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Child Health > Child health assessment > Flashcards

Child health assessment Flashcards

1
Q

Which antibodies cross the placenta from mother to child?

A

Maternal IgG can cross the placenta
At term, the concentration of IgG in the fetal blood is higher than that of the mother
The half life of the IgG is only several weeks

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2
Q

By what age will most of the maternal antibodies have disappeared from the fetal circulation?

A

Most of these antibodies will have disappeared from the circulation by 4-5 months

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3
Q

What does colostrum contain? (and what is colustrum)

A

Colustrum is secreted by the breast during the first few days of lactation
Contains ten times more protein than milk produced later in lactation
Protein is mostly in the form of IgA!!!

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4
Q

What does breast milk contain?

A

IgA, macrophages, lymphocytes and complement

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5
Q

Atopy is characterised by high levels of…

A

IgE

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6
Q

Name three types of lymphocyte

A

B cells
T cells
Natural killer cells

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7
Q

What is stridor

-is stridor an inspiratory or expiratory noise?

A

Stridor refers to the harsh monophonic noise from the upper airway during INSPIRATION

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8
Q

The correct name for croup?

A

Laryngotracheobronchitis

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9
Q

Organism which causes croup

A

Parainfluenza

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10
Q

Do children maintain their oxygen saturations in croup?

A

Yes - oxygen levels may be falsely reassuring

the upper airway problem does not affect gaseous exchange at an alveolar level

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11
Q

Which bacteria causes epiglottitis?

A

H. influenzae

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12
Q

Is MMR contraindicated in children who are allergic to eggs?

A

No, fire away
(for children who have had anaphylactic shock to eggs, seek specialist advice and give vaccination uner controlled conditions)

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13
Q

When would illness stop you giving the MMR?

A

If child has had minor illness without fever or systemic upset then it is fine to give the vaccine.
If child has had acute febrile illness then don’t give vaccine.
(let them recover first)
- this is so they don’t blame the vaccine on the symptoms

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14
Q

Where is the MMR vaccine given?

A

Given by IM injection into the outer aspect of the thigh

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15
Q

Why would you not give an injection in the bum?

A

Incase you damaged the sciatic nerve

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16
Q

How old is a neonate?

A

A neonate is a child who is less than one month old

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17
Q

How old is an infant?

A

An infant is a child up to the age of 12 months

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18
Q

What is cryptorchidism?

A

Hidden testis (i.e. abdominal testis)

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19
Q

Which structure allows fluid to enter the scrotum? and what does this result in?

A

A patent processus vaginalis allows fluid to enter the scrotum from the peritoneal cavity
Results in a hydrocele

  • varies in size but usually resolves by age 2
  • Transillumination is not absolutely diagnostic since children’s tissues contain a high percentage of fluid and transilluminate easily
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20
Q

Reduced blood flow on doppler

A

Testicular torsion

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21
Q

Increased blood flow on doppler

A

Epidymo-orchitis

22
Q

What causes epidymo-orchitis?

A

Usually a result of trauma

23
Q

How do you classify obesity in children?

A

Based on BMI percentile rather than number
A BMI percentile >95th is considered obese
(BMI percentile takes into account the physical changing shape of children as they grow)

24
Q

Are most obese children short or tall?

A

Most obese children are tall, this is as a result of increased caloric intake during the growing years

25
Q

What does a short obese child suggest?

A

Suggests an endocrine aetiology, which would require invesitgation

26
Q

Has an increased energy intake or a decreased energy expenditure caused modern levels of obesity?

A

Generally people are actually eating less, they’re just not doing nearly as much
BUT –> excessive energy intake is responsible for most cases of childhood obesity

27
Q

Pertussis immunisation protects against which disease?

A

Whooping cough

28
Q

Pneumococcal vaccine protects against which disease?

A

Meningitis

29
Q

Which vaccine would protect against epiglottitis?

A

Haemophilus inflenza b (Hib)

30
Q

What causes epiglottitis?

A

Haemophilus infleunza b

31
Q

What is failure to thrive?

A

Failure to thrive, or faltering growth, describes an infant or child who does not gain weight or height at the expected rate for his or her age

32
Q

What might cause failure to thrive or faltering growth?

A

Increased metabolic demands of chronic disease or malabsoprtion

33
Q

Commonest cause of anaemia worldwide?

A

Iron deficiency anaemia is the commonest cause of anaemia in children worldwide

i.e. main cause is dietary

34
Q

Principle sign of anaemia in children

A

Pallor

35
Q

When do signs and symptoms of cardiopulmonary decompensation occur in anaemia?

A

Occur when haemoglobin has decreased below 6g/dl

36
Q

Why might you see irritability, behavioural changes and mood swings in iron deficiency anaemia?

A

Thought to be related to the malfunction of cellular enzymes dependent on iron

37
Q

Hallmark of iron deficiency anaemia?

A

Hypochromic microcytic blood film

38
Q

Ferritin levels in iron deficiency?

BUT WHY SHOULD YOU BE CAREFUL MEASURING THESE

A

Decreased

BUT ferritin is an acute phase protein so should be interpreted with caution - may be artificially high in children who are unwell

(i.e. might have normal/high levels if child is ill which means you might miss iron deficiency anaemia)

39
Q

Why is iron deficiency anaemia bad?

A

Has bad effect of neurodevelopment

40
Q

Which countries are thalassaemias more common?

A

More common in children of Asian, Middle east and south east asian descent

41
Q

Sign of elbow fracture on x-ray

A

visible posterior fat pad

42
Q

A child has unusual bruising, what do you need to investigate them for?

A

Investigate for thrombocytopenia, leukaemia, non-accidental injury

43
Q

Uses toys meaningfully, like cup and spoon

A

2 years

44
Q

Walks and runs without falling, kicks a ball

A

2 years

45
Q

Names 3-5 pictures or objects, joins 2 words together

A

2 years

46
Q

Builds a tower of 5 or 6 cubes, imitates a straight line, turns pages singularly

A

2 years

47
Q

The average age for walking in boys and girls

A

girls - 13 months
boys - 14.5 months
(walking - taking two consecutive steps)

48
Q

When should most children be able to walk by?

A

By 18 months, if not then refer

49
Q

When does duchenne muscular dystrophy present?

And which inheritance pattern?

A

Begin to walk in second half of second year

Autosomal recessive

50
Q

Gower’s sign

A

Duchenne muscular dystrophy

51
Q

What does breastmilk contain?

A

Contains IgA, lymphocytes, macrophages and complement

Child Health (24 decks)

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