Overview Age Motor Language Social NEONATE(0-3 mos) 0-1 mo moro grasp and reflex, visual tracking crying minimal 2 mos holds head up, swipes at objects cooing social smile INFANT (3-12 mos) 3 mos lifting head and chest, moro reflex disappears 4 mos rolls from prone to supine,grasps objects orients to voice colic resolves in most babies by this age laughs 6 mos sits upright babbles stranger anxiety 9 mos crawls, pull-to-stand, pincer grasp, eats with fingers mama-dada (nonspecific) waves bye-bye, responds to name TODDLER(12-24 mos) 12 mos stands mama-dada (specific) picture book 15 mos walks, uses cup several words temper tantrums 18 mos walks up stairs, throws ball names objects toilet-training begins 24 mos runs 2-word sentences, several hundred word vocabulary follows 2-step commands PRESCHOOL (3-6 years) 36 mos rides tricycle (3yrs), eats with utensils 3-word sentences Clinical correlate selective mutism selectively mute in specific settings knows first and last name average age of potty training SCHOOL AGE (6-11 years) development of conscience (super-ego), has same-sex friends ADOLESCENCE(Girls-11yrs, Boys-13 yrs) abstract reasoning, the formation of personality, may have friends of opposite sex Feeding patterns From birth to six months of age, breastfeeding has preferred the source of nutrition All breastfed infants should be supplemented with vitamin D Preterm breastfed infants should be additionally supplemented with iron Solid foods introduced at six months of age Cow's milk introduced at 12 months of age Cyclic vomiting syndrome - an idiopathic disorder in 4-7 yr old children repeated, stereotypical bouts of acute vomiting accompanied by severe nausea, lethargy, and possibly fever, pallor, diarrhea, headache, and/or photophobia with a return to normal health between episodes diagnosis of exclusion supportive therapy for management; amitryptiline may be useful in the prevention children outgrow by teenage years Physical activity should be encouraged at a young age to develop habits children should engage in activities they enjoy with structured time allocated weight lifting is appropriate in young children with proper form and instruction Breath-Holding Spells Introduction breath-holding spells may be cyanotic or pallid Epidemiology incidence 4.6% age can occur between 6 months to 6 years of age most cases occur before 18 months of age Prognosis usually resolves by school age iron supplementation may reduce the breath-holding spell frequency in patients who are anemic or iron-deficient Breath-Holding Spells Type Trigger Clinical Features Treatment Cyanotic (~80% of cases) Emotional insults such as pain anger frustration Typically the patient vigorously cries, which is followed by forced expiration and breath-holding resulting in cyanosis patients often collapse and lose consciousness and can become limp May be associated with generalized clonic jerks opisthotonos bradycardia Education and reassurance Pallid (~20% of cases) The patient may become quiet, which is followed by breath-holding in the expiratory phase that results in pallor brief loss of consciousness loss of muscle tone diaphoretic There is cardiac bradycardia Tonic rigidity may be seen References
QUESTIONS 1 of 15 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (M2.PD.15.196) A mother brings her 10 month-old boy to the pediatrician for a check-up. His birth was without complications and his development to-date has been progressing normally. He currently crawls, pulls himself up to standing, says 'mama' and 'dada' nonspecifically, and responds when called by his name. However, his mother is concerned, as she has noted over the past several weeks that he has periods where he stops breathing when he gets frightened or upset. These episodes last for 20-30 seconds and are accompanied by his lips and face become bluish. His breathing has always resumed normally within 45 seconds after the start of the episode, and he acts normally afterwards. One instance resulted in the child passing out for a 5-10 seconds before a spontaneous recovery. Which of the following is the most appropriate management of this patient's condition? QID: 104202 Type & Select Correct Answer 1 Education and reassurance of the mother 74% (20/27) 2 Echocardiogram 11% (3/27) 3 Electroencephalogram 7% (2/27) 4 Basic metabolic panel 0% (0/27) 5 Lung spirometry 4% (1/27) M 7 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 1 Review Tested Concept Review Full Topic (M2.PD.15.5) A 5-year-old male is brought to the pediatrician by his