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Child health > Child & family > Flashcards

Child & family Flashcards

1
Q

Changes at birth

A 
Clamping umbilical cord 
Closure of the ductus venosus
Closure of foramen ovale
Closure of Ductus arteriosus
Decrease in pulmonary pressure
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2
Q

Child development areas

A

Motor (gross & fine)
Speech/hearing
Social behaviour

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3
Q

Gross motor control development

A

Cephalocaudal development

Head control -> sitting -> balance -> walking/running

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4
Q

Fine motor skills development

A 
Rake grip 
Radial palmar grasp
Radial digital grasp
Inferior finger grasp
Fine pincer grasp
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5
Q

Hearing and language development

A

Hearing is tested at birth
Sound
Understanding
Expression

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6
Q

Social and play behaviour development

A

Smile –> Playing alone -> Playing with others

Object permanence

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7
Q

Vaccines at 8 weeks

A 
Diphtheria
Tetanus
Pertussis
Polio
H.influenzae
Hep B
Meningococcal group B
Rotavirus gastroenteritis
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8
Q

Vaccines at 12 weeks

A 
Diptheria
Tetanus
Pertussis
Polio
Hib
Hep B
Pneumococcal
Rotavirus
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9
Q

Vaccines at 16 weeks

A 
Diptheria
Tetanus
Pertussis
Polio
Hib
Hep B
MenB
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10
Q

Vaccines at 1 year

A 
Hib 
Menc
Pneumococcal
MMR
MenB
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11
Q

Vaccines at 3 years 4 months

A 
Diphtheria
Tetanus
Pertussis
Polio
MMR
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12
Q

Vaccines at 12-13 years

A

HPV

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13
Q

Vaccines at 14 years old

A

Tetanus
Diphtheria
Polio
Meningococcal ACWY

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14
Q

Meconium

A

1st stool - contents of the GI tract in utero

Failure of passage suggests Cystic fibrosis or Hirschsprung’s disease

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15
Q

Pigment birthmarks

A

Mongolion blue spots
Naevi
Cafe au late spots

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16
Q

Vascular birthmarks

A

Haemangioma

Port wine stain

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17
Q

Talipes Equinovarus

A

Club foot –> Ponseti method
Casting
Surgery on achilles tendon
Boots & bar overnight

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18
Q

Developmental dysplasia of the hip

A

Subluxation of the hip
Breech, Large female babies
USS < 3 mth, X-ray >3 mth
Pavlik harness

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19
Q

Examination for DDH

A

Barlow - sublux/dislocate - exit

Ortolani - reducible - entry

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20
Q

Spina Bifida

A

Failure of the neural tube to close
Occulta -> meningocele –> mylomeningocele
Lack of folate
Gestational diagnosis - raised AFP

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21
Q

Hydrops foetalis

A

Fluid accumulation in 2+ foetal spaces

Rh disease or foetal anaemia

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22
Q

Respiratory distress of the newborn

A

Increased work of breathing & BPM > 60

Decreased surfactant (type 2 pneumocytes) - increased surface tension

Steroids & NCPAP

ground glass on x-ray

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23
Q

Transient tachypnoea of the newborn

A

Delay in clearing fluid from lungs

Supportive care for 2 hours –> NICU

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24
Q

Pneumonia

A

Infection in the lung - consolidation seen on x-ray
May be sepsis if immediate
Abx
Group B strep

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25
Q

Meconium Aspiration

A 
Spectrum of illness
Obstruction
Infection
Hypoxia
Inflammation
PPH
Inactivation of surfactant

Observe, anti-inflammatories, suction?

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26
Q

Pulmonary haemorrhage

A

intrauterine growth restriction
surfactant therapy
PDA
coagulopathy.

Resus & ventilate

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27
Q

Common congenital issues with the lungs

A

Diaphragmatic hernia
Tracheoesophageal fistula
Congenital pulmonary airway malformation

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28
Q

Left to right shunts (acyanotic)

A

ASD, VSD, PDA

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29
Q

Right to left shunts

A

Transposition of the great vessels - SVC & Aorta switched

Tetralogy of Fallot -
Overriding aorta, Right v hyperplasia, pulmonary stenosis, VSD

Pulmonary atresia with VSD - Lack of pulmonary vein

Ebsteins defect - septal and posterior leaflets of the tricuspid valve are displaced towards the apex of the right ventricle

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30
Q

Gastro-oesophageal reflux

A

Transient lowering of the oesophageal sphincter

Feed babies upright

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31
Q

Tracheoesophageal fistulas

A

Opening between trachea & oesophagus
Coughing, choking & cyanosis in feeding
Surgical closure

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32
Q

hirschsprung’s disease

A

Lack of Meissners plexus, auerbachs plexus & parasympathetic plexus

Failure to pass first meconium

Rectal biopys & contrast enema

Surgical intervention needed

Associated with downs syndrome

33
Q

Intestinal atresia

A

Absent portion of the jejunum

Failure of recanalization (duodenum)

Anywhere else - ischaemic injury of SMA

X-ray (destension) –> CT with contrast

Gastric decompression Surgery (good outcome)

34
Q

Malrotation

A

Failure of midgut rotation

Billious vomit, distension

Upper GI contrast with followthrough

Surgery

35
Q

Inguinal hernia

A

Protrusion through the inguinal canal

Herniation through the deep inguinal ring

Surgical intervention to prevent strangulation

36
Q

Necrotising enterocolitis

A

Inflammation & necrosis of the premature gut

Bell’s score

Surgery

RF: Prematurity, Low birth weight, formula feed, intestinal dysbiosis

37
Q

Term pregnancy

A

37 - 41 weeks

38
Q

Normal baby weight

A

2.4 - 4 kg

39
Q

Placental insufficieny

A

failure of the placenta to deliver sufficient nutrients to the fetus during pregnancy

