Explanation:

Reassure the mother and recommend close observation

Explanation:

Pervasive developmental disorder

Explanation:

10% glucose solution

Explanation:

Medulloblastoma

Explanation:

A basilar skull fracture

Explanation:

Reassure the mother and recommend close observation

Explanation:

Begins to copy some capital letters

Explanation:

Child protection service (CPS) or children´s aid society (CAS) is a service physician or the general public can contact and report suspected cases of child neglect or abuse.
CPS agencies generally perform a series of functions as follows:
They receive reports of child maltreatment allegations. Then they determine if a received report´s allegations meet statutory definitions for child maltreatment.
If a received report is accepted, then CPS “investigates” or “assesses” the allegations through contacts with the family and pertinent collateral-information providers.
If the child-maltreatment allegations prove sufficiently credible and/or if the family is in need of services to prevent future maltreatment, they are generally provided.
If the child´s remaining in the home creates an imminent or significant long-term risk to the child´s safety, then arrangement for the child´s placement outside of the home is made either with the family´s consent or through the courts.

Explanation:

Building tower of four blocks or more, running, handling a spoon well and scribbling spontaneously occur up to the age of 2. Copying some capital letters occurs at end of 4 years.

Explanation:

A post-traumatic air-fluid level in the sphenoid sinus is associated with basilar skull fractures. This finding is frequently noted on a cervical spine films.
Orbital floor fractures may be associated with double vision, fluid in the maxillary sinus, an air-fluid level in the maxillary sinus, and diplopia. Epidural hematomas are more frequently associated with skull fractures in the area of the meningeal artery. Zygomatic fractures are more visible on Towne´s view. Characteristic swelling and lateral V orbital bruising are typically present. Mandible fractures may be associated with dental misalignment or bleeding. Panoramic views are often diagnostic.

Explanation:

Reflex syncope is a strong diagnostic consideration for episodes of syncope associated with a characteristic precipitating factor. The major categories of syncope include carotid sinus hypersensitivity, and neurally mediated and situational syncopes. The most common and benign forms of syncope are neurally mediated or vasovagal types with sudden hypotension, frequently accompanied by bradycardia. Other terms for this include neurocardiogenic, vasomotor, neurovascular, or vasodepressive syncope. Most patients are young and otherwise healthy. The mechanism of the syncope seems to be a period of high sympathetic tone (often induced by pain or fear), followed by sudden sympathetic withdrawal, which then triggers a paradoxical vasodilation and hypotension. Attacks occur with upright posture, often accompanied by a feeling of warmth or cold sweating, lightheadedness, yawning, or dimming of vision. If the patient does not lie down quickly he or she will fall, with the horizontal position allowing a rapid restoration of central profusion. Recovery is rapid, with no focal neurologic sense of confusion or headache. The event can be duplicated with tilt testing, demonstrating hypotension and bradycardia.

Explanation:

The etiology of cerebral palsy is not well understood, and brain lesions are though: to be associated with prenatal, perinatal, or postnatal events of varying causes. Risk factors for cerebral palsy are multifactorial and can include preterm birth, multiple gestation, intrauterine growth restriction, male sex, low Apgar scores, intrauterine infections, maternal thyroid abnormalities, prenatal strokes, birth asphyxia due to seizures, maternal methyl mercury exposure, and maternal iodine deficiency.

Explanation:

A child usually is not able to pull him or herself to sitting position until he or she reaches 40 weeks of age. At 28 weeks, however, the child is likely to sit with hands forward for support. The other answer choices correctly reflect normal gross motor development of an infant.

Explanation:

Phototherapy is the treatment of choice for pathological neonatal hyperbilirubinemia. Exchange transfusions and Phenobarbital can also lower serum bilirubin, but phototherapy has supplanted them as the safest and most effective primary therapy. Diphenylhydantoin is not useful. Adequate hydration is beneficial but not a mainstay of treatment by itself.

