Buffl

Paediatrics

von Bhavya S.

Mid Arm circumference is distance between ?

Acromian process and Olecranon process.

Shakir's Tape used between which age group ?

6 months - 5 years

Head and Chest circumference at :

9 months - 1 year
Beyond 1 year

HC = CC
CC > HC

BMI Percentiles

Normal Mid Arm circumference ?

Term neonate = 9-11 cm

By end of 1st year = 16 cm

Average birth weight in India ?

2.9 kg

How the weight increases with age ?

How length increases with age ?

Upper to lower segment ratio ?

At birth :

At 3 years :

At 7 - 10 years :

At birth = 1.7 - 1.9 : 1

At 3 years = 1.3 : 1

At 7 - 10 years = 1 : 1

Head circumference at birth ?

Definition of short stature ?

Height

< 3rd Percentile

<- 2 SD

Familial short stature ?

Height < 3rd Percentile of expected but normal according to target height.

Here

Bone Age = Chronological Age

Bone Age < Chronological Age seen in ?

Constitutional delay in growth and puberty ?

Expected height formula ?

Boys

Boys = FH + MH + 13 / 2

Girls = FH + MH - 13 / 2

Achondroplasia ?

AD Inheritance (FGFR3)

Champaign glass pelvis

Bowed legs

Large head / Short stature

Osteogenesis Imperfecta

Brittle bone disease characterized by triad of

Recurrent fractures

Blue Sclera

Deafness

Tx - Bisphosphonates

E.g. Pamidronate

Tall stature definition ?

Height > + 2 SD

Short Trunk dwarfism and Short limb dwarfism ?

Short trunk dwarfism :-US & LS ratio Decreases

And Vice Versa

Microcephaly ?

HC of < - 3 SD

Macrocephaly ?

> + 2 SD

Hydranencephaly ?

Cerebral hemisphere absent replaced by fluid filled sacs with

Transillumination +ve

Hydranencephalus ?

Increase in size of ventricles inside brain due to increased production or impaired drainage of CSF

TRANSILLUMINATION -ve

Tx - VP Shunt

Craniosynostosis ?

Premature fusion of cranial sutures.

Which fonatanelle closes last ?

Anterior Fonatanelle (18 months)

At junction of Coronal and Sagittal sutures

At junction of PARIETAL & FRONTAL bone

Posterior Fonatanelle ?

Parietal and Occipital bone present at junction of Sagittal and Lamboid sutures

Closes at 6 - 8 weeks

Management of Hydrocephalus ?

TOC - Vebtriculo-Peritoneal shunt

Medical Mx -

Acute = 3 % NaCl or Mannitol

Chronic = Acetazolamide / Glycerol

Q. - Female with normal early development now presents with microcephaly, regression of acquired language & motor milestones and hand wringing movements ?

Rett syndrome

Angelmann syndrome ?

Seizure

Ataxia

Mental retardation

Inappropriate laughter (Happy puppet)

Primary Dentition characteristics ?

Begin at 6 months. 1st tooth to erupt - Lower central incisor and last - Second molar Completes at 2.5 - 3 yrs

Total teeth - 20 (ICPM 2-1-0-2)

Secondary Dentition ?

6 years - 12 years (except 3rd molar)

1st to erupt - 1st molar

ICPM (2-1-2-3)

Delayed Dentition ?

No teeth eruption by the age of 13 months

Hutchinson Triad ?

Hutchinson teeth Interstitial keratitis SNHL

Notched incisors (Hutchinson teeth) seen in Congenital syphilis.

Age calculation for pre term ? (Till 2yr)

Landmark - 40 weeks

So 30 weeks preterm - subtract 10 weeks.

Head in plane of body ? (beginning of neck control)

In which month

2 month

3 month - Above plane of body.

Calculate age ?

Can support weight on his hands or extended arms .

6 months

Sitting with support / Tripod position

6 months

Sitting without support / Crawling

8 months

Standing with support

9 months

Standing with support / walk with support

1 yr

Walks without support

13 months

Goes upstairs and down stairs holding railing

18 months

Rides a tricycle

3 years

Upstairs and Down Stairs with alternating feet

4 years

Bidextrous grip?

5 months

Unidextrous Grip / Palmer grasp

6 months

Transfers object from one hand to another

7 months

Immature / assisted pincer grasp

9 months

Mature pincer grasp / unassisted

12 months

Handedness est ?

3 years (appears at 24 months)

Copies rectangle or plus sign

4 years

Copies triangle, X

5 years

Social Smile ?

2 months

Recognises mother

3 months

Mirror play appears at ?

6 months

Waves Bye Bye

9 months

Plays pick a boo

10 months

Dry during day / Domestic mimicry

18 months

Mono-syllabuc babbling

(Ma,Pa,Da)

6 months

Bi-Syllabic babbling

(Mama,Papa)

9 months

Vocabulary with age ?

1 yr = 2 - 3 words

18 months = 8 - 10 word

2 yr = 50 - 100 words

Binocular vision develops at ?

Begins by 6 weeks and est by 4 months of age.

Developmental Red Flags ?

IQ Levels (51-70,35-50,21-35,0-20) ?

1-53

Achondroplasia ?

AD Inheritance (FGFR3)

Champaign glass pelvis

Bowed legs

Large head / Short stature

Osteogenesis Imperfecta

Brittle bone disease characterized by triad of

Tx - Bisphosphonates

Short trunk dwarfism :-US & LS ratio Decreases

At junction of Coronal and Sagittal sutures

At junction of PARIETAL & FRONTAL bone

Parietal and Occipital bone present at junction of Sagittal and Lamboid sutures

Closes at 6 - 8 weeks

Begin at 6 months. 1st tooth to erupt - Lower central incisor and last - Second molar Completes at 2.5 - 3 yrs

Total teeth - 20 (ICPM 2-1-0-2)

6 years - 12 years (except 3rd molar)

ICPM (2-1-2-3)

Hutchinson teeth Interstitial keratitis SNHL

Notched incisors (Hutchinson teeth) seen in Congenital syphilis.

2 month

3 month - Above plane of body.

6 months

6 months

8 months

Social Smile ?

2 months

Recognises mother

3 months

Mirror play appears at ?

6 months

9 months

Plays pick a boo

10 months

Dry during day / Domestic mimicry

18 months

Mono-syllabuc babbling

6 months

Bi-Syllabic babbling

9 months

1 yr = 2 - 3 words

18 months = 8 - 10 word

2 yr = 50 - 100 words

Begins by 6 weeks and est by 4 months of age.

Developmental Red Flags ?

IQ Levels (51-70,35-50,21-35,0-20) ?

Hand regard appears at ?

12 weeks

Persistence beyond 5 months considered abnormal

Nocturnal Enuresis definition ?

Involuntary urine beyond 5 years of age.

1. Lifestyle and Diet.

2.Bed and Alaram.

3. Oral Desmopressin, Imipramine & Oxybutynin.

ADHD Treatment drugs ?

1.Methylphenidate 2.Amphetamine 3.Atomoxetine

Sequence of Pubertal changes in Females

Thelarche (breast) > Pubarche (hair) > Growth spurt > Menarche

Sequence of changes in puberty (males)

Penis enlargement > Pubic hair > Growth spurt > Axillary hair > Facial hair

Author

Bhavya S.

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