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4th year passmedicine by topic > Growth & Development > Flashcards

Growth & Development Flashcards

1
Q

Developmental milestones: gross motor

3 months

A

Little or no head lag on being pulled to sit
Lying on abdomen, good head control
Held sitting, lumbar curve

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2
Q

Developmental milestones: gross motor

6 months

A 
Lying on abdomen, arms extended
Lying on back, lifts and grasps feet
Pulls self to sitting
Held sitting, back straight
Rolls front to back
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3
Q

Developmental milestones: gross motor

7-8 months

A

Sits without support (Refer at 12 months)

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4
Q

Developmental milestones: gross motor

9 months

A

Pulls to standing

Crawls

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5
Q

Developmental milestones: gross motor

12 months

A

Cruises

Walks with one hand held

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6
Q

Developmental milestones: gross motor

13-15 months

A

Walks unsupported (Refer at 18 months)

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7
Q

Developmental milestones: gross motor

18 months

A

Squats to pick up a toy

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8
Q

Developmental milestones: gross motor

2 years

A

Runs

Walks upstairs and downstairs holding on to rail

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9
Q

Developmental milestones: gross motor

3 years

A

Rides a tricycle using pedals

Walks up stairs without holding on to rail

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10
Q

Developmental milestones: gross motor

4 years

A

Hops on one leg

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11
Q

Developmental milestones: fine motor and vision

3 months

A

Reaches for object
Holds rattle briefly if given to hand
Visually alert, particularly human faces
Fixes and follows to 180 degrees

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12
Q

Developmental milestones: fine motor and vision

6 months

A

Holds in palmar grasp
Pass objects from one hand to another
Visually insatiable, looking around in every direction

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13
Q

Developmental milestones: fine motor and vision

9 months

A

Points with finger

Early pincer

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14
Q

Developmental milestones: fine motor and vision

12 months

A

Good pincer grip

Bangs toys together

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15
Q

Developmental milestones: fine motor and vision

building bricks

A

15 months Tower of 2
18 months Tower of 3
2 years Tower of 6
3 years Tower of 9

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16
Q

Developmental milestones: fine motor and vision

drawing milestones

A 
18 months	Circular scribble
2 years	Copies vertical line
3 years	Copies circle
4 years	Copies cross
5 years	Copies square and triangle
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17
Q

Developmental milestones: fine motor and vision

book milestones

A

15 months Looks at book, pats page
18 months Turns pages, several at time
2 years Turns pages, one at time

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18
Q

hand preference before ?months is abnormal and may indicate cerebral palsy

A

hand preference before 12 months is abnormal and may indicate cerebral palsy

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19
Q

Developmental milestones: speech and hearing

3 months

A

Quietens to parents voice
Turns towards sound
Squeals

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20
Q

Developmental milestones: speech and hearing

6 months

A

Double syllables ‘adah’, ‘erleh’

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21
Q

Developmental milestones: speech and hearing

9 months

A

Says ‘mama’ and ‘dada’

Understands ‘no’

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22
Q

Developmental milestones: speech and hearing

12 months

A

Knows and responds to own name

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23
Q

Developmental milestones: speech and hearing

12-15 months

A

Knows about 2-6 words (Refer at 18 months)

Understands simple commands - ‘give it to mummy’

