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Medicine - Year 2 > Block 11 - Reproduction and the growing child (post-birth) > Flashcards

Block 11 - Reproduction and the growing child (post-birth) Flashcards

1
Q

When can a baby smile?

A

8 weeks

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2
Q

What can hearing loss cause?

A

Speech delay

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3
Q

8 stages of social skill and behaviour development

A 
Smiling
Waving
Peek-a-boo
Stranger danger
Pointing
Imaginative play
Getting undressed then dressed
Toilet training
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4
Q

When are the health visitor check ups?

A

1 year

2-2.5 year

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5
Q

Define consanguineous

A

Parents related

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6
Q

6 generic red flags (not age specific)

A 
Regression
Not fixing and following
Not responding to noise
Early hand preference
Abnormal tone
Persistent toe walking
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7
Q

5 specific red flag symptoms (age specific)

A 
No smile at 8 weeks
Not holding objects at 5 months 
Not sitting at 12 months
Not walking at 18 months
Not pointing at 2 years
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8
Q

Define developmental delay

A

Isolated (1 domanin) or global (4 domains)

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9
Q

Define developmental disorder

A

Skills aquired in a strange order but still moving forward

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10
Q

7 causes of developmental problems

A 
Antenatal insults
Cerebral malformation 
Congenital infection
Deprivation/abuse
Genetic syndromes
Perinatal hypoxia / hypoglycaemia
Postnatal meningitis / trauma / metabolic insult
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11
Q

How many centiles must the weight cross to be diagnosed with FTT?

A

2 centiles

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12
Q

5 causes of FTT

A
  • Inadequate intake (under-nutrition e.g. poor feeding or not given food)
  • Inadequate retention (vomiting)
  • Malabsorption (CF or short gut)
  • Failure to utilise nutrients (renal/liver/metabolism disorder)
  • Increased requirements (malignancy, infection, CF)
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13
Q

What do intra-uterine conditions and pubertal hormones influence?

A

Growth

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14
Q

What are the two classes of FTT?

A

Organic and non-organic

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15
Q

Explain the different causes and classifications of short stature

A

Normal e.g. Genetics or late developer

Pathological can be proportionate or disproportionate
- Disproportionate e.g. rickets, skeletal dysplasia,
achondroplasia
- Proportionate can be prenatal or postnatal

      - Prenatal e.g. genetics, TORCH, IUGR
      - Postnatal e.g. reduced GH, hypothyroidism, 
        cushing's, psychological, other system diseases
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16
Q

Define hypertrophy and hyperplasia

A

Hypertrophy: Increase in cell SIZE
Hyperplasia: Increase in cell NUMBER

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17
Q

Explain the extrinsic and intrinsic pathway of apoptosis

A

Extrinsic: Death receptors in cell membrane –> CAPASE protein cascade + apoptosis

Intrinsic: DNA damage –> CAPASE protein cascade + apoptosis

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18
Q

When is foetal GROWTH the greatest?

A

16-20 weeks

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19
Q

What are cartilage stem cells called?

A

Chondroblasts

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20
Q

Explain how bone is formed

A

Chondroblasts divide and lengthen bone, they enlarge and signal calcification –> calcified cartilage

Osteoclasts digest cartilage and osteoblasts replace it with bone –> trabeculae

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21
Q

What are the indirect actions of growth hormone mediated by?

What are they similar to

A

Insulin-like growth factors (IGFs)

Similar structure to insulin

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22
Q

What are the 2 types of IGFs involved in growth?

A

IGF-1 : Predominant pre-birth ; increased levels cause disproportinate growth

IGF-11 : Increases during childhood ; peaks at puberty then decreases

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23
Q

6 mediators for tissue and organ growth (11)

A

Growth factor (fibroblast, platelet derived, nerve)
Thyroid and parathyroid hormones
Sex hormones (oestrogen, testosterone, prolacin, placental lactogen)
Insulin
Vitamin D
Glucocorticoids

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24
Q

What are the 2 thyroid hormones called?

A

T3 and T4

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25
Q

5 roles of the thyroid hormones

A 
Growth 
Physiological function
Protein synthesis in the brain
Bone growth and maturation 
Forms brain neurones, myelinates, branches dendrites
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26
Q

4 causes of insufficient thyroid hormones

A

Thyroid gland defect
Decrease in Thyroid-Stimuating Hormone
Decrease in Thyrotropin-Releasing hormone
Iodine insufficiency

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27
Q

Which hormone do you give babies with congenital hypothyroidism?

A

T4

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28
Q

Is cortisol a corticosteroid?

A

YES

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29
Q

What can increase levels of corticosteroids?

What can this do to growth?

A

Cushing’s syndrome or therapeutic steroids (e.g. asthma/eczema)
Interferes with bone growth plates

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30
Q

What is somatotrophin?