Explanation:

The Sensorimotor stage of Piaget´s Stages of Cognitive Development is marked by the ages younger than two years. During this time, the infant explores his new surroundings and aims to control and manipulate his environment. It is at this time that the infant realizes that he is different than the external world; and. subsequently a sense of self-identity is achieved.

Explanation:

Gender identity typically develops between the ages of three to seven years.

Explanation:

At the age of two, a child is expected to reach 20% of his or her expected adult weight.

Explanation:

In babies three to eighteen months old, the three most common causes of purulent meningitis are H. influenza, N. meningitidis, and S. pneumoniae. Meningitis caused by L. monocytogens, S. aureus, and Gram-negative rods is typically not seen in newborn infants. Klebsiella may cause meningitis in immunocompromised.

Explanation:

The infant has erythroblastosis fetalis, caused by an immune attack by the mother´s antibodies on the infant´s Rh-positive, antigen-bearing red cells. Infants with severe hydrops fetalis experience severe anemia with cardiac decompensation leading to increasing edema and free hemoglobin overload with high serum bilirubin levels. While the skin pigmentation (jaundice) is the most obvious effect of the elevated bilirubin, the most dangerous effect is toxic damage to the developing central nervous system (notably basal ganglia including the caudate nucleus, thalamus, cerebellum, cerebral gray matter, and spinal cord), known as kernicterus. The adenohypophysis, amygdala, corpus callosum, and pons are not particularly vulnerable to damage by bilirubin.

Explanation:

Partial simple seizure is seen in association with focal muscle twitching, usually involving either the arm or the leg. It is often preceded by a lesion in the cranium, such as an infarct or tumor. Partial simple seizures) are seen most often in adults. Partial complex seizures are seen in children, and often are associated with lip smacking and staring. Patients with partial complex seizures demonstrate semi purposeful actions and their seizures are often preceded by sensory delusions, such as a deja vu experience or smelling abnormal odors. Generalized absence seizures are also known as petit mal seizures. They are seen in children, and often are only recordable by a brief episode of staring. Generalized tonic clonic seizures are also known as grand mal seizures. They are characterized by jerking of the extremities and muscle contraction. Sometimes there can be loss of consciousness and biting of the tongue. Finally, alcohol withdrawal seizures are manifested between one and four days after cessation of alcohol consumption. These are typically isolated seizures and are characterized as grand mal seizures.

Explanation:

Arnold Chiari malformations are among the most frequent congenital anomalies of the CNS. Arnold Chiari type 2 is associated with an abnormally small posterior fossa, with resultant downward displacement of cerebellar vermis and medulla through the foramen magnum. This leads to obstruction of CSF flow and hydrocephalus. Important associated abnormalities include lumbar myelomeningocele and syringomyelia. Arnold Chiari type 1is more frequent than type 2 and consists of downward displacement of the cerebellar tonsils through the foramen magnum. Type 1 is frequently asymptomatic and an incidental autopsy finding. If severe, obstruction of CSF flow results in hydrocephalus. Anencephaly is the most severe form of neural tube defect, which results from failure of the neural tube to close, either at its rostral end (leading to anencephaly, encephalocele, or encephalomeningocele) or at its caudal end (leading to spina bifida, meningocele, or myelomeningocele). Anencephaly is frequent (1-5 cases/1000 live births) and incompatible with life. The brain is replaced by a disorganized mass of neural tissue and blood vessels exposed to amniotic fluid. A Dandy Walker malformation is associated with an abnormally large posterior fossa. The cerebellar vermis is absent and replaced by a large ependyma lined midline cyst that represents an expanded 4th ventricle. Brainstem nuclei are also abnormal. Holoprosencephaly results from incomplete separation of the cerebral hemisphere along the midline leading, in its extreme form, to a single midline ventricular cavity enclosed within the forebrain. Associated facial anomalies, including the striking cyclopia (a single midline eye in the forehead with associated proboscis), are frequent. Holoprosencephaly is often associated with trisomy 13 and less often with trisomy 18.

