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what are the placental transfer classifications?
- high placental transfer
- Crosses the placenta rapidly and at equilibrium
- Limited placental transfer
- Fetal concentrations are lower than mothers
- Excess placental transfer
- Fetal concentrations are higher than mothers
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how do antibiotics cross the placenta?
- penicillins: High ampicillin, amoxicillin, methicillin
- Cephalosporins limited cefotamine, cefuroxime
- Aminoglycosides limited gentamycin, kanamycin
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Q: what antiviral drugs cross the placenta?
A: Antiviral high acyclovir, ganciclovir
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Q: what are postnatal factors that effect vision?
- Malnutrition
- Environmental imbalances
- Medication during breast feeding
- O2 deprivation
MEMO
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Q: what is the progression of the grasp?
- A: before 4 mo purely reflex
- By 4 mo can grab objects at will
- By 6 mo move objects between hands
- By 8 mo grab and release obj at will
- By 1 yr pincer grasp
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Q: what are the gross motor milestones?
- A: by 4 mo roll over
- By 7 mo lift head, creep (20% only do ipsilateral)
- 5-8 mo sit
- 8-10 mo crawl
- 9-10 mo first aided steps
- 11 mo stand up alone with furnature
- 12 mo walk
- 15 mo kneel and stand up
- 18-24 mo coordinate different movements
- 24 mo jump, run, tiptoe, walk up and down stairs one at a time
- 36 mo accelerate, turn, and stop
- 3-5 yr alternate step going up and down stairs
- 4 yrs balance, climb trees
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Q: what are the fine motor milestones?
- A: by 6 mo put things in mouth
- 12 mo pincer grasp
- 24 mo pick up book
- 36 mo self- feed with spoon
- 3-4 yr manipulate writing instruments in tripad form
- 5 yr cut with scissors
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Q: what are the 4 periods of cognitive development?
A: sensorimotor Preoperational Concrete operations Formal operations
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Q: what are the visual motor initegration milestones?
- A: by 2 yr | copy
- 36 mo - copy
- 39 mo O copy
- 40 mo | draw byself
- 3 yr draw l and O byself
- 4 yr 1 mo +
- 4 yr 4 mo /
- 4 yr 6 mo draw a square
- 4 yr 7mo
- 4 yr 11 mo oblique cross
- 5 yr 3 mo triangle
- 5 yr 6 mo open square and circle
- 5 yr 9 mo 3 line cross
- 8 yr 1 mo vertical diamond
- 10 yr 11 mo horizontal diamond
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Q: what are the 6 stages of sensory motor?
- •Stage1: reflex, birth to 1 month
- Cannot distinguish self from environment
- •Stage 2: primary: circular reaction, 1-4 months
- Hand-mouth coordination, anticipates
- simple events
- •Stage 3: secondary: circular motion, 4-10 months
- Imitate, hand-eye coordination, increased
- manipulation of objects
- •Stage 4: coordination schemas, 10-12 months
- Anticipates events at specific times,
- uses learned responses in different situations
- •Stage 5: tertiary: circular reaction, 12-18 months
- Learn from trial and error, uses
- different objects to explore surroundings
- •Stage 6: symbolic representation, 18-24 months
- Imitate in absence of mode, imagination
- starts to show, imagination is used to represent objects, starts to solve problems which indicate “thought”, “memory” creation is essential
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Q: what is sensorimotor?
- A: birth to 2 yrs, thinking associated with immediate sensorymotor
- Needs immediate interaction with object to exist
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Q what is the preoperation period
- A: 2- 7 years, symbol systems evolve, develops concept of time, space and quantitiy
- Cannont conceive changes from one state to another
- Learns to classify ideas and things into categories
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Q: what is the concrete operations period?
A: 7-11 years, conceives how objects change, conservation of mass, reverse thinking, decentration
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Q: what is the formal operations period?
