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Phase 3a medicine > Paediatric - Development + Immunisations > Flashcards

Paediatric - Development + Immunisations Flashcards

1
Q

Name 1 developmental milestone at 6 weeks

A

Smile spontaneously; self-soothes; turns head towards sounds

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2
Q

Name 2 developmental milestones at 3 months

A

Turns head towards sound; Recognises faces; raises head and chest while lying on stomach; brings hand to mouth; begins to babble

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3
Q

Name 3 developmental milestones at 6 months

A

Sits without support + rolls; palmar grasp; Enjoys social play; Responds to other’s emotions; finger feeds

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4
Q

Name 3 developmental milestones at 12 months

A

Crawling + unsteady walking; 2 brick tower; One or two words; Hand clapping; uses spoon/fork

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5
Q

Name 3 developmental milestones at 18 months

A

Able to run + jump; 4 brick tower; 6-12 words; imitates activities; holds spoon

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6
Q

Name 3 developmental milestones at 2 years

A

Able to take clothes off; walks upstairs; 8 brick tower; 50+ words

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7
Q

Name one genetic cause of developmental delay

A

Chromosomal disorder (eg. Down’s); Microdeletions or duplications

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8
Q

Name a cause of too much energy being used in childhood resulting in faltering growth

A

Infection (HIV) / Chronic lung or heart disease / Hyperthyroid

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9
Q

Name 2 medical and 2 psychosocial risk factors for faltering growth

A

Medical: Congenital (autism,Down’s,CP); Developmental delay; GORD; Prematurity
Psychosocial: Disordered feeding; Family stressors; FH of abuse; Poor parenting; Postpartum depression; Poverty

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10
Q

Short stature is defined as height below what centile?

A

Second centile

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11
Q

At what age are these immunisations administered?

BCG / 6-in-1 vaccine / 4-in-1 booster / 3-in-1 booster

A

BCG - at birth (only if at risk of TB)
6-in-1 vaccine - 2-4 months (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B)
4-in-1 booster - 3-4 years (diphtheria, tetanus, whooping cough and polio)
3-in-1 booster - 13-18 years (tetanus, diphtheria and polio)

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12
Q

What is the first sign of puberty in boys?

A

Increase in testicular volume

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13
Q

Which immunisations are included in the 6-in-1 vaccine?

A

diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B

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14
Q

At what age would the average child start to say ‘mama’ and ‘dada’?

A

9-10 months

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15
Q

Precocious puberty in females may be defined as the development of secondary sexual characteristics before what age?

A

8 years

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16
Q

What 9 conditions does the heelprick newborn blood spot test screen for?

A
  • Sickle cell
  • CF
  • Congenital hypothyroid
  • Inherited metabolic diseases
    phenylketonuria (PKU)
    medium-chain acyl-CoA dehydrogenase deficiency (MCADD)
    maple syrup urine disease (MSUD)
    isovaleric acidaemia (IVA)
    glutaric aciduria type 1 (GA1)
    homocystinuria (pyridoxine unresponsive) (HCU)
  • Severe combined immunodeficiency (SCID)
17
Q

Most children become toilet trained at or after what age?

A

3 years

18
Q

Most children are able to briefly stand on one leg at what age?

A

3 years

19
Q

At what age do most children sit without support, with a straight back?

A

7-8 months

20
Q

At what age do most children have little or no head lag on being pulled to sit?

A

3 months

21
Q

At what age do most children walk unsupported?

A

12-15 months

22
Q

At what age do most babies begin to crawl?

A

9-11 months

23
Q

A 12-month-old child is brought into surgery for her next routine immunisations. She has received all the recommended immunisations to date. What should be given at this stage?

A

12-13 months immunisations: Hib/Men C + MMR + PCV + Men B

24
Q

Name a cause of failure to thrive under the following headings:

  • Inadequate nutritional intake
  • Difficulty feeding
  • Malabsorption
  • Increased energy requirements
  • Inability to process nutrition
A

Causes of Inadequate Nutritional Intake

  • Maternal malabsorption if breastfeeding
  • Iron deficiency anaemia
  • Family or parental problems
  • Neglect
  • Availability of food (i.e. poverty)

Causes of Difficulty Feeding

  • Poor suck, for example due to cerebral palsy
  • Cleft lip or palate
  • Genetic conditions with an abnormal facial structure
  • Pyloric stenosis

Causes of Malabsorption

  • Cystic fibrosis
  • Coeliac disease
  • Cows milk intolerance
  • Chronic diarrhoea
  • Inflammatory bowel disease

Causes of Increased Energy Requirements

  • Hyperthyroidism
  • Chronic disease, for example congenital heart disease and cystic fibrosis
  • Malignancy
  • Chronic infections, for example HIV or immunodeficiency

Inability to Process Nutrients Properly

  • Inborn errors of metabolism
  • Type 1 diabetes
25
Q

There is evidence that breastfeeding can reduce the risk of which two cancers?

A

Breast and ovarian cancer

26
Q

On formula feed, babies should receive how much milk per kg of weight?

A

babies should receive around 150ml of milk per kg of body weight
(This is split between feeds every 2-3 hours initially, then to 4 hours and longer between feeds. Eventually babies and infants transition to feeding on demand (when they are hungry))

27
Q

When does weaning usually start?

A

Weaning usually starts around 6 months of age

28
Q

What are the 5 Frazer guidelines?

A
  • They are mature and intelligent enough to understand the treatment
  • They can’t be persuaded to discuss it with their parents or let the health professional discuss it
  • They are likely to have intercourse regardless of treatment
  • Their physical or mental health is likely to suffer without treatment
  • Treatment is in their best interest
29
Q

What vaccines are given at 8 weeks?

A
  • 6-in-1 vaccine
  • Rotavirus vaccine
  • MenB
30
Q

What vaccines are given at 12 weeks?

A
  • 6-in-1 vaccine (2nd dose)
  • Pneumococcal (PCV) vaccine
  • Rotavirus vaccine (2nd dose)
31
Q

What vaccines are given at 16 weeks?

A
  • 6-in-1 vaccine (3rd dose)

- MenB (2nd dose)

32
Q

What vaccines are given at 1 year?

A
  • Hib/MenC (1st dose)
  • MMR (1st dose)
  • Pneumococcal (PCV) vaccine (2nd dose)
  • MenB (3rd dose)
33
Q

What vaccines are given at 14 years?

A
  • 3-in-1 teenage booster

- MenACWY

Phase 3a medicine (24 decks)

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