Explanation:

The tumor is a craniopharyngioma. Craniopharyngiomas are benign tumors of epithelial cells that are derived from Rathke´s pouch. They may arise in, or more commonly above, the sella turcica. The histologic pattern recapitulates the enamel organ of the tooth with nests or cords of stratified squamous or columnar epithelium embedded in a loose fibrous stroma. Calcification (and even metaplastic bone formation) is common in these benign tumors. These tumors often impinge upon the optic chiasm which can lead to a bitemporal hemianopsia. In addition, they can compress the pituitary gland, resulting in pituitary or adrenal dysfunction, diabetes insipidus, obesity´, growth failure, and hypothyroidism. Galactorrhea is a common presenting symptom of pituitary adenomas, due to hypersecretion of prolactin. Craniopharyngiomas are more likely to cause pituitary dysfunction. Gigantism is the clinical presentation of elevated levels of growth hormone in children before puberty´. In adults, the condition is known as acromegaly. Here also, the tumor is more likely to cause pituitary dysfunction. Infertility may result from tumors involving sex hormones. Since craniopharyngiomas are benign they are not known to metastasize.

Explanation:

Tay-Sachs disease is a severe autosomal recessive disease characterized clinically by mental retardation, blindness, muscular weakness, and death by 3 years of age. The cherry-red spot is a classic clue for Tay-Sachs disease. The disease is prevalent in Ashkenazi (East European) Jews. Hexosaminidase A normally functions to hydrolyze a bond between N-acetylglucosamine and galactose in the polar head of the ganglioside GM2, an N-acetylneuraminic acid-containing glycolipid found in high concentration in the brain. Without hexosaminidase A activity, this ganglioside accumulates, leading to degenerative CNS changes.

Explanation:

Neurofibromatosis (NF) is a multisystem genetic disorder The diagnostic criteria for NF-1 are met if two or more of the following features are present.

• Six or more café-au-lait macules.
• 5 mm in greatest diameter in prepubertal individuals (as in this patient), and 15 mm in greatest diameter in postpubertal individuals
• Freckling in the axillary or inguinal regions
• Optic glioma
• Two or more Lisch nodules (iris hamartomas)
• A distinctive osseous lesion, such as sphenoid dysplasia or thinning of the long-bone cortex
• A first-degree relative with NF-1 according to the above criteria
• Two or more neurofibromas or one plexiform neurofibroma

The findings in the present patient fulfill the diagnostic criteria for NF-1. Seizures occur more often in patients with NF-1, although they are not a frequent complication. Seizures can be of any type and can begin at any age. Seizures can occur in all three of the phacomatoses (NF, tuberous sclerosis, Sturge-Weber), so seizures should not be used to differentiate one from the others. Skeletal manifestations include long-bone dysplasias and scoliosis. Tibial dysplasia presents as bowing of the tibia. Fracture may occur at the site of dysplasia, causing pseudoarthrosis.
Cardiac rhabdomyoma is a feature of tuberous sclerosis. Skin features include hypopigmented macules (ash-leaf macules), facial angiofibromas (adenoma sebaceum), and Shagreen patches (connective tissue nevi). Seizures are the most common presenting symptom.
Cerebral calcification is seen in Sturge-Weber, which is suspected on the basis of facial nevus, glaucoma in the ipsilateral eye, and seizures contralateral to the side of the nevus. The diagnosis of Sturge-Weber is made with skull X-ray or CT showing the calcification. The present patient meets the criteria for NF-1. Diabetes mellitus is another disorder with associated pigmentation of acanthosis nigricans, which is a velvet/thickening and hyperpigmentation of the skin, is often seen on the neck and in the axilla. Acanthosis nigricans is associated with obesity and insulin resistance.
Malignant melanoma should be suspected if a pigmented lesion shows a rapid growth or change in color. Malignant melanoma is rare in children. In addition, the present patient meets the criteria for NF-1 which is not related to malignant melanoma.

