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Y5 Paeds > Chronic Illness > Flashcards

Chronic Illness Flashcards

1
Q

Definition of chronic illness

A

Condition lasting more than 3 months
Affects child’s usual age appropriate activities
Results in extensive utilisation of health care services beyond that considered age appropriate
Causes impairment / disability / disadvantage

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2
Q

What proportion of children have a chronic condition

A

10-20%

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3
Q

Name 10 common conditions that can lead to chronic disease in children

A

Asthma
ADHD
Arthritis
ASD
AID
Epilepsy
DM
Food allergy
Sickle cell
Spina bifida
Cancer
Obesity
Cerebral Palsy
Cardio conditions

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4
Q

Prevalence of psychiatric comorbidities in children with chronic illness

A

44% CP
29% epilepsy
12% physical disorders

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5
Q

Blood features leading to Dx to T1DM

A

High blood glucose
Ketonuria
High blood ketones

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6
Q

Mx of insulin

A

Blood glucose 4 times daily at least
Multiple daily dose with daytime short acting and night time long acting doses

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7
Q

Insulin MDT

A

DM nurse specialist, dietician, psychologist and consultant

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8
Q

Child who is needle phobic but T1DM. Mx?

A

Work with child psychologist to get over needle fear

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9
Q

Ideal HbA1c value

A

<6.5%

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10
Q

T1DM children should also be screened for…

A

Coaeliac
Thyroid disease
Retinopathy
Microalbuminaemia
BP
Foot review
Injection site examination for lypodystrophy

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11
Q

Advice for parents of children with T1DM and viral illness

A

Infection can lead to increased BG levels so might need more insulin (up to 20%)
Give insulin even if not eating
Viral infections likely self resolve
Check blood ketones

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12
Q

Factors that affect a T1DM teenager to adjust

A

Academic performance at school
Level of peer acceptance and support at school
His level of control over care

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13
Q

Risk of T1DM if close relative has T1DM

A

6%

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14
Q

Risk of T1DM if no close relative has T1DM

A

0.5%

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15
Q

Abroad holiday with T1DM child, what extra arrangements needed?

A

Take a letter from Dr with infomation
Take Mx in hand luggage, but inform airline

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16
Q

Renal complication of DM

A

Renal parenchymal disease due to elevated albumin:creatinine ratio

17
Q

Impact of condition on child depends on…

A

Age
Age condition developed
Severity of illness
Prognosis
Support - social and medical

18
Q

What impact does chronic illness have on a child

A

Emotional problems
Low self esteem
Impaired self image
Behavioural problems
Loss of autonomy and control

19
Q

Impacts on parents

A

Shock and disbelief
Grief
Socially isolated
Financial burden - career issues
Guilt / anger
Time management poor
Loss of control / autonomy
Holiday plans

20
Q

Impacts of siblings

A

Guilt
Anger
Resentment
Closer bond / relationship with sibling
Carer role
Holiday plans

21
Q

Impact on school and peers

A

Reduced vocational / educational skills
Reduced friendships
Reduced school involvement - trips / PE
Risk of underachieving
Adjustments made by school

22
Q

What framework can be applied to chronic illness in children?

A

Bio-psycho-social

23
Q

Biological impacts of chronic illness on adolescent development

A

Delayed / impaired puberty
Short stature
Reduced bone mass accretion - fractures
Increased caloric requirement for growth worsens disease
Hormones impact on disease parameters

24
Q

Psychological impacts of chronic illness on adolescent development

A

Infantilised
Adoption of sick role as personal identifier
Egocentricity
Rejection of medical professionals as part of seperation from parents
Impaired development of sense of attractive self / sexual
Exploratory / risk taking behaviours
Poor adherence due to poor decision making

25
Q

Social impacts of chronic illness on adolescent development

A

Reduced independence inc independent living ability
Choatic eating habits –> poor nutrition
Failure of peer / sexual relationships
XS ETOH, smoking, drugs
Social isolation
Health risk behaviours - sexual
Educational failure

26
Q

What is transition

A

Purposeful and planned movement of children with chronic physical/medical conditions from child-centred to adult-orientated healthcare system

27
Q

What is transfer

A

Single act of moving from one facility to another with ni preparation or planning ahead of time

Y5 Paeds (13 decks)

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