A

Growth hormone

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31
Q

How do levels of GH change throughout childhood?

A

Increase in infancy, plateau in childhood then increases at puberty

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32
Q

How do levels of TH change throughout childhood?

A

Increased in infancy then slowly declines

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33
Q

What is the most common cause of dwarfism?

A

Achondroplasia

34
Q

What mutation causes achondroplasia?

4 impacts

A

Autosomal dominant mutation causing increased function of the fibroblast growth factor receptor

Reduced ossification
Inhibited proliferation of chondrocytes
Reduced cellular hypertrophy
Early closure of epiphyseal growth plates

35
Q

What causes acromegaly?

Common cause

A

Increased secretion of GH at any stage of life

Commonly due to an adenoma of somatotroph cells

36
Q

Treatment of acromegaly?

A

Glucose reduces the secretion of growth hormone

37
Q

What happens in Pituitary Dwarfism?

5 causes

A

Reduced GH in childhood

Tumour, Infection, Infarction, Head trauma, Vascular malformation

38
Q

Define panhypopiturism

A

All pituitary hormones are absent

39
Q

What happens in Laron dwarfism?

2 characteristics of people

A

Mimics GH deficiency as there is a mutation in the GH receptor causing it to be unresponsive
Characterised by increased GH and decreased IGF-1

Short stature and appearance

40
Q

What is the treatment for Laron dwarfism?

A

Recombinant IGF-1

41
Q 
How does a child's speech and language develop at:
3-6 months
1-2 years
2-3 years
3-4 years
4 years
Childhood
A

3-6 months: babbling
1-2 years: 1-2 words
2-3 years: 2-3 word phrases (telegraphic)
3-4 years: 3-4 word phrases
4 years: Understands and hold conversations
Childhood: Understands sophisticated words and grammar

42
Q

Give 7 family beliefs which influence children

A 
Values and beliefs
Acceptable and unacceptable behaviour
Gender roles
Beliefs about illness causes
Attitudes about transplant and transfusion
Birth and death
Ways of expressing emotion
43
Q

6 factors which affect a child’s communication

A 
Hearing or visual impairment
Expressive language
Receptive language  (e.g EFL)
Major life events
Having a bad day
Feeling unwell
44
Q

Define social desirability

A

The child’s response may not be true

They may say what they think you would want them to say

45
Q

What does WHO define as an adolescent?

A

10-19 years

46
Q

What does the children’s act state?

A

Children should be informed and participate in decisions about their future

47
Q

What does the nature/nurture debate say about the stability of child development?

A

Nature: Development is stable over time
Nurture: Development can change e.g. traumatic events

48
Q

What is Bronfenbrenner’s theory?

A

5 socially organised subsystems that underpin and guide human growth
Made from the microsystem, macrosystem, protective factors and risk factors

49
Q

What are the 3 predominant functions of emotions?

A

Adaptation, Communication, Survival

50
Q 
What emotional and social development occurs at:
0-1 year
1-3 years
3-6 years
6-11 years
Teen years
A

0-1 year : Trust / Mistrust
1-3 years : Autonomy /Shame (trying new skills)
3-6 years : Initiative / Guilt (overprotective parenting)
6-11 years : Industry /Inferiority (working with others)
Teen years : Identity / Confusion

51
Q

3 social and emotional developments in childhood and adolescence

A

Childhood: Forming relationships; understanding and regulating emotions

Adolescence: Understanding of moral and social conventions, acceptance and identity

52
Q

Define metacognitive thought

A

Thinking about thinking

53
Q

What are the 4 stages of cognitive development?

A
  1. Schemes: Basic unit of understanding about the world
  2. Adaptation: Schemes develop through adjusting by assimilation and accommodation
  3. Assimilation: Making information compatible with current understanding of the world
  4. Accommodation: Alteration to incorporate new experiences or information
54
Q

What are the 4 periods of cognitive development

What age do they develop at?

A

Sensoriomotor period (0-2 years)
Pre-operational period (2-7 years)
Period of concrete operations (7-11 years)
Period of formal operations (11+ years)

55
Q

What develops in the sensoriomotor period?

A 
0-1 month: Reflex
1-4 months: Self-investigation
4-8 months: Reaching out 
8-12 months: Goal-directed behaviour
12-18 months: Experimentation
18-24 months: Problem solving
56
Q

What develops in the pre-operational period?

A

Reasoning and symbolic functions

57
Q

What develops in the period of concrete operations?

A

Logical operations applied to concrete problems

58
Q

What develops in the period of formal operations?

A

Hypothetical problem solving, testing of hypothesis and validating reasoning
Forming arguments, counter-arguments and reasoning

59
Q

What was Gardner’s theory?

What was he the first person to state?