Explanation:

The patient described in the vignette has cerebral palsy, which is often accompanied by comorbidities. These conditions include cognitive disability, mental retardation, visual impairment, skeletal malformations, communication disorders, seizures, poor oral-motor function, and poor growth and development. This patient will most likely also have trouble with feeding and constipation. Cerebral palsy is characterized by non-progression of motor impairment, not regression.
Recurrent rashes and tachycardia would not be seen specifically in someone who has cerebral palsy. Tendon releases may be necessary in severe cases of cerebral palsy if contractures occur. The current physical examination does not show any contractures. These are not as common as constipation at this young age.

Explanation:

Haemophilus influenzae is now a rare cause of meningitis in children since development of the Haemophilus influenzae type b (Hib) vaccine. The case reveals a questionable immunization history, thus making this patient susceptible to H. influenzae type b. Kernig´s sign is elicited by placing the patient in supine position, flexing the leg at the hip to 90 degrees and then straightening the knee to elicit pain in the back or posterior thigh as predictive evidence of meningitis.
Laboratory and CSF data support bacterial etiology, and Gram´s stain with growth on chocolate agar confirms the diagnosis of Haemophilus influenzae as the causative agent. Haemophilus ducreyi is the causative agent for chancroid (soft chancre).
Neisseria meningitidis is a gram-negative diplococcus that also can grow on chocolate agar, but grows best on modified Thayer- Martin media. Meningococcal meningitis classically presents with a petechial rash. Streptococcus pneumoniae and Listeria monocytogenes are both organisms that cause meningitis.
Both, however, are gram-positive. Listeria monocytogenes is predominantly seen as cause of neonatal meningitis.

Explanation:

One of the most common causes of meningitis among neonates and infants up to the age of 3 months old is Listeria monocytogenes. Other agents responsible for meningitis in this age group include Escherichia coli and Group B Streptococcus. L.
monocytogenes is more common in those with immune system defects, particularly of the cellular (T cell) immune system and sometimes neutrophil defects. Neonates and the elderly have decreased T-cell immune function; therefore, Listeria is more common in the very young and the very old.
Borrelia burgdorferi is not as common as Listeria among neonates and infants. B. burgdorferi this the etiological agent behind Lyme disease, a zoonotic disease transmitted by ticks. The question will usually give a clue, such as a tick-bite or an annular red rash (the erythema migrans rash that occurs at the site of the tick bite) or a person from Massachusetts, New York, etc.
Cryptococcus neoformans is a fungus that primarily occurs in patients who are immunocompromised, such as those patients who are HIV positive. Although it is common among this patient population, it is not the most common agent to cause meningitis among this population. Cryptococcus is usually associated with those HIV positive patients who have profound decreases fin their T-cell counts to levels less than 100 cells.
Mycobacterium tuberculosis is incorrect as there is nothing in the question stem that points toward this etiological agent (such as a history of TB, cough, weight loss or night sweats). It is not as common as Listeria among neonates and infants.
Neisseria meningitidis is the most common cause of meningitis among adolescents and young adults. It is spread by respiratory droplets and results in the characteristic petechial rash. It is not the most common cause of meningitis among neonates and infants.
Streptococcus pneumoniae is the most common cause of meningitis overall, however, it is not the most common cause of meningitis among neonates and infants.
Treponema pallidum is the causative agent behind syphilis.
It is not the most common cause of meningitis among neonates or infants. Congenital syphilis is divided into early and late stages.
Early stage manifestations appear before 2 years of age and include fever, anemia, failure to thrive, a maculopapular rash, snuffles, hepatosplenomegaly, periostitis of the long bones, and thrombocytopenia. Late-stage manifestations are skeletal and include saber shin, Hutchinson teeth, saddle nose and knee synovitis.
Measles virus being a virus is not as common in this age group.