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24
Q

Developmental milestones: speech and hearing

2 years

A

Combine two words

Points to parts of the body

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25
Developmental milestones: speech and hearing | 2½ years
Vocabulary of 200 words
26
Developmental milestones: speech and hearing | 3 years
Talks in short sentences (e.g. 3-5 words) Asks 'what' and 'who' questions Identifies colours Counts to 10 (little appreciation of numbers though)
27
Developmental milestones: speech and hearing | 4 years
Asks 'why', 'when' and 'how' questions
28
Developmental milestones: social behaviour and play
``` 6 weeks Smiles (Refer at 10 weeks) 3 months Laughs Enjoys friendly handling 6 months Not shy 9 months Shy Takes everything to mouth ```
29
Feeding milestones
May put hand on bottle when being fed 6 months Drinks from cup + uses spoon, develops over 3 month period 12 -15 months Competent with spoon, doesn't spill with cup 2 years Uses spoon and fork 3 years Uses knife and fork 5 years
30
Dressing milestones
Helps getting dressed/undressed 12-15 months Takes off shoes, hat but unable to replace 18 months Puts on hat and shoes 2 years Can dress and undress independently except for laces and buttons 4 years
31
Play milestones
``` Plays 'peek-a-boo' 9 months Waves 'bye-bye' Plays 'pat-a-cake' 12 months Plays contentedly alone 18 months Plays near others, not with them 2 years Plays with other children 4 years ```
32
Development problems - Referral points
doesn't smile at 10 weeks cannot sit unsupported at 12 months cannot walk at 18 months
33
Gross motor problems | most common causes of problems:
variant of normal, cerebral palsy and neuromuscular disorders (e.g. Duchenne muscular dystrophy)
34
Speech and language problems - always check?
always check hearing | other causes include environmental deprivation and general development delay
35
General contraindications to immunisation
confirmed anaphylactic reaction to a previous dose of a vaccine containing the same antigens confirmed anaphylactic reaction to another component contained in the relevant vaccine (e.g. egg protein)
36
Situations where vaccines should be delayed
febrile illness/intercurrent infection
37
Contraindications to live vaccines
pregnancy | immunosuppression
38
DTP: vaccination should be deferred in children with
an evolving or unstable neurological condition
39
Immunisation schedule | At birth
BCG if risk factors At birth the BCG vaccine should be given if the baby is deemed at risk of tuberculosis (e.g. Tuberculosis in the family in the past 6 months).
40
Immunisation schedule | 2 months
'6-1 vaccine' (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B) Oral rotavirus vaccine Men B
41
Immunisation schedule | 3 months*
'6-1 vaccine' (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B) Oral rotavirus vaccine PCV
42
Immunisation schedule | 4 months
'6-1 vaccine' (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B) Men B
43
Immunisation schedule | 12-13 months
Hib/Men C MMR PCV Men B
44
Immunisation schedule | 2-8 years
Flu vaccine (annual)
45
Immunisation schedule | 3-4 years
'4-in-1 pre-school booster' (diphtheria, tetanus, whooping cough and polio) MMR
46
Immunisation schedule | 12-13 years
HPV vaccination
47
Immunisation schedule | 13-18 years
'3-in-1 teenage booster' (tetanus, diphtheria and polio) | Men ACWY
48
Children in the UK receive two doses of the Measles, Mumps and Rubella (MMR) vaccine before entry to primary school. This currently occurs at
12-15 months and 3-4 years as part of the routine immunisation schedule
49
Contraindications to MMR
severe immunosuppression allergy to neomycin children who have received another live vaccine by injection within 4 weeks immunoglobulin therapy within the past 3 months
50
MMR pregnancy should be avoided for at least ?month following vaccination
pregnancy should be avoided for at least 1 month following vaccination
51
Adverse effects MMR
malaise, fever and rash may occur after the first dose of MMR. This typically occurs after 5-10 days and lasts around 2-3 days
52
Normal changes in puberty
gynaecomastia may develop in boys asymmetrical breast growth may occur in girls diffuse enlargement of the thyroid gland may be seen
53
Males | first sign is testicular growth at
around 12 years of age (range = 10-15 years)
54
Testicular volume ?ml indicates onset of puberty
esticular volume > 4 ml indicates onset of puberty
55
Males maximum height spurt at ?yrs
maximum height spurt at 14
56
first sign is breast development at around ?years
11.5 years of age (range = 9-13 years)
57
Females height spurt
reaches its maximum early in puberty (at 12) , before menarche
58
Females menarche at
