Paediatrics - toddlers and children

Question 1

Typical walking milestone?

Answer 1

19 months however earlier at

10-14 months is common

Question 2

general rule for milestones for babies born prematurely at 35 weeks?

Answer 2

add 5 weeks to milestones

Question 3

gross motor skill milestones for babies at 3 months?

Answer 3

1. lying supine with head in midline
2. no head lag when pulling from supine to sitting
3. lift head when on tummy

Question 4

when would it be expected for a baby to be crawling?

Answer 4

10-12 months

Question 5

when would it be expected for a baby to be cruising on furniture?

Answer 5

1 year

Question 6

fine motor skills at 3 months?

Answer 6

• hands in mouth

- holding things without realising

Question 7

fine motor skills at 6 months?

Answer 7

• reaching/grasping objects and putting in mouth
• transferring things from one hand to the other
• poking and pointing with index finger (6-12)

Question 8

when would it be expected for a baby to make coo noises

Answer 8

6 weeks

Question 9

when would it be expected for a baby to be very vocal?

Answer 9

3 months

Question 10

when would it be expected for a baby to start using words

Answer 10

9-10 months

Question 11

Visual concerns: When to refer baby?

Answer 11

• cannot see things or white/cloudy eyes
• squints a lot after 3 months
• baby not interested with whats going on around them

Question 12

hearing concerns - when to refer:

Answer 12

• not responding to sounds

- not interested in whats going on around them

Question 13

MSK concerns when to refer:

Answer 13

• not moving both arms and legs
• not sitting by self by 10 months
• not WB by 1 year
• not holding head up on tummy at 3-4/12

Question 14

What is a primitive reflex?

Answer 14

are the first part of the brain and CNS to develop that are normal in infants but not in adults

Question 15

What causes primitive reflexes to be suppressed?

Answer 15

frontal lobe development as baby grows

Question 16

what reflexes replace primitive reflexes?

Answer 16

postural reflexes

Question 17

List the primitive reflexes?

Answer 17

Rooting: cheek
Moro: startle
Walking/stepping
Babinski
Tonic neck reflex
Galant: hip swing (stroke back)
Grasp

Question 18

general rule to treating retained primitive reflexes?

Answer 18

fatigue the reflex

- repetition > intensity

Question 19

What is plagiocephaly?

Answer 19

assymetrical or misshapen head

Question 20

when to be concerned about plagiocephaly?

Answer 20

if head doesnt go back to normal within 6 weeks

Question 21

treatment for plagiocephaly?

Answer 21

• counterpositioning
• increased tummy time
• corrective helmets

Question 22

Genu Varus?

Answer 22

Bow legs

Question 23

Genu valgus?

Answer 23

knock knees

Question 24

At what age would a waddling type gait be an abnormal finding?

Answer 24

over 3 years old

Question 25

Osteosarcoma?

Answer 25

type of cancer that produces immature bone. Most common form of bone cancer and is usually found at the end of long bones usually around the knee

Question 26

typical features of an osteosarcoma

Answer 26

- common in ages 10-25 - pain and swelling over bone or joint - bone that breaks for no reason

Question 27

Ewings sarcoma:

Answer 27

``` Type of cancer that forms in bone or ST. SSx: - swelling and pain at tumour site - fever - fracture ```

Question 28

where do ewings sarcomas usually form (general)

Answer 28

bone marrow and bone shaft

Question 29

common features of ewings sarcoma:

Answer 29

- age 10-25 - pain and swelling - worse at night - soft warm lump in legs, chest, arms - fever, tiredness, weight loss

Question 30

Acute lymphoblastic leukemia definition.

Answer 30

cancer that is characterised by an overproduction of immature WBcs.

Question 31

Acute lymphoblastic leukemia SSx

Answer 31

features include by slow healing, infections, unexplained bleeding or bruising. anaemia

Question 32

Rhabdomyosarcoma definition

Answer 32

an aggressive, highly malignant form of cancer that develops from skeletal muscle cells that have failed to fully differentiate

Question 33

Rhabdomyosarcoma SSx

Answer 33

lump or swelling that keeps getting bigger. bulging eye, HA, difficulty urinating or bowel movements Often found in head, neck, trunk, extremities and GU system

Question 34

what is the difference between osteomyelitis and septic arthritis?

Answer 34

OM is an infection in the bone marrow SA is an intraarticular infection

Question 35

What features would lead to suspicion of transient synovitis?

Answer 35

- limp - recent history of viral URTI - decreased hip ROM especially IR - able to walk but painful

Question 36

What is perthes disease?

Answer 36

occurs when blood supply to the femoral head is interrupted. This leads to avascular necrosis of the femoral head.

Question 37

SSx of perthes disease?

Answer 37

gradual onset of pain in the hip +/- knee with limping, slow joint movements and wasting of thigh muscles

Question 38

Slipped capital femoral epiphysis?

Answer 38

when the epiphyseal plate on femur slips down and backwards.

Question 39

what demographic is associated with SCFE?

Answer 39

boys | obesity

Question 40

SSx of SCFE?

Answer 40

slowly developing symptoms. mimic a pulled muscle in the groin, hip, thigh or knee. Apperent shortening of the femur

Question 41

Juvenile Arthritis:

Answer 41

umbrella term used to describe the many AI conditions that develop in children under 16

Question 42

SSx of juvenile arthritis?

Answer 42

- joint pain - swelling - eye/skin/muscle/GI symptoms

Question 43

management for growing pains?

Answer 43

heat pack, panadol, massage