A 
Theory of multiple intelligence's
First person to state that IQ is not fixed
1. Linguistic
2. Musical
3. Logio-mathematical
4. Spatial
5. Bodily-kinesthetic (athletic)
6. Interpersonal (people)
7. Intrapersonal (yourself)
8. Naturalist (outdoor)
60
Q

4 signs of social well-being (and dysfunction)

A

Positive self esteem (negative self esteem)
Communication (withdrawal)
Appropriate social behaviour (inappropriate behaviour)
Rewarding relationships (poor relationships)

61
Q

4 signs of emotional well-being (and dysfunction)

A

Stable and secure attachments (unstable and insecure)
Appropriate emotions (inappropriate)
Positive self esteem (negative self esteem)
Happy and optimistic (anxiety and depression)

62
Q

4 signs of cognitive functioning (and impairment)

A

Age appropriate (underachievement)
Appropriate progress (lack of expected progress)
Positive or realistic perception of ability (negative or unrealistic)
Opportunities to reach potential (may need special education)

63
Q

Give 8 examples of psychopathology in children

A 
Childhood schizophrenia
Childhood depression
Attention deficit disorder
Autistic spectrum disorder
Specific learning difficulty (e.g. dyslexia)
Sensory impairment
Homeless/poverty 
Toxicity (e.g. lead)
64
Q

What is the difference between cognitive impairment, learning difficulty and specific learning difficulty?

A

Cognitive impairment: Wide range of problems
Learning difficulty: Global cognitive impairment
Specific learning difficulty: In one area

65
Q

What is the difference between plasma and serum?

A

Plasma is blood with no cells

Serum is blood with no cells or coagulation proteins

66
Q

What does it mean if the blood is orange?

A

Increased levels of bilirubin

67
Q

Define selective requesting

4 purposes

A

Tests carried out on the basis of an individuals clinical situation
Diagnosis, Assess severity, Monitor disease, Detect side effects

68
Q

What do dynamic function tests test for?

A

The body’s response to external stimuli

69
Q

Define analytical variation

A

Whether you trust that the test gave you the actual results

70
Q

Define sensitivity

A

How little of the analyte the test can detect

71
Q

Define specificity

A

How good the assay is at discriminating between the required analyte and interfering substances

72
Q

What is tested for in the liver function tests? (6)

What do they indicate?

A

Bilirubin: haem breakdown, secreted in bile, increased if blockage
Aminotransferases: ALT+AST (increased in liver damage)
Alkaline phosphatase: Increased with cholestasis
Glutamyltranspeptidase: Increased with cholestasis
Plasma proteins: Decreased in liver disease
Prothrombin time: Coagulation protein (increased in liver disease)

73
Q

What is the difference between a core and specialised test?

A

Core: Ions, glucose, Urea, Creatinine, Protein, Bilirubin, Amylase, ALT, AST, Amylase

Specialised: Hormones, Specific proteins, Trace elements, Vitamins, Drugs, DNA, Lipids

74
Q

What do the blood results look like in someone who is jaundiced?
3 causes

A

Causes: haemolytic, cholestatic, hepatocellular

Increased bilirubin, ALP and AST
Normal prothrombin time
Bilirubin in the urine

75
Q

What do the blood results look like in someone who has acute liver disease?
2 causes

A

Causes: poisoning, hepatic failure

Increased bilirubin, ALP, AST, Prothrombin time
Decreased albumin

76
Q

What do the blood results look like in someone who has chronic liver disease?
3 causes

A

Causes: alcoholic fatty liver, bilary cirrhosis, chronic active hepatitis

Increased prothrombin time and cirrhosis

77
Q

3 causes of lipoprotein disorders

A

Heart disease, Pancreatitis, Cataracts

78
Q

How do you measure the levels of LDL and VLDL in the body?

A

Most plasma cholesterol is present in LDL so plasma cholesterol is an estimate of LDL
Most plasma triglycerides present in VLDL so plasma triglyceride is an estimate of VLDL

79
Q

Give 4 examples of secondary hyperlipoproteinemias

What do the blood results look like

A

Toxins
Renal dysfuncion
Metabolic disorders e.g. diabetes, obesity
Hormonal e.g. hypothyroid, pregnancy

Increased VLDL and LDL
Decreased HDL in obesity but increased in pregnancu

80
Q

What are the 6 metabolic disorders which the newborn screening test looks for?

A 
Phenylketonuria (PKU)
Maple syrup urine disease (MSUD)
Isovaleric acidemia (IVA)
Glutaric aciduria type 1 (GA1)
Homocystinuria (HCU)
Medium chain acyl-CoA dehydrogenase deficiency (MCADD)
81
Q

Explain what happens in the metabolic disease PKU

A

Phenylalanine –> Tyrosine in the liver by PAH (phenylalanine hydroxylase)

No enzyme = increased Phenylalanine = mental retardation

Medicine - Year 2 (19 decks)

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