Explanation:

Explanation:

Duchenne muscular dystrophy is the most common type of muscular dystrophy. It is an X-linked genetic disorder that happens in 1:3,600 boys. It is characterized by progressive muscle weakness caused by degeneration of muscle fibers. The main pathophysiologic mechanism of Duchenne muscular dystrophy is a mutation in the gene that is responsible for the production of dystrophin.
Dystrophin is located on the plasma membrane of muscle fibers. Its function is to stabilize the muscle membrane, thereby protecting it from degradation. Its absence results in degeneration of muscle fibers, causing progressive weakness. The disease is rarely symptomatic at birth but usually develops to clinically evident stage before the age of 5 years. Poor head control can be the first sign. Weakness is prominent in proximal muscles. Affected children often present with toe-walking and difficulty climbing stairs. The gait is waddling, and patients often fall. The Gower sign is characteristic of Duchenne muscular dystrophy. It is considered positive if the patient uses his hands to “walk” up the legs when going from a prone to an upright sitting position because he does not have enough proximal muscle power to rise in a normal fashion. Pseudohypertrophy of the calves is also a prominent feature. Many Duchenne patients die in their 20s because of respiratory, failure. Complaints of leg pain may also be found with early disease.
Juvenile inflammatory myopathy includes juvenile polymyositis (JPM) and juvenile dermatomyositis (JDM). Even though the features of muscle weakness could be similar to Duchenne, affected children with JDM or JPM present with a prodrome of nonspecific findings that includes malaise, muscle pain, fever, and irritability which is often mistaken as a viral illness; Low-grade fever is noted in about 50% of cases. Rash in JDM is characteristic. Moreover, the history of poor head control in a sibling points toward the diagnosis of a genetic disease, especially Duchenne.
Muscle phosphorylase deficiency is seen in McArdle disease, which is inherited in an autosomal recessive pattern. Patients with this condition typically present in adolescence or early adulthood with exercise intolerance with fatigue, myalgia, cramps, myoglobinuria, muscle swelling, and fixed weakness (instead of progressive). McArdle disease is suspected on the basis of the history of exercise-induced symptoms.
Mutations of genes coding for proteins of the nuclear envelope are seen in Emery-Dreifuss muscular dystrophy, a rare, often slowly progressive form of muscular dystrophy that affects the muscles of the arms, legs, face, neck, spine, and heart. The disorder consists of the clinical triad of weakness and degeneration (atrophy) of certain muscles, joints that are fixed in a flexed or extended position (contractures), and abnormalities affecting the heart (cardiomyopathy).
Emery-Dreifuss muscular dystrophy is inherited as an X-linked, autosomal dominant, or autosomal recessive trait Thyroid hormone deficiency in children most commonly manifests with declining growth velocity and short stature. The delay in growth tends to be gradual in onset, and may be present for several years before other symptoms occur, if they occur tall. Other common symptoms are sluggishness, lethargy, cold intolerance, constipation, d[y skin, brittle hair, facial puffiness, and muscle aches and pains.
Physical examination reveals short stature, overweight puffy faces with a dull expression, bradycardia, pseudohypertrophy of the muscles, and delayed deep tendon reflexes. The most common cause of hypothyroidism in children is chronic autoimmune (Hashimoto) thyroiditis. The present patient has adequate growth, and does not have hair and skin abnormalities.

Explanation:

Explanation:

Explanation:

