child health non milestones stuff Flashcards by M Njm

What is the average age (in years) that a girl enters puberty in the UK?

How well did you know this?

Not at all

Perfectly

What is the average age (in years) that a boy in the UK experiences their pubertal growth spurt?

How well did you know this?

Not at all

Perfectly

The HEEADSSS framework is useful when taking a history from young people. It stands for?

–Home (home life/relationships)
–Education/Employment – progress at school, financial concerns
–Eating – weight, body image
–Activities – peers, physical activity
–Drugs
–Sex – Sexual activity, orientation, STIs
–Suicidality
–Safety – risk taking behaviour/criminality

How well did you know this?

Not at all

Perfectly

Live attenuated vaccines?

MMR, Flu, rotavirus

How well did you know this?

Not at all

Perfectly

Inactivated/ killed vaccines?

PCV - pneumococcal conjugate

IPV - polio

How well did you know this?

Not at all

Perfectly

Inactivated TOXIN vaccines?

Diphtheria

Tetanus

How well did you know this?

Not at all

Perfectly

Subunit/ conjugate vaccines?

All the meningitis (ACWY, B)
Hepatitis C
Hib
Pertussis

How well did you know this?

Not at all

Perfectly

What size of boys’ testes (in ml) is consistent with onset of puberty?

4ml

How well did you know this?

Not at all

Perfectly

The Reference Nutrient Intake for a vitamin or mineral is likely to meet the requirements for what percentage of the population?

97%

How well did you know this?

Not at all

Perfectly

which food type would deliver the most vitamin C

Blackcurrants

How well did you know this?

Not at all

Perfectly

which food type would deliver the most vitamin D

Oily fish

How well did you know this?

Not at all

Perfectly

which food type would deliver the most vitamin A

Cheese

How well did you know this?

Not at all

Perfectly

which food type would deliver the most vitamin E

Nuts

How well did you know this?

Not at all

Perfectly

The correct sequence for basic life support in a child is:

Safe approach
 stimulate
shout for help, 
open airway, 
look/listen/feel for breathing, 
give 5 rescue breaths, check for signs of life, give 15 chest compressions, 
continue CPR at 2 breaths to 15 compressions for 1 minute 
 then call emergency services.

How well did you know this?

Not at all

Perfectly

What is the correct position for maximising the airway?

the ‘sniffing’ position

How well did you know this?

Not at all

Perfectly

What is the correct position for chest compressions?

the lower half of the sternum

How well did you know this?

Not at all

Perfectly

What is the preferred method of opening the airway in a child with a suspected neck injury?

Jaw thrust

How well did you know this?

Not at all

Perfectly

Each of the following children have a form of cerebral palsy. What is the most appropriate diagnosis?
A 10 year old girl with increased tone in her right arm and right leg, who walks with a limp.

Hemiplegic cerebral palsy

How well did you know this?

Not at all

Perfectly

Each of the following children have a form of cerebral palsy. What is the most appropriate diagnosis?
A 5 year old boy with weakness in both legs, requiring the use of a wheelchair. Both arms are normal.

Paraplegic cerebral palsy

How well did you know this?

Not at all

Perfectly

Each of the following children have a form of cerebral palsy. What is the most appropriate diagnosis?
A 12 year old girl who attends mainstream school who walks unaided but has an intoing gait affecting both right and left. She has normal use of her arms but has increased tone.

Diplegic cerebral palsy

How well did you know this?

Not at all

Perfectly

Each of the following children have a form of cerebral palsy. What is the most appropriate diagnosis?
A profoundly disabled 7 year old boy who can not walk and is unable to feed himself. Both arms have fixed contractures and he requires regular baclofen to relax his muscles

Quadriplegic cerebral palsy

How well did you know this?

Not at all

Perfectly

How many weeks is full term gestation?

40 weeks

How well did you know this?

Not at all

Perfectly

How do you correct the age of a preterm baby when assessing developmental milestones?

Take off the number of weeks they were born preterm off their chronological age.

(e.g. he anticipated developmental skills of a 6-month-old baby (chronological age) born 2 months early at 34 weeks’ gestation are more like those of a 4-month-old baby (corrected age).)