13 (11-15)
59
factors which point towards child abuse include:
story inconsistent with injuries repeated attendances at A&E departments late presentation child with a frightened, withdrawn appearance - 'frozen watchfulness'
60
Possible physical presentations of child abuse - fractures
particularly metaphyseal, posterior rib fractures or multiple fractures at different stages of healing
61
Possible physical presentations of child abuse include sexually transmitted infections e.g. Chlamydia, Gonorrhoea, Trichomonas
true
62
Possible physical presentations of child abuse include torn frenulum: e.g. from forcing a bottle into a child's mouth
true
63
Neglect comes under the umbrella of abuse and includes things like Failure to seek medical advice which compromises the child's health Child who is persistently smelly and dirty
true
64
adults often do not believe children's allegations of abuse
true
65
Sexual abuse higher incidence in children with
special educational needs
66
Features which may be present in a sexually abused child include sexually precocious behaviour
true
67
Features which may be present in a sexually abused child include enuresis and encopresis
true
68
Features which may be present in a sexually abused child include recurrent symptoms e.g. headaches, abdominal pain
true
69
Child health surveillance - antenatal
Ensure intrauterine growth Check for maternal infections e.g. HIV Ultrasound scan for fetal abnormalities Blood tests for Neural Tube Defects
70
Child health surveillance - Newborn
Clinical examination of newborn Newborn Hearing Screening Programme e.g. oto-acoustic emissions test Give mother Personal Child Health Record
71
Child health surveillance - GP examines baby ? weeks after birth?
6-8 weeks
72
Heel-prick test occurs when?
day 5-9
73
Heel-prick test covers?
hypothyroidism, PKU, metabolic diseases, cystic fibrosis, medium-chain acyl Co-A dehydrogenase deficiency (MCADD)
74
meningitis B has now been added to the routine NHS immunisation. Three doses are now given at:
2 months 4 months 12-13 months
75
Otoacoustic emission test is performed on newborns
True | A computer generated click is played through a small earpiece. The presence of a soft echo indicates a healthy cochlea
76
Distraction test is a hearing test for newborns and infants
false | for 6-9 months
77
Auditory Brainstem Response test is routinely performed on newborns and infants
false | May be done if otoacoustic emission test is abnormal
78
Hearing test for 18 months - 2.5 years comprises of?
Recognition of familiar objects Uses familiar objects e.g. teddy, cup. Ask child simple questions - e.g. 'where is the teddy?'
79
Which hearing test is Done at school entry in most areas of the UK
Pure tone audiometry
80
Obesity in children consider tailored clinical intervention if BMI
91st centile or above
81
Obesity in children consider assessing for comorbidities if
BMI at 98th centile or above
82
Asian children: four times more likely to be obese than white children
true
83
obesity more common in male children
false | female
84
taller children: children with obesity are often above the ?th percentile in height
taller children: children with obesity are often above the 50th percentile in height
85
Cause of obesity in children
``` growth hormone deficiency hypothyroidism Down's syndrome Cushing's syndrome Prader-Willi syndrome ```
86
Consequences of obesity in children | orthopaedic problems
slipped upper femoral epiphyses, Blount's disease (a development abnormality of the tibia resulting in bowing of the legs), musculoskeletal pains
87
Consequences of obesity in children
``` orthopaedic problems psychological consequences sleep apnoea benign intracranial hypertension long-term consequences ```
88
Precocious puberty | Definition
'development of secondary sexual characteristics before 8 years in females and 9 years in males'
89
thelarche is
the first stage of breast development
90
adrenarche is
the first stage of pubic hair development
91
Precocious puberty - FSH & LH raised suggests?
``` Gonadotrophin dependent ('central', 'true') cause due to premature activation of the hypothalamic-pituitary-gonadal axis ```
92
Precocious puberty - FSH & LH lowered suggests?
``` Gonadotrophin independent ('pseudo', 'false') due to excess sex hormones ```
93
Precocious puberty - in males gonadotrophin release from intracranial lesion presents with?
bilateral enlargement of testes
94
Precocious puberty - in males gonadal tumour presents with?
unilateral enlargement of testes
95
Precocious puberty - in males adrenal cause (tumour or adrenal hyperplasia) presents with?
small testes

4th year passmedicine by topic (96 decks)

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