This child has developed hydrocephalus, as indicated by the symptoms of poor feeding, irritability, and reduced activity; and the signs of tense anterior fontanelle, distended scalp veins, sunset sign (eyeballs are deviated downward and upper lids are retracted). He also has a history of prematurity´ and seizures alter birth. These findings are compatible with germinal matrix hemorrhage (GM). The germinal matrix is a highly vascularized layer of neuroectodermal precursors lining the ventricular cavities, which becomes more developed between 22 and 30 weeks of intrauterine life.
The vessels of the germinal matrix are especially vulnerable to hypoxic insults. Babies born prematurely are thus at high risk of hemorrhage in the germinal matrix region, as they often suffer from poor oxygenation.
The pathophysiologic consequences depend on the severity of GM.
Severe forms of GM extend into the ventricles and result in death, or obstructive hydrocephalus and neurologic deficits later in life.
Both types of Arnold-Chiari malformation (more frequently type 2) my lead to obstructive hydrocephalus due to compression of the fourth ventricles by the downward displacement of the cerebellar tonsils, but would not be the most likely cause of this patient´s condition (given his history of prematurity´).
Kernicterus refers to brain damage due to accumulation of unconjugated bilirubin in the central nervous system. This complication occurs in babies suffering from severe forms of jaundice, e.g., those with erythroblastosis fetalis.
Periventricular leukomalacia is incorrect inasmuch as it would not lead to obstructive hydrocephalus. This also occurs in premature babies as a result from ischemic damage, but to the periventricular white matter and not the ventricular lining. In premature infants, the periventricular white matter is also vulnerable to hypoxic injury.
Ulegyria is a complication related to intrauterine hypoxic injury. The depth of the sulci is more prone to ischemia than the crests of the gyri during intrauterine life. A fetus suffering from early cerebral ischemic damage will thus develop atrophy of the base of the gyri, which then acquire a mushroom-like shape (hence the designation: Ulex = mushroom). Germinal matrix hemorrhage, ulegyria, and periventricular leukomalacia are among the consequences of perinatal brain anoxia, and lead to e complex set of neurologic manifestations referred to as cerebral palsy.

Explanation:

This 9-month-old infant presents with failure to thrive, which is determined by the decline in her length and weight to below the 5th percentile. Failure to thrive is failure to gain weight or deceleration of weight growth. Failure to thrive can be either organic or inorganic (i.e., social). Although it is important to identify the causes of organic failure to thrive, most cases are inorganic. In this clinical vignette, since the reduction of weight happened after the mother returned to work, an inorganic cause is likely. One of the most common causes of failure to thrive is improper preparation of the formula, resulting either from an incorrect water- to-formula ratio or from poor mixing techniques. In addition to b obtaining a detailed history of how the formula is mixed, it might be very useful to have the child´s caregiver actually demonstrate how she prepares the formula. In this case, the most likely reason that the infant has failure to thrive is that the grandmother has mixed the formula improperly. Also, a 9-month-old should be eating some regular table foods, including meats, poultry, and vegetables. Hospitalization for documentation of caloric intake would be appropriate if the patient had any signs and symptoms of abuse by deprivation in addition to the inadequate weight gain, such as unkept look, impetiginized diaper rash, flattened occiput with pressure, alopecia secondary to long hours of lying on the back, irritability, and/or poor muscle tone. Lactose intolerance is an uncommon cause of failure to thrive. It usually presents with abdominal pain, bloating, and diarrhea.

Explanation:

The child´s condition is the autosomal recessive disease, ataxia-telangiectasia, which is a multisystem disorder of unknown etiology. The ataxia is noticed in early childhood, and with time, progresses to severe disability. Choreoathetoid movements, slurred speech, ophthalmoplegia, and progressive mental retardation characterize the disease as it advances. Telangiectasias, as described in the question stem, are a helpful diagnostic clue. These children also are vulnerable recurrent sinopulmonary infections.
Immunologic evaluation may demonstrate a lack of IgA and IgE, cutaneous anergy, and a progressive cellular immune defect. Other features of the syndrome include endocrine disorders and a predisposition for certain cancers (leukemias, brain cancer, and gastric cancer). Most of these patients die of their neurologic deterioration by age 30.
IgG and IgM are not specifically affected in this condition.