Maternal smoking, drug use, preeclampsia, growth restriction

40
Q

APGAR Score

A

Measure of perinatal adaptation - 1 & 5 mins

Appearance
Pulse
Grimace reflex
Activity
Respiration
41
Q

Haemorrhagic disease of the newborn

A

Low vitamin K - deficiency in factor 2,7,9,10

Presentation - spontaneous bleed

Give neonates IM vitamin K supplement

42
Q

Allergy Pathophysiology

A

Exposure to an allergen causes sensitisation

Repeat exposure causes TH-2 reaction & IgE release

43
Q

Diagnosing allergy

A

Skin prick test

Challenge testing

44
Q

Treating allergy

A

Mast cell stabilisers - sodium chromoglycate

Anti-histamines

45
Q

Atrial septal defect

A

Blood flows from left to right

- Partial or full

46
Q

Findings in ASD

A

Ejection systolic murmur
Splitting of the second heart sound
RBBB
Right axis deviation

47
Q

Presentation of ASD

A

Heart failure
Arrhythmia
Recurrent chest infection

48
Q

Treating ASD

A

Cardiac catherisation

49
Q

Risk factors for Atrial septal defect

A

Maternal rubella
Maternal alcohol use
Maternal lupus
Down Syndrome

50
Q

Benign Childhood myositis

A

Inflammation of muscles after viral illness
Pain & refusal to walk
Bloods may show raised CK
Paracetamol, ibuprofen & safety netting

51
Q

Bronchiolitis presentation

A

Young baby (<18 mths) - brought to hospital in the night with fever, cough, wheeze and difficulty breathing

52
Q

Cause of Bronchiolitis

A

RSV - Single stranded RNA virus

Metapneumovirus

53
Q

Treating bronchiolitis

A

Supportive - O2 dependant on sats

No need for abx & steroids

54
Q

Major complication of bronchiolitis

A

Bronchiolitis obliterans - non reversible lung damage

Plugging of lungs with granulation tissue

55
Q

Symptoms of Cerebral Palsy

A 
Learning difficulties
Visual impairment
Hearing impairment
Epilepsy 
Behavioural issues
Joint issues
56
Q

Types of spastic CP

A

Hemiplegic - 1 limb
Quardaplegic - 4 limbs
Diplegic - 4 limbs but legs are worse than arms

57
Q

Diagnosing balanced translocations

A

FISH

58
Q

Coarction of the aorta

A

Narrowing of the thoracic aorta near the ductus arteriosus - seen at 3 days due to closure

59
Q

Symptoms of coarction of the aorta

A

Grey baby
heart murmur
Turners syndrome 45 XO

60
Q

Treating coarction of the aorta

A

IV prostaglandins to keep PDA

Surgery - balloon stenting
Prophylaxis for endocarditis

61
Q

Clavicle fracture

A

Fall onto outstretched hand
Collar & cuff
ORIF - if non-union
Beware of non union

62
Q

Supracondyle fracture

A

Fracture of distal humerus
Brachial artery injury
Fat pad displacement & sail sign

63
Q

Pulled elbow

A

Dislocation of the radial head
External relocation
Forced supination causes reduction

64
Q

Monteggia fracutre

A

Ulna break & dislocation of the distal radius

65
Q

Galeazzi fracture

A

Break of the radius & dislocation of the proximal ulna

66
Q

Greenstick fracture

A

Damage of the outer bone causing bending

67
Q

Types of cyanotic heart disease

A 
Tetralogy of fallot
Transposition of the great arteries
Coaction of the aorta
Pulmonary atresia
Pulmonary stenosis
68
Q

DDH

A

Congenital dislocation of the hip

Breach babies
Female babies
Incorrect swaddling

69
Q

Screening for DDH

A

Orolanis & barlows assessment

  • Looking for skin fold & leg length discrepancies
  • UUS < 4.5 Months
  • X-ray > 4.5 months
70
Q

Treating DDH

A

Pavlik harness

Surgery

71
Q

Duchenne muscular dystrophy

A

Lack of dystropin - causes excess calcium to enter cells - oxidative stress

72
Q

Diagnosing Duchennes Muscular dystrophy

A 
Raised CK
Gowers sign +ve 
EGM - muscle destruction
Biopsy - Absence of dystrophin
Genetics - Xp21 defect
73
Q

Treating Duchennes muscular dystrophy

A

Corticosteroids
Physiotherapy
Wheelchair use

74
Q

Febrile seizure

A

Tonic clonic seizure in the presence of temperature (>38 degrees)

Not a diagnosis of epilepsy

Paracetamol & calpol - anti-pyretics

75
Q

Fifths disease

A

Slapped cheek syndrome - Paravirus B19

May cause fever and rash _ joint pain

Supportive treatment

76
Q

Causes of gastroenteritis

A

Viral
-Norovirus, rotavirus, adenovirus, enterovirus, ebola
Bacteria
- Campylobacter, E.coli, salmonella, shigella, staph
Parasites
-Giardia, Entamoeba, cryptosporidium

77
Q

Who is referred for audiological assessment

A 
Premature birth
Low birth weight
Intraventricular haemorrhage
Neonatal jaundice
Neonatal hypoxia
Aminoglycoside use
Failure of distracting testing
Parental suspicion
Abnormal & delayed speech
Hearing loss in family
78
Q

Hearing loss in children

A

Usually middle ear cause

Otitis media with effusion

79
Q

hirschsprung disease

A

Genetic lack of parasympathetic innervation to the large bowel - more common in boys & those with Down Syndrome

Lack of passage of meconium - rectal biopsy needed

Surgical treatment

Child health (1 decks)

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