mother, who relates a primary complaint of a recent history of five independent episodes of vomiting over the last 10 months, most recently 3 weeks ago. Each time, he has awoken early in the morning appearing pale, feverish, lethargic, and complaining of severe nausea. This is followed by 8-12 episodes of non-bilious vomiting over the next 24 hours. Between these episodes he returns to normal activity. He has no significant past medical history and takes no other medications. Review of systems is negative for changes in vision, gait disturbance, or blood in his stool. His family history is significant only for migraine headaches. Vital signs and physical examination are within normal limits. Initial complete blood count, comprehensive metabolic panel, and abdominal radiograph were unremarkable. What is the most likely diagnosis? QID: 105403 Type & Select Correct Answer 1 Reye's syndrome 0% (0/28) 2 Intracranial mass 11% (3/28) 3 Cyclic vomiting syndrome 86% (24/28) 4 Gastroesophageal reflux 0% (0/28) 5 Intussusception 0% (0/28) M 6 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 3 Review Tested Concept Review Full Topic (M2.PD.15.21) A 1-year-old male presents to his pediatrician for a well-child visit. Through a history from the mother and physical examination, the pediatrician learns that the baby babbles non-specifically, takes several steps independently, and picks up his cereal using two fingers. His weight is currently 22 lbs (birth-weight 6 lbs, 9 oz), and his height is 30 inches (birth length 18 inches). Are there any aspects of this child's development that are delayed? QID: 105419 Type & Select Correct Answer 1 Inadequate growth 4% (1/26) 2 Language delay 77% (20/26) 3 Gross motor skill delay 0% (0/26) 4 Fine motor skill delay 4% (1/26) 5 There are no developmental concerns 12% (3/26) M 6 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 2 Review Tested Concept Review Full Topic (M2.PD.15.52) A mother brings her 4-year-old son to his pediatrician. Over the last eight months, her son has been exhibiting several "odd" behaviors. Most importantly, he repeatedly says that he is playing games with a friend named "Steven," though she is certain that he does not exist. She has often found him acting out magical scenarios as though someone else is present, when no one is there. What is the most likely diagnosis in this patient? QID: 105450 Type & Select Correct Answer 1 Developmental delay 0% (0/25) 2 Schizophrenia 0% (0/25) 3 Normal development 92% (23/25) 4 Schizoid personality disorder 4% (1/25) 5 Schizophreniform disorder 0% (0/25) M 6 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 3 Review Tested Concept Review Full Topic (M2.OMB.4843) A 3-year-old girl is brought to the office for a routine well-child appointment. She was delivered preterm at 35 weeks, and her medical history is significant for several ear infections over the last year. Her older brother has been diagnosed with attention-deficit hyperactivity disorder (ADHD), but the rest of her family history is otherwise unremarkable. The patient has become more withdrawn lately and has sometimes been ignoring her parents when asked to perform tasks at home. This seems to have worsened over the last 8 weeks. Otherwise, the patient is energetic and started preschool 3 months ago. Her temperature is 98.6°F (37°C), blood pressure is 98/62 mmHg, pulse is 97/min, and respirations are 26/min. The patient successfully draws a square and can stand on 1 foot. Her language skills are unchanged from her appointment 6 months ago. Her neurological examination is normal, and she is at the 50th percentile for height and weight. She seems distracted during the interview and responds only intermittently to the physician’s directions. Which of the following is the most appropriate next step in management? QID: 216239 Type & Select Correct Answer 1 Audiometry testing 59% (40/68) 2 Autism spectrum screening questionnaire 21% (14/68) 3 Parent and teacher ADHD rating scales 7% (5/68) 4 Refer to genetic testing 7% (5/68) 5 Speech and language assessment 1% (1/68) M 10 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 1 Review Tested Concept Review Full Topic Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK
All Videos (1) Login to View Community Videos Login to View Community Videos Breath Holding Spells Greg Kurkis Pediatrics - Normal Development Landmarks D 3/4/2015 354 views 5.0 (3) Pediatrics | Normal Development Landmarks Pediatrics - Normal Development Landmarks Listen Now 10:27 min 8/17/2021 151 plays 3.7 (3)