Explanation:

Vomiting in a 10 month old infant without diarrhea, along with lethargy, dehydration, and a full anterior fontanelle is an ominous sign, pointing towards an intracranial process. In addition, the child is exhibiting posturing, not having seizure, from continued overhydration and increasing intracranial pressure. Accordingly, intravenous dexamethasone must be administered to decrease the intracranial pressure, along with other measures.
Corticosteroids are used in the management of mass lesions such as ´brain tumor and brain abscess, owing to the anti-inflammatory and membrane stabilizing effects. Corticosteroids counteract the vasogenic edema associated with these conditions. The most likely cause of this child´s increased ICP is a brain tumor, although they are a rare occurrence in the pediatric population (about 1 in 25,000 children annually).
Administering another bolus of normal saline would further exacerbate the child´s condition by increasing his ICP. The goal of treatment is to decrease the cerebral fluid load, no increase it Administering fosphenytoin or lorazepam would be appropriate if the child were seizing, but this patient is not having a seizure, so these drugs would be ineffective in treating his condition.
Administering prochlorperazine, an anti-emetic, would only mask the patient´s vomiting, but not treat the underlying condition.

Explanation:

Most infants are expected to triple their birth weight by the age of 12 months. Infants usually double their birth weight by 6 months, not 1 year.
Infants usually quadruple their birth weight by 24 months. Infants usually double their length by 4 years. Infants do not usually triple their length until they are out or infancy and into puberty.

Explanation:

Explanation:

Febrile seizures occur in children < 6 years with body temperature > 38˚C and no previous afebrile seizures and that have no other identifiable cause. Diagnosis is clinical after exclusion of other causes. Treatment of seizures lasting < 15 min is supportive.
Seizures lasting ≥ 15 min are treated with IV lorazepam and, if persistent, IV fosphenytoin. Maintenance drug therapy to prevent recurrent febrile seizures or development of afebrile seizures is usually not indicated unless multiple or prolonged episodes have occurred.

Explanation:

Autism is a neurodevelopmental disorder characterized by impaired social interaction and communication, repetitive and stereotyped patterns of behavior, and uneven intellectual development often with mental retardation. Symptoms begin in early childhood. The cause in most children is unknown, although evidence supports a genetic component; in some, autism may be caused by a medical condition. Diagnosis is based on developmental history and observation. Treatment consists of behavioral management and sometimes drug therapy.

Explanation:

Infantile spasms are characterized by sudden flexion of the arms, forward flexion of the trunk, and extension of the legs. Seizures last a few seconds and recur many times a day. They occur only in the 1st 5 years of life, then are replaced by other types of seizures. Developmental defects are usually present. Absence seizures do not present until age 1-8 years. Febrile seizures would occur when the child has a fever.

Explanation:

Hearing loss can be present at birth or progress over time. Hearing loss can be hereditary or acquired by environmental means. As the majority of children with hearing loss have no other abnormalities or distinguishing features (called non-syndromic hearing loss), many children have late diagnosis of their loss with significant consequences in delay in language acquisition from the delay in diagnosis.
Accurate testing in children can be difficult primarily of a child´s inability to respond during standard testing. Other tests have been developed that require no direct response from children being tested. These tests are utilized in the hospital just after birth (universal screening) that is identifying children with hearing loss at an early age and allowing for early and appropriate therapy. Advances in genetic testing (molecular biology) has led to the ability to diagnose the cause of hearing loss in many felt to previously to have an unknown cause for their hearing loss.

Explanation:

The growth percentiles by themselves don´t say much. What really matters is the velocity of growth. A normal velocity of growth means the child´s growth points will closely parallel the percentile line above it on the chart. Physicians don´t worry about insufficient (or excessive) growth until a child´s growth velocity has crossed at least two percentile lines (e.g., from above the 90th to below the 50th percentile). Additionally, if a child´s weight, height, or head size is below the 5th percentile, they might also call them small for age. In that case, what´s most important is to see if the growth points parallel the 5th percentile line (meaning growth velocity is normal) or if the child is falling further behind (which is more concerning).

Explanation:

Tumors of or near the cerebellum (above the back of the neck), especially medulloblastomas in children, can cause alterations in eye movements, incoordination, unsteadiness in walking, and sometimes hearing loss and dizziness. They can block the drainage of cerebrospinal fluid, causing fluid to accumulate in the spaces within the brain (ventricles). As a result, the ventricles enlarge (a condition called hydrocephalus), and pressure within the skull increases. Symptoms include headaches, nausea, vomiting, difficulty turning the eyes upward, lethargy, and coma with herniation of the brain. In infants, the head enlarges.