How well did you know this?

Not at all

Perfectly

A baby is born at 32 weeks gestation and is now 6 months old. Assuming that her neurodevelopment is normal, which of the following milestones is it reasonable to expect her to have reached?

Raises head to 45o when prone
Vocalises alone or when spoken too - coos and laughs
Reaches out for toys

How well did you know this?

Not at all

Perfectly

Which symptom indicates a focal seizure?

Abnormal taste sensation | Presence of aura with smell and taste abnormalities and/or distortion of sounds and shapes

Which symptom indicates a generalised seizure disorder?

Conscious level

Which symptom indicates a migraine?

Precipitants e.g. food, exercise.

Which symptom indicates a febrile convulsion?

fever

If you suspect congenital heart disease, which of the following is it important to ask about?

Colour change Feeding pattern Previous episodes of respiratory distress

Which condition causes developmental regression?

Hunter's syndrome

Which 2 conditions cause developmental delay?

Cerebral palsy | Downs syndrome

Which condition causes developmental deviation?

Autism spectrum disorder

what is the autistic triad?

problems with social interaction, communication and flexibility of thought/imagination.

Examples of active immunity?

Cell mediated response to BCG vaccine Seasonal flu vaccine Acquisition of anti-RSV antibodies following a viral upper respiratory tract infection

Examples of passive immunity?

cross-placental transfer of antibodies from mother to child

Healthy Start Vitamins are provided to young children of low-income families. This is most likely to reduce the prevalence of which one of the following deficiency diseases?

Healthy start vitamins for children contain vitamins A, C and D. Vitamin D deficiency can cause bones to become soft and weak leading to bone deformities such as Rickets.

Which of the following statements best describes the reason for measuring the occipitofrontal (OFC) circumference in infants?

the principal aim of checking OFC regularly is to detect abnormal brain/skull growth.

All children born in the UK are offered a range of screening tests when they are born. Which of the following diseases are these tests designed to detect?

Cystic fibrosis Sickle cell disease Congenital hypothyroidism Cystic Fibrosis Medium chain acyl-coA dehydrogenase deficiency Deafness

Globally, more than half child deaths could be prevented. The WHO has identified some key steps that could be taken to reduce child mortality. These include:

According to the World Health Organization, six solutions to the most preventable causes of under-5 deaths include: Immediate and exclusive breastfeeding Skilled attendants for antenatal, birth, and postnatal care Access to nutrition and micronutrients Family knowledge of danger signs in a child’s health Water, sanitation, and hygiene Immunizations

What's the diagnosis? A 4 year old girl with a 2 day history of runny nose and high temperature. She has developed a barking cough over the course of the day and is now showing signs of respiratory distress. She has audible stridor.

Croup

What's the diagnosis? A 6 month old boy with a 3 day history of runny nose, cough and poor feeding. He has developed worsening respiratory distress over the course of the day. He has bilateral creps and wheeze.

Bronchiolitis

Whats the diagnosis? A 9 year old boy who had a viral URTI 7 days ago but never fully recovered. He has a fever, mild respiratory distress and a dull right base with reduced air entry. His sats are 92% in air

Bacterial pneumonia

A 3 year old child is recommended to be physically active for hour(s) per day, spread throughout the day.

A 12 year old boy is recommended to have ≥ hour(s) of moderate to vigorous intensity physical activity per day.

A 7 year old girl is recommended to do vigorous activity for day(s) a week

A 13 year old boy who has had 4 generalised tonic-clonic seizures over the past 3 months. He is otherwise well, with normal development. There are no obvious precipitating factors for the seizures, but they are more likely to occur if he is tired.

Epilepsy

A 10 year old boy who has experienced 3 generalised tonic-clonic seizures over the past 6 months. Each episode has occurred whilst he has been whilst playing football. He is otherwise well.

Arrhythmia

A 2 year old girl who has lost consciousness after hurting herself on 4 occasions. A typical episode will start with crying, she will then go blue and then briefly lose consciousness. She is back to normal immediately after.

