What are the developmental milestones for gross motor skills of a baby from 3 months to 48 months?
3 months: head control when pulled to sit
6 months: sitting balance, roll back from stomach
9 months: crawling
12 months: standing, taking steps
18 months: run
24 months: stairs w/ both feet
36 months: stairs w/ alternate feet, pedal tricycle
What are the developmental milestones for Fine motor skill for a baby from 3 months to 48 months?
3 months: midline
6 months: palmar grasp for toys
9 months: scissor grasp
12 months: pincer grasp
18 months: 3-4 bricks
24 months: 6-7 bricks
36 months: 9 bricks, cut with scissors
48 months: draw a simple man
What are the developmental milestones for language & hearing in a baby from 3 months to 48 months?
3 months: vocalize, turn towards sound
6 months: babbles
9 months: imitates sounds, says mama & baba
12 months: responds to own name
18 months: knows body parts, 5-20 words
24 months: simple instruction, 50+ words
36 months: complex instruction, ask questions
48 months: tell stories of experiences
What are the developmental milestones for Social behavior & play in a baby from 6 weeks to 48 months?
6 weeks: responds w/ social smile
6 months: friendly with strangers
9 months: stranger awareness
12 months: drink from cup
18 months: feed with spoon
36 months: toilet trained, aware of others
48 months: dresses fully
What are some red flags indicating developmental delays?
- 6 months: do not reach for objects
- 12 months: cannot sit on its own, already have preferred hand (cp)
- 18 months: Unable to walk (check Creatine Kinase), no speech,
- Loss of skills at any stage
what are the skills babies should have during 6-8 months
- sits without support
- puts food in mouth
what are the skills babies should have during 10-12 months
- play peekaboo
- waves bye bye
what diseases are screened in UK routine screening for babies
- Hearing test (for deafness)
- Blood spot (heal prick test)
Sickle cell disease
Inherited metabolic diseases
What are the causes & hints of meningitis in children?
- neonate: Group B streptococcus
- children/adults: neisseria meningitidis (meningococcus), streptococcus pneumoniae (pneumococcus)
- Premature births, mother on antibiotics during labor, resp distress 4+ hours after birth
What are the symptoms and signs of meningitis in children?
- Poor feeding, lethargy, confused, vomiting, abnormal vital signs
- Non-blanching purpuric red rashes (meningococcemia from neisseria, rashes that don’t disappear w/ pressure)
- stiff neck, bulging fontanelle, light hurts eyes
What is the investigation & results for meningitis in children?
- Lumbar puncture showing raised ICP with cerebrospinal fluid having low sugar, increased WBC & protein
- blood culture & PCR for meningococcal septicemia/ nisseria meningiditis (meningococcemia rashes)
What is the treatment for meningitis in children?
- 3 months- :IV cefotaxime and IV amoxicillin
- 3 months+: IV cefotaxime
- Steroids dexamethasone for bacterial meningitis patients 3+ years old to reduce neurological damage & hearing loss
What is the cause & target group of bronchiolitis?
- respiratory syncytial virus RSV esp in winter
- 3-6 months, neonates are protected by maternal IgG
what are the symptoms of bronchiolitis?
- Coryzal symptoms: runny nose, sneezing, throat mucus, dyspnoea
- Feeding difficulty, mild fever, dyspnoea (^RR), wheeze (expiration) retraction (indrawing chest during inspiration),
What is the treatment for bronchiolitis?
Supportive: aim oxygen 92%+(if O2 is lower), nasogastric feeding, upper airway secretion suction
What are the causes & effect + symptoms of croup?
- Upper resp infection from parainfluenza viruses causing laryngeal oedema esp in autumn
- Stridor (inhaling), barking cough, fever, runny nose, sneezing, dyspnoea
What are the clinical investigations for croup?
- Clinical exam: stridor + barking cough, resp auscultation showing wheezing and crackles
- X-ray show steeple sign & thumb sign
what is the treatment for croup
- Single dose of oral dexamethasone
- admit if they have resting stridor, tachycardia
What are the causes & symptoms of Down’s syndrome)?
- Trisomy 21 & Maternal age
- Dysmorphic features: brachycephaly (flat head), epicanthal folds, flat face
- Limbs: hypotonia, short broad hands, transverse palmar crease
- Intellectual disability
What conditions are commonly associated with down’s syndrome?
- Atrioventricular septal defect
- Visual and hearing defects
- Obstructive sleep apnoea (large tongue )
- Hypothyroidism, hypotonia
- Immune deficiency, Increased leukemia risk
What investigation do you need for both baby and mother for Down’s syndrome?
- Prenatal screening with combined or quadruple test
- Full blood count, echo
- Hearing and visual screening
- CK for hypotonia
- TFT for hypothyroidism
Define cerebral palsy and indicate the causes
Disorder of movement and posture due to non-progressive lesions of motor pathway
- Antenatal: cerebral malformation & congenital infection (rubella, CMV)
- Intrapartum: birth asphyxia (oxygen deprivation)/ trauma
- Postnatal: intraventricular hemorrhage, meningitis, head trauma
What are the symptoms of cerebral palsy?
- Hypertonia: stiffness and difficulty moving
- Hypotonia: limpness and poor muscle control
- Delayed motor milestones, abnormal gait
- Feeding difficulties
- Non-motor problems: learning difficulties
Name all the viruses covered by the immunization system
- diphtheria, tetanus, pertussis (whooping cough), polio, Hib (haemophilus influenzae type B), hepatitis B
- Pneumococcal, Rotavirus, MMR, HPV
- Men B and Men A, C, W, Y
What is the 6-1, 4-1, 3-1 vaccine? When do children get it?
- 6-1: diphtheria, tetanus, pertussis (whooping cough), polio, Hib (haemophilus influenzae type B) and hepatitis B at 2, 3, 4 months
- 4-1: diphtheria, tetanus, pertussis (whooping cough), polio at 3 years 3 months
- 3-1: diphtheria, tetanus, polio at 14 years
What is the MMR? When do children get the vaccine?
- 12-13 months and 3 years 4 months- 5 years
- Measles: cold symptoms -> white spots inside mouth-> rash all over body
- Mumps: swelling of face, double chin/ hamster cheeks
- Rubella: rash all over body, takes 2-3 weeks to appear post infection
When are children vaccinated from meningitis?
- Men B: 8 weeks, 16 weeks, 1 year
- Men A,C, W, Y: 14 years
(apparent B+C is given accoridng to delta)