Explanation:

Cleft palate if untreated will lead to the baby having feeding problems, speech pathologies and recurrent infections, but in the first months feeding problem have greater importance. Surgical repair can be done at 6-9 months of age.
Cleft lip with partial palate involvement

Explanation:

During the school-aged period, children typically obtain a “best friend.” However, it is not typical until adolescence (>14 years of age) that a child begins to listen and be pressured by these friends (peer pressure).

Explanation:

At 18 months, the child is likely to demonstrate all the characteristics described in the question. He or she also can throw a ball without falling, seat him or herself in a chair, take off his or her gloves and socks, and unzip fasteners.

Explanation:

By the age of five, or approximately at the kindergarten-age level, a child should have garnered the ability to memorize his/her own name, address, and phone number.

Explanation:

The general rule of thumb for infant growth claims that at one year after birth, a normal healthy infant is approximately three times his birthweight. The infant is two times his birthweight at four to five months of age. And after losing weight in the first few days of life, the infant returns to normal birthweight at approximately seven to ten days of age.

Explanation:

By the age of five years, a child should have developed the ability to recite the alphabet without help. If this has not occurred, intelligence testing is indicated to determine whether there are any mental handicaps that are preventing the child from doing so.

Explanation:

Children at the age of five have developed the ability to dress by themselves; however, many mothers still dress the child at this age even though the child can do it alone.

Explanation:

An individual is capable of thought at approximately 18 months. It is at this age when an infant can represent an object in a mental frame- work.

Explanation:

Pyridoxine toxicity while very rare is associated with peripheral sensory neuropathy Vitamin E toxicity may cause a necrotizing enterocolitis and hepatitis in children. Vitamin K toxicity, although uncommon, may cause vomiting and hemolysis, as well as albuminuria and hemoglobinuria. Vitamin D toxicity is associated with hypercalcemia, as well as constipation, and sometimes nephrocalcinosis. Pantothenic acid toxicity is associated with diarrhea.

Explanation:

The optic cups derive from the optic vesicles, which are evaginations of the diencephalon. The anterior two layers of the optic cup (neurectoderm), in association with choroidal mesoderm, give rise to the ciliary body and the iris: The optic cup also gives rise to the neural and pigment layers of the retina.
Retinal ganglion cell axons, which run in the optic stalks, become the nerve fibers of the optic nerve. Closure of the choroid fissure in the optic stalk occurs during the seventh week of development. The former optic stalk is then called the optic nerve. Mesoderm surrounding the optic cup becomes the sclera and choroid of the eye. Mesoderm surrounding the optic stalk gives rise to the meninges surrounding the optic nerve.

Explanation:

Explanation:

Explanation:

This child is presenting with symptoms of Reye syndrome, which is an acute encephalopathy associated with high ammonia levels. It most commonly occurs in young children after a viral illness. Administration of aspirin (the painkiller given to this patient increases the risk of developing this disorder. The lethargy, vomiting, and irritability are characteristic for encephalopathy.
Delirium, seizures, and coma occur.
Renal failure leading to uremia is characterized by an increase in urea nitrogen level. However, the history of illness would be more chronic and the patient´s presentation would be more indicative of renal failure.
Hypercalcemia can cause mental status changes, and management would include intravenous hydration and furosemide. Again, presentation would be more acute, and a history of a malignancy, use of thiazides, milk alkali syndrome, or the like would be elicited. Opiate intoxication would cause pinpoint pupils, depressed breathing, and obtundation. Combativeness should not occur.
Hyponatremia or hypernatremia can cause mental status changes. This patient´s presentation makes this less likely. A history of lung cancer, diuretic use, primary polydipsia, or dehydration would make this diagnosis higher on the differential diagnosis.

Explanation: