Child Health

Question 1

Nutritional assessment: what should the history include?

Answer 1

Diet
Recent illness
Birth weight, milestones, immunisations
Family illness
Family circumstance

Question 2

What to look for on nutritional assessment examination

Answer 2

Visible severe wasting (upper and lower limbs)
Oedema on dorsum of feet
Anthropometric measurements

Question 3

Which anthropometric indicator is the most sensitive for changes in nutritional status

Answer 3

Weight-for-age

Question 4

What are Z-scores?

Answer 4

Z-scores express anthropometric value as standard deviations from the mean or median

Question 5

Advantages of using Z-scores?

Answer 5

1. Curves are normally distributed can be used for the individual child and for populations
2. Fixed Z-score interval corresponds to fixed weight/ height difference
3. Greater precision
4. Ease in interpretation and classification of malnutrition

Question 6

Classification for MAM

Answer 6

NO symmetrical oedema
Weight for height (-3 to -2)
MUAC 11.5-12.5cm

Question 7

Classification for SAM

Answer 7

Symmetrical oedema

Weight for height

Question 8

What is growth faltering?

Answer 8

When growth curve is flat or dropping for 2 consecutive months.

Question 9

Management of MAM

Answer 9

Promote breast-feeding.
 Counsel about complementary feeding
 Treat underlying illness.
 Screen for anaemia/ TB/ HIV
 Deworm with mebendazole or albendazole.
 Supplement with vitamin A
 Provide nutritional supplements
 Follow-up a feeding problem in 7 days; if no feeding problem follow-up in 14 days

Question 10

What is the requirement for entry into nutrition therapeutic programme

Answer 10

Growth faltering

Question 11

Exit criteria for nutrition therapeutic programme

Answer 11

1. Adequate weight gain for three consecutive months
2. Unssuccessful (6 months)
3. Defaulters

Question 12

Classification of coughs

Answer 12

Duration
Specific vs non-specific
Quality

Question 13

What are the 7 red flags for a cough

Answer 13

1. Onset with choking incident
2. Relentlessly progressive
3. Pointers to an underlying dx
   - Symptoms of TB or other systemic disease
   - Signs of CLD
   - Persistent hyperinflation
4. Cough starting in neonatal period
5. Associated with feeds or swallowing difficulties
6. Dyspnoea
7. Wet cough >3-4 weeks

Question 14

Classification of cough by time

Answer 14

8 weeks = chronic

Question 15

SPUR Red flags for recurrent respiratory tract infections

Answer 15

Severe
Persistant (and failure to recover normally)
Unusual organisms
Recurrent infections

Question 16

Red flags for recurrent respiratory tract infections

Answer 16

Symptoms from first day of life
Very sudden onset of symptoms
Chronic moist cough
Symptoms related to feeds
Chronic, severe upper airway symptoms
Features of systemic immunodeficiency
Continuous, unremitting or worsening symptoms

Question 17

Development occurs with sequential acquisition of skills in which four different areas

Answer 17

Gross Motor
Fine Motor
Language
Psychosocial

Question 18

How to calculate developmental quotient

Answer 18

developmental age/ chronlogical age x 100