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1st Year Med > Child Development (W2 KPH) > Flashcards

Child Development (W2 KPH) Flashcards

1
Q

why are routine measurements of babies a standard practice?

A

to identify or rule out growth disorders
to identify and monitor obesity
to assess feeding
to assess disease impact

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2
Q

what measurements are normally distributed in healthy individuals?

A

height
haemoglobin
BP
plasma sodium
protein intake

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3
Q

what statistics would be useful to determine a normal BMI?

A

median
IQR (25th-75th centile)
2nd and 98th centile

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4
Q

how are infant growth charts constructed?

A

collecting samples of data at each age and gender from hundreds of healthy children

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5
Q

what factors are important in considering what population growth charts should be based on?

A

increasing height over generations
ethnic differences in growth
breastfed infants gain weight differently than bottlefed infants

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6
Q

what is the standard for a population representing an ideal growth chart?

A

healthy, breastfed infants who live in an ‘optimal’ growth potential environment

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7
Q

what ways can be used to judge if measurements are normal?

A

plotting on a growth chart
calculating BMI
assessing growth over time

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8
Q

describe the mid-parental centile

A

the point inbetween the mother and father’s percentile
most children aew within +/- 2 centile spaces of the mid-paternal centile

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9
Q

what is the breast made up of and comprised of?

A

made up of the nipple, areola, mammary glands and supporting CT

comprised of fat, blood, lymphatic vessels and nerves

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10
Q

explain the prevalence of alveoli in the breast

A

contained within lobes (~20 per breast)
lactocytes (milk-producing cells) within alveoli
surrounded by myoepithelial cells (smooth muscle)

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11
Q

what is the role of oxytocin in the breast?

A

stimulates myoepithelial cells to contract, pushing milk into lactiferous ducts towards the nipple

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12
Q

what is the role of montgomery tubercles in the breast?

A

glands secreting sebaceous fluid that lubricates the nipple and protects the skin
the fluid has an individual aroma attracting the infant

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13
Q

explain the hormonal control in breast development

A

oestrogen promotes mammogenesis by developing the ductal system
progestorone and human/placental lactogen enhance milk producing structures

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14
Q

explain the posterior pituitary mechanism of lactation

A

suckling -> stimulus to hypothalamus -> posterior pituitary secretes oxytocin -> contracts myoepithelial cells -> milk released into lactiferous ducts

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15
Q

explain the anterior pituitary mechanism of lactation

A

suckling -> anterior pituitary produces prolactin -> allows lactocytes to secrete milk into alveoli

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16
Q

compare the protein composition of breast milk and infant formula

A

breast milk - whey based (alpha lactalbumin)

formula - bovine serum albumen

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17
Q

compare the carbohydrate composition of breast milk and infant formula

A

breast milk - lactose (~40%) improves Ca absorption

formula - lactose (+ sucrose, fructose and glucose)

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18
Q

compare the fat composition of breast milk and infant formula

A

breast milk - long chain fatty acids

formula - vegetable or egg based

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19
Q

compare the vitamin/mineral composition of breask milk and infant formula

A

breast milk - present in small quantities

formula - extras added to the powder

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20
Q

what substances are present in breast milk that are not present in human milk?

A

growth factors
immune cells
enzymes
stem cells
lactoferrin
milk lipids

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21
Q

name some of the benefits provided by breast milk not present in formula milk

A

prevents pathogenic entry (IgA on gut surface)
improves immune response (Il-7 increases thymus size)
Promotes healthy bacteria growth (oligosaccharides)

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22
Q

how does a mother transfer her microbial heritage to her infant?

A

vaginal birth
skin-skin contact
breastfeeding

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23
Q

what are the functions of an infants microbiome?

A

produces vitamin K, biotin and folate
immune system development
prevents toxin absorption
provides energy sources for enterocytes

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24
Q

what is colostrum?

A

the first milk produces from breasts
thick, yellowish fluid increasing in amount over first 3-4 days to accomodate infants needs

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25
Q

what are the main components and functions of colostrum?

A

rich in vitamin A
creates acidic environment
contains Ig’s, antibodies and anti-inflammatory molecules
contains EGF
is a mild purgative (laxative)
high in viral fragments and white cells

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26
Q

explain how breastfeeding can result in immunity for the infant against pathogens

A

the mother creates sensetised lymphocytes which create secretory antibodies in the breast
then transferred through breast milk to infant

27
Q

name 3 developmental advantages to breastfeeding

A

promotes brain development (long chain fatty acids)
promotes maturation of gut
protects mothers health

28
Q

what are the benefits of skin-skin contact in mothers/infants?

A

triggers lactation and mothering hormones
triggers calming hormones
stimulates digestion
stimulates instinctive feeding behaviour
provides protective bacteria for infant

29
Q

explain the positioning of effective breastfeeding

A

keep baby close
tilt baby’s head back so chin can lead
keep baby’s head and body in line
nose to nipple positioning for effective attachment
(acronym - CHIN)

30
Q

what is responsive breastfeeding?

