name
Outline speech and hearing milestones between 15m and 5 years
Speech // hearing
15m: 2-6 words // simple commands
18m: SKIPPED
2y: combines two words // points to body parts
2. 5y: 200 words
3y: 3-5 word sentences + what, who+ count to 10 // identifies colours
4y: why how
Outline feeding and dressing milestones from 3 months to 5 years
Feeding // dressing
3m: Nothing
6m: Hand on bottle // none
12-15m: cup drinking + spoon holding // helps dressing
18 months: Takes off shoes and hat
2y: competent cup and spoon // puts on hat and shoes
3y: Spoon and fork // nothing
4y: nothing // dress and undress
5y: knife and fork // nothing
When would you refer regarding
Smiling
Sitting
Walking
Handedness
Speech and language
Smiling: 10 weeks
Sitting: 12 months
Walking: 18 months
Handedness: if <12 months, suspect cerebral palsy
S+L: Once hearing and environment accounted for
Differentiate cerebral palsy and duchenne musclar dystrophy using the following
Clinical picture
Specific pointers
Onset
Palsy // dystrophy
Altered tone + co-ord and speech trouble // Proximal muscle weakness
pre-mature handedness // Gower’s sign
Since infancy // 5 years
What gait would a cerebral palsy kid show? What kind of lesion is this a result of?
plantarflexion requiring swinging around of legs to move
Upper motor neurone lesion (increased tone and reflexes, preserved muscle bulk)
How do you manage cerebral palsy
Heavy MDT with paeds managing meds and ortho helping with muscle problems
How do myotonic and becker’s dystrophy differ from Duchennes both genetically and clinically
Genes // Clinic
Myotonic: Autosomal DM1/2 defect // gaunt, frontal balding, eye + speech problems
Beckers: milder dystrophin defect // lesser intellectual impairment
Duchenne’s: X-linked recessive // Gower’s sign, fake calf growth
How do you confirm a diagonsis of DMD?
genetic testing
raised CK will also be seen
What counselling points are required about DMD?
Walking until 12yrs
Survival until 25-30yrs
What cardiac condition is associated with DMD?
Dilated cardiomyopathy
What neuro exam tip can help point towards myotonic dystrophy
Get them to hold and release your hand
delayed response due to prolonged contraction
Tall, no puberty, small testes, infertile, gynaecomastia indicates which paeds condition?
Klinefelter’s syndrome
What is the underlying genetic pathology for Klinefelter’s
47 XXY
No period, groin swellings, some breast development indicates which paeds condition?
Androgen insensitivity syndrome
What genetic pathology is AIP?
X-linked recessive
Causes testosterone resistance
Turner’s vs Fragile X syndrome for
Appearance
Repro changes
Cardiac
Other
Turner’s // Fragile X
Webbed neck, wide chest // low ears, thin face, high palate
No periods // Large testicles
Bicuspid valve, coarctation // Mitral valve prolapse
Horseshoe kidney // Autism
What are the LH/FSH readings for
Klinefelter’s
Kallman’s
AIP
Testosterone tumour
Kline: Low/high
Kall: Low/Low
AIP: high, high
Tumour: Low/ high
Small head and eyes, cleft palate, extra digits, scalp lesions
Patau syndrome
trisomy 13
Small jaw, low ears, overlapped fingers, rocker bottom feet
Edward’s syndrome
Trisomy 18
Large head and ears, long face, large testicles, learning difficulties
Fragile X
Webbed neck, pectus excavatum, short stature, pulmonary stenosis
Noonan syndrome
Small jaw, displaced tongue, cleft palate
Pierre-Robin syndrome
Hypotonia, hypogonadism, obesity
Prader-Willi Syndrome
Short stature, Learning difficulties, Friendly, neonatal hypercalcaemia, aortic stenosis
William’s syndrome
