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Growth and Development
Growth and Development Review for American Board of Pediatrics (ABP) Board Certification Exam
115
Medical
Professional
10/01/2012

Additional Medical Flashcards

 


 

Cards

Term
Birth Weight "Pearls"
Definition

Birth weight

Doubles by 5 months

Triples by 1 year

Quadruples by 2 years

Term
HEAD CIRCUMFERENCE "PEARLS"
Definition

Normal HC at birth (Term) = 35cm

HC at 12 months, 35+12 = 47cm

Term

GROSS MOTOR MILESTONES

(First Year of Life)

Definition
  • 3 Months - Supports chest in prone on outstretched arms (Puppy prop)
  • 6 Months - Sits with trunk support only (no hands)
  • 9 Months - Creeping
  • 12 Months - Walking
Term

Gross Motor Milestones

1 Month

Definition
Turns and Lifts Head Up In Prone
Term

Gross Motor Milestones

2 Months

Definition
Lifts Head and Chest up in Prone
Term

Gross Motor Milestones

3 Months

Definition
  • "Puppy prop" Weight Supported on Forearms with Head Up, Chest Clears Mat

 

  • Some Head Lag on Pull to Sit
Term

Gross Motor Milestones

4 Months

Definition
  • Chest Off the Mat with Weight Bearing on Extended Arms in Prone

 

  • Rolls Front to Back

 

  • Head Even on Pull to Sit
Term

Gross Motor Milestones

5 Months

Definition
  • Rolls Back to Front

 

  • Leads with Head on Pull to Sit
Term

Gross Motor Milestones

6 Months

Definition
Tripod Sitting
Term

Gross Motor Milestones

7 Months

Definition
  • Sits Without Support

 

  • Commando/Combat Crawl
Term

Gross Motor Milestones

8 Months

Definition
  • Assumes Sitting Position

 

  • Can Reach From Quadruped (Hands and Knees)
Term

Gross Motor Milestones

9 Months

Definition
  • Pulls to Stand

 

  • Creeps on Hands and Knees
Term

Gross Motor Milestones

10 Months

Definition
Cruises
Term

Gross Motor Milestones

11 Months

Definition
Stands without Support
Term

Gross Motor Milestones

12 Months

Definition
Walks
Term

Gross Motor Milestones

18 Months

Definition
  • Runs
  • Pushes Large Object
  • Throws Ball From Standing
  • Can Ascend and Descend Stairs With One Hand Held
Term

Gross Motor Milestones

24 Months

Definition
  • Runs Well
  • Kicks Ball
  • Jumps in Place
  • Throws Ball Overhand
  • Ascends/Descends Stairs by Placing BOTH Feet on Each Step
Term

Gross Motor Milestones

36 Months

Definition
  • Pedals a Tricycle (3 years/3 wheels)
  • Ascends Stairs by ALTERNATING Feet
  • Descends by placing BOTH Feet on Each Step
Term

Gross Motor Milestones

4 Years

Definition
  • Hops 5 Times
  • Balances on One Foot for 5 Seconds
  • Ascends/Descends Stairs by Alternating Feet
Term

Gross Motor Milestones

5 Years

Definition
  • Skips by Alternating Feet
  • Hops in Place 10 Times
  • Balances on One Foot for Over 10 Seconds
Term

Gross Motor Milestones

6 Years

Definition
  • Hops on One Foot for 15 Feet

 

  • Running Broad Jump of 2-3 Feet
Term

Gross Motor Milestones

7 Years

Definition
Rides a Bike
Term

Stair-Climbing Abilities

Definition
  • 18 months:
    • Ascend/Descend with one hand held
  • 2 years:
    • Ascend/Descend by placing BOTH feet on each step
  • 3 years:
    • Ascend with ALTERNATING feet
    • Descend by placing BOTH feet on each step
  • 4 years:
    • Ascend/Descend by Alternating feet
Term
Gross Motor "Red Flags"
Definition
  • Rolling before 3 months
  • Poor head control at 5 months
  • Not sitting by 9 months
  • Persistence of Moro, ATNR or tonic labyrinthine reflex past 6 months
  • Hand dominance before 18 months
  • Not walking independently by 18 months
Term
Tower Building Skills
Definition

14 months -----> Tower of 2 cubes


16 months -----> Tower of 3 cubes

 

18 months -----> Tower of 4 cubes

 

22 months -----> Tower of 6 cubes

 