A: 11 yrs +, abstract thought, thoughts about objects and thoughts, considers different alternatives for same problem, deals with ideas contrary to fact, metaphors or symbols of symbols
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Q: What are the language development milestones?
- A: 6 mo imitation, (ma-ma, da-da)
- 7 mo understands pitch
- 12 mo simple words
- 13-15mo visual and auditory memory
- 15-18 mo follows simple instrutions
- 21 mo 50 words
- 24 mo complete sentences
- 3 yr 900 words, 3-5 word sentences
- 5 yr 1500 words
- 7 yr elaborate conversations
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Q: what are the emotional development milestones
- A: 6 mo attachments
- 7-8 mo anxiety
- 7-10 mo optimal attachments
- 12 mo loose attachments
- 24 mo potty training, temper tantrums
- 3-4 yr develops self estem
- 6-7 yr nervous tics
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Q: what is the growth progression of the volume of the orbit?
- A: from birth to 1 yr more than doubles biggest growth
- From 1-5 yrs nearly doubles again
- 5 ys to adult nearly doubles again
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Q: what is the shape of the orbit like at birth compared to an adult?
- A: opening more circular,
- Lacrimal fossa more conical (lateral in adults)
- Roof larger and flatter
- Palbebral fissure grows vertical then horizontal
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Q: what conditions might change the shape of the developing orbit?
- A: Lymphangioma
- Rhabdomyosarcoma
- Neuroblastoma
- Dermoid cysts
- Teratoma
- Fibrodysplasia
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Q: what is the normal IOP in newborns?
A: 9.56
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Q: when are the EOMs adult relations reached?
A: by 20 mo.
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Q: what are the cones like in an infant?
A: shorter and broader, less densely packed
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Q: when do cones become adult-like?
A: by 4 yo
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Q: what is the total refractive power of a newborn eye
A: +85D
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Q: what is the expected refractive condition of a newborn?
A: +2.4D
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Q: What is the avg axial length of a newborn eye?
A: 6 mm smaller than adult (15.74mm)
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Q: how long does emmetropization follow expected pattern?
A: up to 4-6 years
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Q: What is the expected spherical error in infants?
- A: newborns (pl - +4D)
- By 6-8 yo (-0.62D - +0.62D)
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Q: what is the predicted astigmatism magnitude in children?
- A: newborns 1.5D
- 18 mo 0.75
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Q: what is the order of speed in reduction of astigmatism?
A: WR > OA > AR
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Q: What are the trends of variations of refractive conditions
- A: premies tend to be myopic at birth
- If hyperopia is equal non/cyclo (w/i 0.75D) Tends to remain hyperopic
- If hyperopia is greater with cyclo regression to emmetropia
- If myopia is milder w. cyclo myopia likely to decrease
- If high myopia w/o cyclo tend to be stable myopia
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Q: what are the predisposing factors to developing myopia?
- A: spherical error +0.50D to pl by ages 5-6yo
- AR astigmatism by 5 yo
- Esophoria
- Inheritance 40% if one parent has myopia, 70% if both have myopia
- Congenital tends to remain high through life
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Q: what do you need to know about juvenile myopia?
- A: age of onset 6-15 yo
- Avg progression 0.5D/yr for up to 6 yrs
- Seldom progresses more than 6D
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Q: what do you need to know about young adult myopia?
- A: mostly seen in college students
- Progression 2-3D
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Q: what drugs have limited placental transfer?
- Cephalosporin (antibiotic)
- Aminoglycosides (antibiotic)
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Q: what drugs have excessive placental transfer?
- Anticonvulsants
- Benzodiazepines (anxiolytics and sedatives)
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Q: What are the four basic models of vision care?
- Medical
- Optical
- Functional
- Behavioral
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Q: what are the ethnic factors in myopia?
- A: blacks higher incidence of severe myopia, lower for juvenile and young adult myopia
- Chinese/Japanese higher incidence of high myopia by adolescence
- Jews
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