Development and Behaviour – Exam Review Set 4

What this deck covers

Development and Behaviour – Exam Review Set 4 in 50 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. The gap that widened
2. Fifteen words at two
3. A different word every attempt
4. Half of what the nursery hears
5. The band under the tongue
6. Clutter is what defeats him
7. Late to move, quick to listen
8. Two attempts, still no answer
9. Two tests, two different answers
10. Before the first day of class
11. She ate everything as a baby
12. Since the day he choked
13. Only ever given puree
14. Fed, thriving, no appetite
15. Wet only when she laughs
16. Only where he chooses, standing up
17. Dry in the holidays
18. Twenty times a day, none at night
19. Never seen a dentist
20. The child who never asks
21. Always lying the same way
22. Planning the first period
23. The hunger that never switches off
24. Liveliest at two in the morning
25. Ordinary looks, ruined planning
26. Rocking and banging at bedtime
27. Crashing the toy cars again
28. The child who checks her face
29. Should she come on the day?
30. A year on, nothing has moved
31. He knows all her tablets
32. Just flavoured water, he says
33. Four hours, and nothing lost
34. The boyfriend she met online
35. Asked with a parent in the room
36. Four visits, nobody asked
37. A voice that is not there
38. Top sets last year, failing now
39. Only one person filled it in
40. What the six-week check is for
41. Four passes and one fail
42. Taken once, over a hat
43. What the two-year review asks
44. The mouth ahead of the hand
45. Disruptive once he has finished
46. The cheapest test comes first
47. The child nobody screened
48. Skills she used to have
49. Three years and no answer
50. When the scan is earned

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Cerebral palsy, Gastro-oesophageal reflux disease, for, Advice on brushing alone, Arrange a hysterectomy now, Attachment difficulty from the adoption, His school lateness, As emerging psychosis, to, A repeat hearing screen, Confirming that the child is walking, A chromosomal microarray.

Clinical pearls from this deck

• A late talker understands and catches up. When comprehension is affected too and the gap widens past four, the language itself is the disorder.
• At two it is what surrounds the words that decides: understanding, pointing, sharing and play intact means a late talker, and most of them catch up.
• The same word, different every time, and worse the longer it gets: the plan for the movement is what is missing, not the sounds and not the words.
• Ask the stranger, not the parents: half at two, three quarters at three, and all of it by four. A four-year-old at half needs therapy, not another year.
• A tongue tie counts only when it stops the tongue moving. If it lifts, protrudes and moves sideways, cutting it will not clear the speech – therapy will.
• Normal eyes, reactive pupils and a child who sees one bright thing in a dark room but nothing in a busy one: the fault is behind the eye, and the treatment is the environment.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all development and behaviour case decks · pediatric reference values.