Breath holding attack

There are very few contraindications to vaccination. These include:

severe anaphylactic reaction to previous dose of same antigen Live vaccines in the immunocompromised Severe latex allergy Egg allergy (some flu vaccines and yellow fever)

Why is vaccine contraindicated in this scenario: | A 4 year old girl with acute lymphoblastic leukaemia who is due to receive her MMR. She is undergoing chemotherapy.

Live vaccines in the immunocompromised

What are the top 7 causes of child mortality in subsaharn africa? In order

``` Pneumonia Prematurity Intrapartum related complications Diarrhoea Neonatal sepsis Malaria HIV/AIDs ```

The current routine immunisation schedule given at 2 months of age includes immunisation against?

Diptheria, Tetanus, Pertussis (Whooping cough), Polio, Pneumococcus, Rotavirus, Haemophilus influenzae B

Social work and police ask for your opinion after you have examined an eighteen months old boy with unexplained bruising. He has a non tender reddish blue bruise to his lower back. They want to know how old it is. What is your response?

Unable to comment | Estimating the age of a bruise is notoriously difficult.

Semi skimmed milk should not be given before ... years

2 years

Some infants require solids earlier than recommended, but they should not be introduced until ... months of age, at the earliest

4 months

Skimmed milk should not be given before ... years

5 years

It is recommended that infants are weaned onto family foods at approximately ... months of age

6 months

For each of the conditions below, choose the most appropriate test Turner's syndrome

Array Comparative Genomic Hybridisation (aCGH)

For each of the conditions below, choose the most appropriate test Prader Willi syndrome

deletions/microdeletions | Array Comparative Genomic Hybridisation (aCGH)

For each of the conditions below, choose the most appropriate test DiGeorge syndrome

deletions/microdeletions | Array Comparative Genomic Hybridisation (aCGH)

For each of the conditions below, choose the most appropriate test Sickle cell disease

autosomal recessive | Next generation sequencing

For each of the conditions below, choose the most appropriate test Down's syndrome

aCGH

At what age (in years) would a boy be considered to have delayed puberty if he has no signs of secondary sexual development

At what age (in years) would a girl be considered to have delayed puberty if he has no signs of secondary sexual development

When assessing a child with neurodevelopmental delay. For each of the following cases, which single investigation would you choose in order to reach a diagnosis? A 3 year old boy with global developmental delay, generalised hypotonia, flat occiput and brushfield spots.

acgh

When assessing a child with neurodevelopmental delay. For each of the following cases, which single investigation would you choose in order to reach a diagnosis? 6 year old girl who hates loud noises and gets very upset in a busy classroom. She struggles to form friends and gets upset if her daily routine is disturbed.

Validated questionnaire

When assessing a child with neurodevelopmental delay. For each of the following cases, which single investigation would you choose in order to reach a diagnosis? A 5 year old boy who struggles to walk up the stairs. His calves appear enlarged. Development is otherwise normal

Below which age (in years) would a girl with pubertal development be considered to have precocious puberty?

Below which age (in years) would a boy with pubertal development be considered to have precocious puberty?

Do they have capacity? | A 16 year old boy with profound global developmental delay who requires an appendicectomy

Do they have capacity? A 14 year old girl who attends your clinic seeking the oral contraceptive pill. She is in a sexual relationship and doesn't want to get pregnant and would appear to have an understanding of potential side effects.

yes

Do they have capacity? A 13 year old girl who is on holiday with her Aunt and Uncle and presents with acute abdominal pain. She requires a blood test and demonstrates good understanding of the procedure and why it is being done.

yes

Do they have capacity? A 13 year old boy who presents with a purpuric rash and fever and refuses to have blood tests done. He won't explain why and doesn't engage with you when you explain the rationale for treatment.

Do they have capacity? | A 16 year old boy with normal development who requires an appendicectomy

yes

Where is water mainly absorbed?

Jejunum

ORS relies on what structure for osmotic pull of water?

Sodium Glucose Co-transport System. Active transport of sodium

T/F 1. Commercially available ORS solution in the UK contains less sodium than that which is used in developing countries 2. Can be easily made using a combination of salt, sugar and water

T, T