Paediatric development:

Question 1

Learning outcomes:

Answer 1

Question 2

What are the 4 areas of development?

Answer 2

1. Gross motor
2. Fine motor and visioon
3. Speech and hearing
4. personal, social and emotional

Question 3

Gross motor:

In babies? head control, rolling, sitting up,

Question 4

Fine motor: What are they?

Answer 4

Question 5

Speech and language:

What are the two types?

Answer 5

Question 6

Personal emotional and social development:

What is this?

Answer 6

Is the baby smiling?

Waving? Laughing? Playing peek a boo? Feeding?

Question 7

PAG developmental tables read:

Gross motor: Outline : Read

Answer 7

Question 8

Essential milestones that must be remebered:

4-6 weeks?

6-7 months

9 months?

10 months?

12 months?

18 months?

24 months?

Answer 8

Question 9

Fine motor skills: Development: Fine motor skills:

Read PAG:

Answer 9

Question 10

Why is it important we study child development?

What can it be a marker of?

Neglect?

School? Social life?

Answer 10

Early assessment and understanding of the problem assists later develeopment

Question 11

Correcting for prematurity with development:

Correct until 2 years of age

Answer 11

Question 12

Speech and language development read:

Social development read:

PAG Notes:

Answer 12

Question 13

Ways children can be picked up to have devlopmental delay:

Answer 13

Question 14

Formal assessments for when a developmental disorder is found?

What tests and further investigations are done?

Answer 14

Question 15

Terminology:

Global development delay?

specific?

regression of milestones?

Answer 15

Question 16

Key red flags: For developmental delay:

PAG Read and know!

Answer 16

Question 17

Other important red flags requiring immediate assessment:

Answer 17

Question 18

What does a developmental history aim to find out?

Answer 18

Question 19

Developmental history: continued:

Family history?

Answer 19

Question 20

Developmental examination: Outline: What are you interested in:

Answer 20

• Full systems exam
  
  • include neuro- looking for persistence of primitive reflexes, ocular abnormalities (e.g clouding of cornea in storage disease, hearing etc)
  • Look for neurocutaneous stigmata: cafe au lait spots (tuberosclerosis) , depigmented patahces, port wine spots
  • Look for heaptosplenomegaly - may suggest a metabolic disorder
  • if case is borderline- always follow up and
  • always refer to paeds:
    *

Question 21

What are investigations for global developmental delay (first line investigations)

Answer 21

MRI

LP

24 hour ECG

Further bloods: Plasma

Question 22

Key causes of global developmental delay:

Read and understand:

Answer 22

Question 23

Answer 23

Contraction of SCM muscles on respiration: causes head bobbing

Question 24

MCQ:

Answer 24

When pulmonary vascular resistance decreases:

at 4-6 weeks shunt changes

Question 25

What questions to as when you see the baby you think has heart failure? Lots of questions

Answer 25

* Feeding * Cyanosis * Sacral oedema * WOB * Intercostal withdrawing * color of child * level of arousal * are they tired fter feeds? * Notice anything about the breathing? * Feeding?

Question 26

MCQ:

Answer 26

C- Characteristic A- area R- radiation I- Intensity o- Occurence timing:

Question 27

MCQ:

Answer 27

What techniques can be used to improve success in decreasing voluntary guarding in abdominal exmamination: 1) Distraction 2) Stethoscope technique 3) Legs up to abdomen 4) Parents help hold Examine with a teddy bear first- Starting at hands- blowing up glove:

Question 28

Key points: From Dr Look from a far, look at how mother is interacting with child Look at pattern of breathing through clothes ALWAYS measure: Height, weight HC Hx taking: Key points: Know useful open ended question, know when the problem started (especially if recurrent, no each episode, is it better worse? trend? acute? chronic problem?) Whats the average interval when they are well?How long are they well Work out the trend: Thorough system review in all paeds patients!!!!!!

Answer 28

Question 29