Children & Young People

Question 1

Malabsorption in children

Answer 1

✓ Alpha-1-antitrypsin deficiency in neonates may present with neonatal jaundice and hepatitis and older children can develop cirrhosis and liver failure. Diarrhoea is not a feature.
✓ Cow’s milk protein allergy, lactose intolerance, Cystic Fibrosis and Coeliac disease are all causes of malabsorption in children.
✓ Other features of malabsorption include failure to thrive, nutrient deficiency and steatorrhea.
✓ Other causes of malabsorption in children include Inflammatory Bowel Disease and infections like Giardiasis.
✓ In all cases close monitoring of weight is essential and plotting trends in the Personal child health record ‘red book’.

Question 2

Failure to Thrive

Answer 2

Inadequate calories intake: breastfeeding problem, improper feed formulation, GERD, cleft lip/ palate, caregiver neglect, poverty, mood disorder, eating disorder, IBS

Inadequate calorie absorption: food allergy, CMPA, coeliac disease, GERD, malabsorption, cystic fibrosis, inborn error of metabolism, IBD

Excessive calorie expenditure: thyroid disease, chronic infection, immunodeficiency, chronic pulmonary disease, congenital heart disease, malignancy

Question 3

Newborn Screening

Answer 3

Community based
@72 hours and 6 weeks NIPE - eyes, heart, hips, testes
@5 days Newborn blood test for 9 diseases - sickle cell disease, cystic fibrosis, congenital hypothyroidism, metabolic disease (PKU, MCADD, MSUD, IVA, GA1, HCU)

Question 4

Infections with rash in children

Answer 4

1st disease - Measles
2nd disease - Scarlet Fever (Grp A Strep)
3rd Disease - Rubella
4th Disease - Duke’s
5th Disease - Erythema infectiosum (slapped cheekS
6th Disease - roseola infantum