A

the sensitive, reciprocal relationship developed between mother and infant during breastfeeding

31
Q

why might women choose not to breastfeed?

A

negative public attitude
breast pain/discomfort
perception of inadequate breastmilk supply
mother and infant routine reasons

32
Q

name some of the societal reasons why women may not breastfeed

A

cultural/social barriers
public breastfeeding frowned upon
little support for longer-term breastfeeding
can be seen as a sign of sexual display

33
Q

what is complimentary feeding?

A

mothers express milk with a pump and give it to the infant in a bottle
breastfeeding can later be introduced
this is often done if there is maternal breastfeeding complications

34
Q

what is the role of the health visitor in breastfeeding?

A

measure growth/development of infant
promote skin-skin contact
ensure adequate breastfeeding technique

35
Q

what are some of the clinical features of childhood obesity?

A

acanthosis nigricans
asthma
skin striae
obstructive sleep apnoea
constipation

36
Q

how can childhood obesity impact the immune system?

A

metabolic inflammation - fat in adipose tissue activates immune response causing chronic inflammation (cytokines, macrophages etc)
also linked to MS

37
Q

what are the biological determinants of obesity?

A

genetics, leptin and appetite regulation

38
Q

what are the psychological determinants of obesity?

A

personality, impulse regulation, attachment security, self esteem

39
Q

what are the social environment determinants for obesity?

A

time, money, food insecurity

40
Q

what are the physical environment determinants of obesity?

A

walkability, greenspace, fresh food availability

41
Q

what is the main commercial determinant of obesity?

A

production and marketing of processed unhealthy foods (often appealing)

42
Q

what are some of the common negative effects of childhood obesity?

A

CV disease
type 2 diabetes
psychosocial problems
malignancies
orthopaedic problems

43
Q

what is an obesogenic environment?

A

an environment promoting obesity

44
Q

what is food insecurity?

A

uncertain or unreliabe access to food for individuals or household
can be mild (worry), moderate (compromise/reduction) or severe (regular hunger)

45
Q

explain the 2 aims of immunisation programmes

A

to protect those at highest risk (selective)

to eradicate, eliminate or contain diseases (mass)

46
Q

what might put someone in a high risk category for a vaccination? give an example for each

A

travel (typhoid)
occupational risk (hep B)
high risk groups (boosters for asplenic patients)
outbreak control (hep A)

47
Q

what is the aim of an ideal vaccine?

A

produce same immune protection as natural infection without causing disease
generate long-lasting immunity
interrupt infection spread

48
Q

what are some of the contradictions or precautions with vaccines?

A

those with immunodeficiency
those on immunosuppressing therapy
pregnant women

49
Q

what are live vaccines?

A

attenuated strain which replicates in host
attenuated = weakaned pathogen so no disease
e.g: MMR, BCG

50
Q

what are inactive vaccines?

A

do not contain a pathogen capable of replicating and causing disease
e.g Hep B, Polio

51
Q

what are the pros and cons of live vaccines?

A

pros - long lasting immunity, strong immune response

cons - poor stability, can revert to virulence

52
Q

what are the pros and cons of inactivated vaccines?

A

pros - unable to cause infection, stable, constitutents clearly defined

cons - shorter immunity, may need several doses

53
Q

what is herd immunity?

A

a threshold level of infected population
if threshold reaches, infectious agent unable to transmit between population

54
Q

name an example of a herd immunity disease and the infection threshold necessary

A

measles
95% must be vaccinated

55
Q

what is passive immunity?

A

an immediate but temporary form of immune protection given to those at high risk of severe disease
doesnt stimulate immune system to produce any antibodies
e.g transplacental antibodies

56
Q

what are the pros and cons of antibody preparations?

A

pros - rapid, preventative, given to those where vaccine contradicted

cons - expensive, no lasting immunity, potential for adverse events

57
Q

what can be some of the outcomes of poor breastfeeding attachment?

A

painful/danaged nipples
engorgement
baby feeds more frequently
decreased milk production
baby struggles to gain weight

58
Q

what are the signs and symptoms of iron deficiency in infants?

A

lethargy
breathlessness
cognitive impairment
impaired immune function
decreased capacity for physical activity

59
Q

what factors should be taken into consideration when creating a vaccine programme?

A

aim/cost of programme
population accessibility
cultural attitudes/practices
facilities available

60
Q

what are age recommendations for vaccines based on?

A

age-specific risks for disease/complication
ability to respond to vaccine
immune system interference from different antibodies (maternal antibodies)

61
Q

name a vaccine administered at each key age group

A

primary - rotavirus
infant - MMR
adolescent - HPV
adults - shingles

62
Q

what is vaccine equity?

A

vaccines are distributed based on need and priority rather than evenly distributed to all regions/locations

63
Q

what are some of the challenges of global immunisation?

A

funding
uptake
violence (war)
different priorities in different areas

1st Year Med (52 decks)

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