children vs adults Flashcards
• Understand the different anatomical and physiological characteristics of a child. • Recognise the range of pathologies that are unique to childhood and those that have their onset in childhood. • Highlight the changing nature of child health presentations • Identify the common inpatient and outpatient presentations • Discuss Sudden Infant Death Syndrome (SIDS)
4 Ps - difference between children and adults
physical
physiological
psychological
pathologies
physical differences between adults and children
children are smaller
arm length vs total body - babies can’t touch the top of their head
growth
obesity in children
don’t use absolute BMI
e.g. BMI 17 = normal at 3 then 6-16, overweight 3-6, underweight at 17
convert to centile score
- epidemiology 85% and 95%
- clincally 91% and 98%
physiological differences between adults and children
SA:vol
% water content
metabolic reserves
children get more easily: cold, dehydrated, hypoglycaemia
faster HR, RR
lower BP
- maintained until very shocked
ketotic hypoglycaemia
most common form of hypoglycaemia in children aged 18mths-5yrs
6-7am hypoglycaemic episode
1-2y/o
skinny
intercurrent illness
glycogen reserves have been used
fat reserves are being broken down
- ketones produced as a result
children’s immune system
remarkably robust
infections during 4/o-5yrs are expected as immunity from mother’s wear off and they develop their own immunity
psychological differences in children
behaviour varies with age - terrible two’s, latent phase, adolescence
pathological differences in children
some conditions aren’t seen in adults
e.g. abdominal migraine, bronchiolitis, bronchopulmonary dysplasia, croup, enuresis, febrile convulsion, glue ear, intraventricular haemorrhage, necrotising enterocolitis, non accidental injury, sudden unexplained death, toddler’s diarrhoea, vesico-ureteric reflux, viral induced wheeze
pathological differences in children - chronic conditions with childhood onset
asthma (COPD) autism cerebral palsy CF gastroschisis Hirschsprungs disease spina bifida ?dementia
many others
reasons for reduced infant and childhood mortality
obstetric care
better housing and nutrition
immunisations
better healthcare
age range distribution in children presenting with illness
> 50% of acute presentations are <2y/o
what are the most common acute medical problems that children are admitted for
acute LRTI asthma bronchiolitis croup URTI wheeze
febrile convulsions
fever
gastroenteritis
vomiting