36 months -----> Tower of 9 cubes

Term

Fine Motor Milestones

3 Months

Definition
Hands unfisted most of the time
Term

Fine Motor Milestones

6 Months

Definition
Transfers hand to hand across midline
Term

Fine Motor Milestones

9 Months

Definition
Inferior pincer grasp of pellet
Term

Fine Motor Milestones

10 Months

Definition
Mature pincer grasp of pellet
Term

Fine Motor Milestones

12 Months

Definition
Releases cube voluntarily into a cup
Term

Fine Motor Milestones

16 Months

Definition
Releases pellet into container
Term
Can support chest in prone position on outstrecthed arms
Definition
3 months
Term
Sits with trunk support only (no hands)
Definition
6 months
Term
Creeping
Definition
9 months
Term
Walking
Definition
12 months
Term
Lifts and Turns Head in Prone
Definition
1 month
Term
Lifts head and chest up inprone
Definition
2 months
Term
Weight supported in forearms with head up, chest clears mat
Definition
3 months
Term
Head lag on pull to sitting
Definition
3 months
Term
Chest off mat with weight bearing on extended arms in prone
Definition
4 months
Term
Rolls front to back
Definition
4 months
Term
Head even on pull to sitting
Definition
4 months
Term
Rolls back to front
Definition
5 months
Term
Leads with head on pull to sitting
Definition
5 months
Term
Tripod sitting
Definition
6 months
Term
Sits without support
Definition
7 months
Term
Commando/Combat crawl
Definition
7 months
Term
Assumes sitting and can reach from quadruped (hands and knees)
Definition
8 months
Term
Pulls to stand
Definition
9 months
Term
Creeps on hands and knees
Definition
9 months
Term
Cruises
Definition
10 months
Term
Stands without support
Definition
11 months
Term
Walks
Definition
12 months
Term

Runs

Pushes Large Object

Throws Ball From Standing

Definition
18 months
Term

Runs Well

Kicks Ball

Jumps in Place

Throws Ball Overhand

Definition
24 months
Term
Pedals a Tricycle
Definition

36 months

(3 years/3 wheels)

Term

Hops 5 times

Balances on one foot for 5 seconds

Definition
4 years
Term

Skips by alternating feet

Hops in place 10 times

Balances on one foot for over 10 seconds

Definition
5 years
Term

Hops on one foot for 15 seconds

Running broad jump of 2-3 feet

Definition
6 years
Term
Rides a bike
Definition
7 years
Term
Ascends/Descends stairs with one hand held
Definition
18 months
Term
Ascends/Descneds stairs by placing both feet on each step
Definition
2 years
Term
Ascends stairs by alternating feet, Descends stairs by placing both feet on each step
Definition
3 years
Term
Ascends/Descends stairs by alternating feet
Definition
4 years
Term
Hands unfisted most of the time
Definition
3 months
Term
Transfers hand to hand across midline
Definition
6 months
Term
Inferior pincer grasp of pellet
Definition
9 months
Term
Mature pincer grasp of pellet
Definition
10 months
Term
Releases cube voluntarily into a cup
Definition
12 months
Term
Releases pellet into a container
Definition
16 months
Term
Tower of 2 cubes
Definition
14 months
Term
Tower of 3 cubes
Definition
16 months
Term
Tower of 4 cubes
Definition
18 months
Term
Tower of 6 cubes
Definition
22 months
Term
Tower of 9 cubes
Definition
36 months
Term
Looks Toward Voice
Definition
4 months
Term
Turns Toward Voice
Definition
6 months
Term
Understands "No"
Definition
10 months
Term
Orients to Name
Definition
10 months
Term
Follows Command With Gesture
Definition
12 months
Term
Follows Command Without Gesture
Definition
14 Months
Term
Points to a Body Part
Definition
15 months
Term
Points to 3 Body Parts
Definition
18 months
Term
Points to Self
Definition
18 months
Term
Follows 2-Step Commands
Definition
24 months
Term
Understands me/you
Definition
24 months
Term
Protodeclarative/Protoimperative pointing should ALWAYS be present by . . .
Definition
18 months
Term
Social smile
Definition
2 months
Term
Coos
Definition
2 months
Term
Babbles
Definition
6 months
Term
Waves Bye
Definition
9 months
Term
"Dada/Mama" Appropriate
Definition
10 months
Term
First Word
Definition
11 months
Term
Names One Object
Definition
14 months
Term
Says "No" Meaningfully
Definition
14 months
Term
Protodeclarative Pointing
Definition
14 months
Term
By 18 months, should have how many words?
Definition
10-25
Term
By 24 months, should have how many words?
Definition
50+
Term
Vocabulary Milestones
Definition

1 year ---> 2 words

2 years ---> 2 word sentences

Term

Receptive Language Milestones

(4, 6, 10, 12, 14, 15, 18 and 24 months)

Definition
  • 4 months: Looks Toward Voice
  • 6 months: Turns Toward Voice
  • 10 months: Comprehends "No", Orients to Name
  • 12 months: Follows Command With Gesture
  • 14 months: Follows Command Without Gesture
  • 15 months: Points to Body Part
  • 18 months: Points to 3 Body  Parts and Self
  • 24 months: 2-Step Commands, Understands me/you
Term

ExpressiveLanguage Milestones

(2, 6, 9, 10, 11, 14, 18 and 24 months)

