Child and adolescent health Flashcards
special features of a child
large head and occiput high ant larynx and floppy epiglottis flexible ribs smaller blood volume large surface area to volume
how can a large SA to volume cause issues in children
burns of proportional size on adults affect a larger % of child SA
dehydration more common
true/false - curved laryngoscopy blade is used to intubate babies
false - a straight one is used to push back the epiglottis
most common pathogen in bronchiolitis
RSV
most treatment of bronchiolitis is supportive. what may be done in cases that are more severe
NG tube to feed
IV resus
oxygen, or CPAP
what is the most common cause of croup
parainfluenza
x ray on a patient with croup reveals
steeple sign
differential for child with croup
croup
epiglottitis
bacterial tracheitis
foreign body
management of croup
consider admitting
single dose oral steroids
characteristic symptoms of croup
barking cough
stridor
symptoms of meningitis
stiff neck non blanching purputic petechial rash fatigue confusion tiredness photophobia pyrexia
what should be considered in UTI in children
abnormal renal tract
consider performing USS
what is a febrile seizure
generalised tonic clonic seizure in response to fever
what is a breath bolding attack
TLOC and possible fit in response to breath holding whilst crying
how do you identify PQTS in a child with syncope
screen for cardiac arrhythmia with an ECG
causes of fits, blackouts and seiziure
epilepsy breath holding attack febrile seizure vasovagal episode PQTS non-epileptic events other arrhythmia
possible causes of trauma in children?
RTA trampoline burns ingestion choking
first and foremost priority in NAI
safety and welfare of child
surgical causes of GI obstruction
pyloric stenosis
intusseption
volvulus
malrotation
features of pyloric stenosis
6 weeks old
vomiting
alkalotic ABG
acute abdomen in older children is often _____
appendicitis
emergency cause of abdominal pain in boys
testicular torsion
biological development in adolescents?
puberty
CNS development
growth
psychological development in adolescents?
abstract thought
morality development
development of identity
social development in adolescents?
independence
changing relationship
what makes a competent young person
understand simple terms, nature and purpose of treatment
benefits, risks, alternatives
make choice free of coercion
retain info long enough
true/false - <16s can consent to treatment without parental consent
true
true/false- parents can overrule an under 16s decision to consent
false - they cannot unless the patient is not deemed clinically competent
when can a young persons confidentiality by invalidated
risk to their health or welfare or grave risk to others without disclosure
assessing adolescent development
STEP sexual maturity thinking education and employment peers and parents
things to discuss with adolescents in social hx
HEEADSSS home education/employment eating activities drugs sex suicide safety
age for the majority of childhood deaths
<1
second highest age for majority of childhood deaths
15-19
most preventable
mental health issues in adolescents
eating disorders mental illness pre-existing condition chronic fatigue functional
physical health conditions in adolescents
epilepsy
asthma
IBD
diabetes
social health conditions in adolescents
sexual relationships
smoking, drugs and alcohol
features to include in a transfer from paediatrics to adult clinic
involve the patients
transition planning with concerns raised
support before and after transfer with clinics
pros of specialist hospital adolescent units
highly skilled staff, used to dealing with risk behaviour
developmentally appropriate
supports health promotion
increased independence
cons of specialist hospital adolescent units
encourages mimicry
inappropriate behaviour
takes skilled workers away from other clinics
too comfortable
what can be given for reflux in babies
gaviscon
common respiratory conditions in primary care
bronchiolitis croup viral URTI asthma tonsillitis
rare respiratory conditions in primary care
CF epiglottitis foreign body pneumonia malignancy
medical causes of abdominal pain in children
uti
gastroenteritis
constipation
surgical causes of abdominal pain in children
intussception volvulus incarcerated hernia appendicitis testicular trauma ovarian torsion
medical, but not abdomen specific causes of abdomional pain in children
DKA adrenal crisis sickle cell disease function ectopic pregnancy PID IBD
causes of arthralgia in children
inflammatory arthritis transient synovitis perthes SUFE osgood schlatters growth pains tumour infection
what is hydrocephalus and how is it investigated
head growth out of proportion to rest of body due to fluid accumulation
USS to look at ventricle size
what conditions are caused due to abnormal head suture formation
scaphocephaly
gonocephaly
plagacephaly
red flags for headache
expanding head size vomiting young age waking at night corse on cough/sneeze change in behaviour change in cognitive ability new squint/ CN palsy diplopia or vision change
red flags for heart murmur
cyanosis poor feed SOB fatigue fail to thrive sweating colour change absent fem pulses liver edge gallop creps oedema
red flags for cough
night time waking
failure to thrive
recurrence
red flags for abdo pain
fail to thrive
bloody/bilious vomiting
bloody stool
what rare conditions may lead to constipation
hirschprings disease
gut atresia
spinal lesions
red flags for issues with bowels
weight loss blood fatigue joint/eye involvement rash mouth ulcers
how common is a type 1 food allergy?
pretty uncommon, anaphylaxis is rare
symptoms of a food allergy
constipation rhinorrhoea glue ear vomiting cough abdominal pain rash fatigue myalgia itch
red flag diseases associated with fatigue?
inflammtory brain tumours addisons thyroid disease coeliac anaemia
what type of children suggest having a GH deficiency
short and obese children
features of functional pain in children
headache abdo pain fatigue poor sleep anxiety
describe the presentaiton of pyloric stenosis
projectile vomiting
milky and following feed
6wks
abdominal swelling, visible peristalsis
diagnosis and management of pyloric stenosis?
USS sees short thick channel at bottom of stomach
single cut along pylorus to expand valve
presentation of intussception?
bilious/food vomiting upset legs drawn up visible/palpable mass blood in nappy
diagnosis and management of intissception
USS reveals sausage shape lesion telescoping in on itself
air enema or surgical intervention
describe how malrotation can lead to volvulus
longest distance in abdomen is from terminal ileum to DJ flexure
this is supplied by SMA
if terminal ileum lies high and DJ flexure lies low then this can lead to volvulus and ischaemia
investigation of malrotation and volvulus
upper GI with contrast and follow through
how does idiopathic scrotal oedema appear and how is it managed
redess and scotal swelling extending to groin and down to perineum
analgesia/antihistamines
what is a hydrocele and how does it appear
on descent of the testicel a piece of peritoneum is brought with it, causing fluid accumulation
diffuse non tender swelling that transilluminates light
how does a hernia in the groin area appear anf how is it managed
appear as swelling with extension to groin
cannot get above it
need to operate as there is risk of strangulation
