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Paediatrics > Children are not Young Adults > Flashcards

Children are not Young Adults Flashcards

1
Q

What are the physiologicaldifferences

A

Large SA: volume = more cold
Reduced metabolic reserves = hypoglycaemia and dehydration
Smaller target = greater amount of energy absorbed
Large head = easily injured
Smaller mass = drug dose and fluid differ
Skeleton not calcified = deforms and less protection
Less elastic tissue =degloving
Less type 1 respiratory fibres

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2
Q

What is the most common form of hypoglycaemia in <5

A

Ketotic hypoglycaemia

Common in skinny 1-2 y/o with intercurrent illness

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3
Q

What are CVS differences in children

A 
Faster pulse (110-160)
Faster RR (30-40)
Lower BP - can maintain until very shocked (60-70)
Sats threshold <92% 
Smaller circulating volume 
SV increases as increase size 
Pulmonary resistance decreases as get older
Systemic resistance increases
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4
Q

What are conditions that are not seen in adults

A 
Abdominal migraine
Bronchiolitis
Croup
Febrile convulsion
Glue ear
Intraventricular haemorrhage
Toddler diarrhoea
VUJ reflux
Viral induced wheeze  
NAI 
Sudden unexplained death of infants
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5
Q

What are chronic conditions with childhood onset

A 
Asthma
Autism
Cerebral palsy
CF
Gastroschisis
Hirschsprung
Spina bifida
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6
Q

What accounts for reduced mortality in children

A 
Obstetric care
Better housing
Better nutrition 
Immunisations 
Antibiotics 
NHS
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7
Q

Who most commonly presents to inpatient and how long do they stay

A

<2 years
Respiratory
<48 hours

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8
Q

What are other causes of acute admission

A 
Acute LRTI
Asthma
Bronchiolitis
Croup
Febrile convulsion
Fever
Gasrtoenteritis
URTI
Vomiting
Wheeze
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9
Q

What are the most common treatmnet

A 
Watchful waiting
Ax
Prednisolone
Salbutamol
Dexamethasone
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10
Q

What is decreased birthweight associated with

A 
Impaired glucose tolerance / DM
Hypertension
CHD
Stroke
Renal failure
Asthma
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11
Q

How does metabolism differ in children

A

Brown fat
Immature shivering
Hypoglycaemia as little glycogen stores which exacerbates hypothermia

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12
Q

How do you assess paed

A

ABCDE

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13
Q

When do you start oxygen / neb

A

Sats <92%

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14
Q

What do you do for viral wheeze

A

SABA

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15
Q

What do you do if child deteriorates

A 
ABCDE
IV access 
Fluid 
Increase O2
Nebulised SABA / steroid
ABG 
CXR
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16
Q

What are respiratory differences

A 
RR higher 
Higher O2 requirement
Smaller airway 
Diaphragmatic / accessory muscles to breath
Easily fatigued 
Soft bones = compliant chest wall so indrawing and recession 
Less type 1 respiratory fibres
Can tolerate lower sats
17
Q

Airway differences in babies

A 
Large head to body
Large tongue
Large adenoids
Nasal breather so obstruct easily
Narrow airway
Short neck
18
Q

Differences between adult and children bone

A

Children have growth plate (physic) which is metabolically active cancellous bone
Some bones are still cartilage - patella / tibia / fibula
Ligaments stronger than cartilage
Young bone more porous and tolerate defomration
Less protection of internal organs

19
Q

What are absorption changes in children

A

Reduced gastric acid
Reduced gastric emptying
Delayed IV
Increased through skin

20
Q

What are distribution changes

A

CHldren have high ECF / TBW
Low fat
Low plasma protein so more active drgu
BBB not fully developed

21
Q

What are elimination changes

A

Immature liver metabolism so increased half life

Decreased renal

22
Q

What increases sensitivity

A

Fever
Dehydration
Acidosis

23
Q

What are problems in adolescent

A

Changes in hormone secretion
Change in growth and body weight
Non-compliance
Ilicit and legal drugs used

24
Q

What are problems in prescribing

A 
Effect on growth and development not known
Lack of studies on efficacy / toxicity 
Lack of SPS information
More sensitive
Greater variation 
Increased risk of ADR

Paediatrics (35 decks)

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