Definition
  • 2 months: Social Smile, Cooing
  • 6 months: Babbles
  • 9 months: Waves Bye
  • 10 months: Dada/Mama Appropriate
  • 11 months: First Word
  • 14 months: Names 1 Object, Meaningful "No", Protodeclarative Pointing
  • 18 months: 10-25 Words
  • 24 months: 50+ Words
Term
Expressive Language "Bottom Lines"
Definition
  • Vocabulary
    • 1 year  ---> 2 Words
    • 2 years ---> 2 Word Sentences

 

  • "Understandability"
    • 2 years ---> 2/4 (50%)
    • 3 years ---> 3/4 (75%)
    • 4 years ---> 4/4 (100%)
Term
Object Permanence Develops By What Age?
Definition
1 year
Term

Social/Emotional Milestones

(15-18, 18-21, 21-24 months)

Definition
  • 15-18 months: 
    • Awareness of self with coyness
    • Awareness of shame and Guilt
  • 18-21 months: 
    • Associates feelings with words (Happy/Sad)
    • Initiates Interactions With Adults
  • 21-24 months: 
    • Imitates to Please Others
    • Parallel Play
    • Modulates Emotional Expression by Social/Cultural Influences
Term
Leading Preventable Cause of Cognitive Impairment
Definition
Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Spectrum Disorder (FASD)
Term
Leading Genetic Causes of Cognitive Impairment
Definition

Fragile X (Most are fertile)

Down Syndrome

Term
Cognitive Impairment Evaluation
Definition
  • Clinical History
  • 3-Generation Family HIstory
  • Dysmorphologic Examination
  • Neurologic Examination (MRI if there is a DEFINITE neurologic abnormality)
  • Targeted Studies for Metabolic Disorders

 

  • Consider: EEG/Serum Lead
Term
Fetal Alcohol Syndrome
Definition
  • Characteristic facial anomalies
    • Short palpebral fissures
    • Flat upper lip
    • Midface hypoplasia (flattened philtrum and midface)
  • Evidence of Growth Retardation
    • Low Birth Weight
    • Decelerating weight gain over time not related to nutrition
    • Disproportionately low weight-to-height ratio
  • CNS Neurodevelopmental Abnormalities
    • Microcephaly
    • Structural Brain Abnormalities
      • Microcephaly
      • Agenesis of Corpus Callosum
      • Cerebellar Hypoplasia
    • Hard or soft neurologic signs
      • Hearing Loss
      • Fine Motor Coordination
      • Difficulty with tandem gait
      • Poor hand-eye coordination
Term
Alcohol related Birth Defects
Definition
  • Cardiac
    • ASD/VSD/TOF
  • Skeletal
    • Clinodactyly, pectus, nail hypoplasia, scoliosis, radial-ulnar stenosis, flexion contractures
  • Renal
    • Dysplastic/hypoplastic/aplastic, Horseshoe, Hydronephrosis
  • Ocular
    • Strabismus, refractive problems
  • Auditory
    • Neurosensory or conductive loss
Term
Fragile X Syndrome
Definition
  • Greater then 200 repeats of CGG in FMR1 gene
  • Males more severely affected (IQ 50-70). Females may be borderline normal
  • MOST COMMON HERITABLE CAUSE OF COGNITIVE IMPAIRMENT
Term
Physical features of Fragile X
Definition
  • Large ears
  • Connective tissue differences: soft skin, flat feet, pectus excavatum, high palate
  • Low muscle tone
  • Flexible joints
  • Long face
  • Large testicles (after puberty)
  • Seizures (20%)
Term
Behavioral features of Fragile X
Definition

Speech/Language Delay

Delayed crawling, walking, toileting

Tactile defensiveness (Sensory integration)

Impulsivity

Autism Spectrum D/O's

Cognitive impairments (Borderline to Mild MR)

+FH of CI, LD or ASD's

+FH of Adult-onset ataxia/tremor

Term

Down Syndrome (Dysmorphology)

[7 features]

Definition

Small Brachycephalic Head
Epicanthal folds
Upslanting palpebral fissures
Flat Nasal Bridge

Simian Crease
Wide space between first and second toes
Clinodactyly (5th finger does not pass DIP of 4th finger)

Term

Down Syndrome (Medical Conditions)

[5 with >50% occurence]

Definition
  • Variable CI
  • Hearing Loss Risk (75%) [Screen q6 months]
  • OSA (50-79%) [Sleep eval before age 4]
  • Eye disease [cataract, refractive error] (60%)
  • Congenital Heart Dz [AV Canal, VSD, TOF] (50%) [ECHO prior to leaving hospital]

 

 Atlantoaxial xrays no longer routinely recommended


Term
Rett's Syndrome
Definition
  • Females
  • Normal HC at birth
  • Normal development until 6 months
  • Between 6m and 30m, head growth slows and loss of language and social skills
  • Purposeful hand movements lost
  • Stereotyped hand movements ("Wringing" or "Washing")
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