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MRCPCH Clinicals > Development > Flashcards

Development Flashcards

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1
Q

What are the primitive reflexes?

A

Moro, grasp, rooting, stepping, asymmetrical tonic neck reflex

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2
Q

What are the postural reflexes?

A

Labyrinthine righting, postural support, lateral propping, parachute

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3
Q

What are the three types of cerebral palsy in order of how common they are?

A

Spastic, dyskinetic, ataxic

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4
Q

What causes a concomitant squint?

A

Refractive error

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5
Q

What causes a divergent squint?

A

Paralysis of the motor nerves

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6
Q

Lifetime prevalence of anorexia nervosa

A

1% females, <0.5% males

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7
Q

Lifetime prevalence of bulimia nervosa

A

2% females, 0.5% males

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8
Q

Lifetime prevalence of binge eating disorder

A

3.5% females, 2% males

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9
Q

Risk factors for eating disorders

A 
Exposure to ideally thin body image
Rapid weight loss due to dieting
FH of eating disorder, mental health issues
Obsessional, perfectionist personality
Comorbid mental health issue
Certain sports e.g. ballet
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10
Q

What is superior mesenteric artery syndrome?

A

Seen in referring, due to compression of the SMA as it is no longer protected by a fat pad. Presents with abdominal pain, feeling of fullness, vomiting

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11
Q

What is the global prevalence of ADHD?

A

5% of children, 2.5% adults

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12
Q

Risk factors for ADHD?

A

Parental ADHD
Maternal cigarette and alcohol use during pregnancy
Low birthweight

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13
Q

What are the diagnostic criteria for ADHD?

A 
Inattention
Hyperactivity and impulsivity
Present before 12y
Impairs functioning
Present in at least 2 settings
Not explained by another disorder
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14
Q

What are the 2 main medications used in ADHD?

A

Dexamphetamine or methylphenidate

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15
Q

What is the mechanisms of action of dexamphetamine and methylphenidate?

A

Increase extracellular synaptic dopamine

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16
Q

Side effects of stimulant use in ADHD?

A

Anorexia, weight loss, insomnia, social and emotional withdrawal, priapism, emotional lability, occasional psychosis

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17
Q

What can be used instead of stimulants in ADHD if the parents want a non-stimulant medication?

A

Atomoxetine

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18
Q

What is the mechanism of action of atomoxetine?

A

Highly selective inhibitor of the presynaptic noradrenaline transporter - increases extracellular noradrenaline and dopamine levels in the prefrontal cortex

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19
Q

When is clonidine useful in ADHD?

A

Where there is comorbid tic disorder

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20
Q

What is the mechanism of action of clonidine?

A

Alpha-2 noradrenergic agonist

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21
Q

What are the side effects of clonidine?

A

Drowsiness, cardiotoxicity, depression, confusion, dry mouth

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22
Q

Where is melatonin produced?

A

The pineal gland

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23
Q

What is the heritability of autism spectrum disorder?

A

50%

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24
Q

What is the recurrence rate in subsequent siblings of a child with autism spectrum disorder?

