Pediatrics Flash Cards - Case 28 - Dev delay 18mo

Question 1

How do you calculated corrected age for prematures infants?

Answer 1

40 weeks - gestational weeks of preemie; Subtract the result from the chronological age to obtain the “corrected age.”; use on growth chart and dev milestones

Question 2

According to CDC, when should you stop using corrected age on growth charts?

Answer 2

2 years old

Question 3

What is periventricular leukomalacia?

Answer 3

result of damage to the white matter surrounding the ventricles in the brain as a result of hypoxia, ischemia, and inflammation; correlated with intraventricular hemorrhage

Question 4

Basic outline of a neuro exam for an 18 month old?

Answer 4

Mental Status, CNs, Muscle strength, Tone, DTRs, Babinski, Cerebellar (balance, etc.)

Question 5

Positive Babinski after it should have extinguished means lesion where?

Answer 5

corticospinal tract

Question 6

Persistance of Babinski after ___ age is abnormal.

Answer 6

2 years of age

Question 7

What are the subcategories of cerebral palsy?

Answer 7

[1] Spastic quadriplegia, [2] Spastic diplegia, [3] Dyskinetic cerebral palsy (athetoid, dystonic), [4] (Spastic) hemiplegia, [5] Ataxic CP

Question 8

general involvement pattern, classic etiology and example of clinical scneario seen with [1]spastic quadriplegia

Answer 8

Entire body -> etio = global brain abnormalities -> various clin examples

Question 9

general involvement pattern, classic etiology and example of clinical scneario seen with [2] Spastic diplegia

Answer 9

legs > arms -> periventricular white matter abnormality -> e.g. premie

Question 10

general involvement pattern, classic etiology and example of clinical scneario seen with [3] Dyskinetic cerebral palsy

Answer 10

Variable often enitre body -> basal ganglia cerebellum or thalamus abnl -> perinatal asphyxia, kernicterus

Question 11

general involvement pattern, classic etiology and example of clinical scneario seen with [4] (Spastic) hemiplegia

Answer 11

arm and leg on one side -> unilateral UMN abnl -> stroke

Question 12

general involvement pattern, classic etiology and example of clinical scneario seen with [5] Ataxic CP

Answer 12

Entire body -> cerebellar abnl -> cerebellar hypoplasia/pontocerebellar hypoplasia

Question 13

W/u for new dx of cp?

Answer 13

Detailed H&P (is this static, progressive? degenerative?); EEG; MRI; and screening for developmental delays, ophthalmologic abnormalities, hearing impairment, speech and language disorders, and disorders of oral-motor function

Question 14

Helpful physical exam finding for Fragile X syndrome?

Answer 14

marcoorchidism

Question 15

Perinatal events/conditions linked w/ development of CP?

Answer 15

premature delivery, chorio, prolonged labor, hypoxia, CNS infections and post-natal corticosteroid use

Question 16

What the dx: neurodegenerative dz; presents between 6 mos and 2 yrs w/ global delays & milestone regression. Other s/sx: HSM, interstitial lung dz, and cherry red macula spot?

Answer 16

Niemann-Pick