A

10-20%

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25
What are the diagnostic criteria for autism spectrum disorder?
``` Impaired social communication Restricted, repetitive behaviours Onset in early childhood Impairs functioning Not explained by another disorder ```
26
Which conditions are associated with autism spectrum disorder?
Rett, fragile X, tuberous sclerosis, Angelman, Down
27
Which medications might be useful in autism spectrum disorder?
Stimulants SSRIs - for compulsive/ritualistic behaviours Melatonin Atypical antipsychotics e.g. risperidone for aggression
28
How is Rett syndrome inherited?
X-linked dominant but sporadic in 99% of cases
29
What is the mutation in Rett syndrome?
Almost always MECP2
30
What are the features of Rett syndrome?
``` Developmental regression Dyspraxic gait Stereotypical hand movements Seizures Breathing problems Abnormal tone Screaming or laughing spells Scoliosis Autonomic dysfunction GI problems ```
31
What is Rolando variant Rett syndrome?
Congenital where development is impaired earlier
32
What is Zapella variant Rett syndrome?
Preserved speech - speech is regained after the regression
33
What medications might be needed in Rett syndrome?
``` Lamotrigine for early seizures Sodium valproate or carbamazepine for later seizures Anti dystonic e.g. baclofen SSRIs for agitation Melatonin for sleep ```
34
How many children with developmental delay have an underlying issue?
40% have chromosomal abnormality 5-10% have a developmental malformation 4% have metabolic disorders
35
Gross motor milestones at 6 weeks
Raises head to 45 degrees when on tummy Stabilises head when raised to sitting Head can be held in same plane as body on ventral suspension
36
Gross motor milestones at 3 months
Able to raise head and chest on forearms when prone | Head steady when pulled to sit
37
Gross motor milestones at 6 months
Can roll over | Sits without support with rounded back
38
Gross motor milestones at 9 months
Sits with straight back Pivots to reach objects Stands holding onto objects
39
Gross motor milestones at 12 months
Crawling Pulls to stand Cruising or walking
40
Gross motor milestones at 15 months
Walking well
41
Gross motor milestones at 18 months
Stoops and retrieves objects Carries toys while walking Running Jumping
42
Gross motor milestones at 2-2.5 years
Climbs and descends stairs one step at a time Throws a ball at shoulder level Kicks a ball (2.5y) Climbs furniture
43
Gross motor milestones at 3 years
Pedals tricycle Jumps well Hops on one foot for 3 steps Walks upstairs one foot per step, downstairs two feet per step
44
Gross motor milestones at 4 years
Stands on one foot well
45
Gross motor milestones at 5 years
Was down stairs one foot per step | Bounces and catches ball
46
Fine motor and vision milestones at 6 weeks
Fixes and follows through 90 degrees horizontally
47
Fine motor and vision milestones at 3 months
Fixes and follows through 180 degrees horizontally Hands beginning to be brought to the midline Attempts to make contact with offered object
48
Fine motor and vision milestones at 6 months
Transfers Reaches our for objects Mouthing objects Palmar grasp
49
Fine motor and vision milestones at 9 months
Looks for toy fallen from view Pokes objects with index finger Inferior pincer grip
50
Fine motor and vision milestones at 12 months
Neat pincer grip Banging bricks together Stacks 2 bricks
51
Fine motor and vision milestones at 15 months
Pincer grip refined, can pick up tiny objects | Casting should disappear by 18m
52
Fine motor and vision milestones at 18 months
Delicate pincer grip Scribbles to and fro Stacks 4 bricks
53
Fine motor and vision milestones at 2-2.5 years
Copies a vertical line Tower of 8 bricks Shape matching Turns several pages of a book at once
54
Fine motor and vision milestones at 3 years
``` Copies a circle Matches 2 colours Builds a bridge or train Can make single cuts at 3 years, cuts pieces at 3.5 Griffiths beads Turns one page of a book at a time ```
55
Fine motor and vision milestones at 4 years
Copies a cross and a square Draws a man with 3 parts Cuts paper in half Builds 12 blocks, or steps
56
Fine motor and vision milestones at 5 years
``` Copies triangle Draws a man with 6 parts Writes name Can do up buttons Can build big steps Can thread small beads ```
57
Language milestones at 6 weeks
Makes throaty noises | Stills, startles at loud noise
58
Language milestones at 3 months
Vowel sounds and noises uttered on social contact | Turns head to sound, level to the ear
59
Language milestones at 6 months
Unintelligible babble Will turn when name is called Understands 'bye bye' and 'no'
60
Language milestones at 9 months
Shouts to gain attention Two syllable babble Imitates adult sounds Responds to own name
61
Language milestones at 12 months
``` 2 words with meaning Responds to 'give it to me' Understands nouns Points to own body parts Shows recognition of objects by using them e.g. brush ```
62
Language milestones at 15 months
Expression of several words Understands words like cup, names of siblings Jargon and jabbering Echolalia
63
Language milestones at 18 months
``` Understands up to 50 words Knows common objects by name e.g. cat Follows one step commands 1-6 different words Points to doll's body parts ```
64
Language milestones at 2 years to 2.5 years
Uses plurals Understands verbs a 2y, prepositions at 2.5y Follows two step requests Identifies objects from hearing their use Selects toy from others e.g. 'give me the sheep' 2 words together at 2 years 3-4 at 2.5
65
Language milestones at 3 years
``` Knows some colours Three to four word sentences Name, age and sex on request Pronouns and plurals Knows more about time, today and not today Starts to tell stories Understands negatives and adjectives Understands comparatives (3.5y) ```
66
Language milestones at 4 years
``` Counts to 10 Identifies several colours 100s of questions Understands numbers Past tense Increasing concentration ```
67
Language milestones at 5 years
Comprehension of 'what do you do if you are hungry, cold, tired?' Understands opposites
68
Social milestones at 6 weeks
Social smile
69
Social milestones at 3 months
May show displeasure on interruption of social contact
70
Social milestones at 6 months
``` Plays with feet Holds onto bottle when fed Puts object to mouth Shakes rattle Reaches for bottle/breast ```
71
Social milestones at 9 months
Finger feeds Resists when objects removed Stranger fear
72
Social milestones at 12 months
``` Waves bye bye Claps hands Empties cupboards Plays alone if familiar person nearby Drinks from beaker with lid ```
73
Social milestones at 15 months
Drinks from a cup | Indicates wants without crying i.e. pointing, pulling, asking
74
Social milestones at 18 months
Holds spoon and gets food to mouth Takes shoes and socks off Imitates everyday activities
75
Social milestones at 2 to 2.5 years
Plays alone | Eats with spoon
76
Social milestones at 3 years
``` Out of nappies during the day, bowel control Separates from mother easily Eats with spoon and fork Dresses with supervision Begins to share toys ```
77
Social milestones at 4 yeas
``` Concern/sympathy for others if hurt Has best friend Shares toys Out of nappies at night Brushes teeth Toilet alone Eats skilfully with little help Dressing and undressing ```
78
Social milestones at 5 years
Acts out role play, imaginative play | Handles knife

MRCPCH Clinicals (17 decks)

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