Community, CP and Public Health

Question 1

Define developmental impairment

Answer 1

Arrest or incomplete development of the mind, especially characterised by impairment of skills

Question 2

Give 2 prenatal causes of developmental impairment

Answer 2

• Down’s syndrome

- PKU

Question 3

Give 2 perinatal causes of developmental impairment

Answer 3

• Intravascular haemorrhage

- Hypoxic Ischaemia

Question 4

Give 2 postnatal causes of developmental impairment

Answer 4

• Post cranial radiotherapy

- Acquired brain injury

Question 5

What is the difference between global delay and specific delay?

Answer 5

Global: impairment in 2 or more domains

Specific: impairment in 1 domain

Question 6

Give 6 red flags which prompt urgent referral in terms of developmental impairment

Answer 6

1. Regression
2. Hearing loss
3. Suspected cerebral palsy
4. No speech by 18 months
5. Can’t sit alone by 12 months
6. Complex disability

Question 7

Give 3 causes of gross motor delay

Answer 7

1. DMD
2. Cerebral palsy
3. Stroke

Question 8

Give 3 causes of speech delay

Answer 8

1. Familiar
2. Hearing impairment
3. ASD

Question 9

Which 3 areas does a child with Autism have impairments of?

Answer 9

Social interaction

Social communication

Repetitive/ritualised behaviour

Question 10

Give 3 presenting features of ASD

Answer 10

Poor eye contact

Restricted behaviours

No interest in interactions with others

Question 11

How is Down’s syndrome diagnosed postnatally?

Answer 11

Neonatal unit blood test with results in 24 hours

Question 12

Define cerebral palsy

Answer 12

Umbrella term for central (brain) motor deficit, non-progressive and caused in early life

Question 13

Give 3 management steps in cerebral palsy

Answer 13

1. Refer to SALT
2. Consider gastrostomy if recurrent aspiration
3. Medical and physio management of spasticity/dyskinesia

Question 14

Define nocturnal enuresis

Answer 14

Involuntary wetting during sleep, without frequency or pathophysiology at least 2x a week in children over the age of 5

Question 15

What is the difference between primary and secondary nocturnal enuresis?

Answer 15

P: never achieved sustained continence

S: previously dry at night for over 6 months

Question 16

Give 2 causes of primary nocturnal enuresis with daytime symptoms

Answer 16

• Overactive bladder

- Chronic constipation

Question 17

Give 2 causes of primary nocturnal enuresis without daytime symptoms

Answer 17

• Lack of sleep arousal

- Polyuria

Question 18

Give 2 causes of secondary nocturnal enuresis

Answer 18

• Diabetes

- UTI

Question 19

Give 2 management steps for nocturnal enuresis

Answer 19

Advise on fluid intake

Use of alarm

Question 20

Define constipation

Answer 20

Frequency of stools <4 per week (Bristol stool type/4)

Question 21

Give 3 management options for constipation

Answer 21

• Delayed meconium passage, refer to surgeons
• Encourage good bowel habit
• Movicol

Question 22

Which 5 conditions does Guthrie heel prick test look for and when is it carried out

Answer 22

5 days old:

• PKU
• Congenital hypothyroidism
• Cystic fibrosis
• Sickle cell disease
• MCADD

Question 23

At what ages are the 3 DTaP/IVP/Hib immunisations given?

Answer 23

8 weeks
3 months
4 months

Question 24

At what ages are the MMR and it’s booster vaccine given?

Answer 24

13 months

3.5 years old

Question 25

When is the second baby check carried out and by who?

Answer 25

8 weeks old at GP

Question 26

Name the four categories of child abuse

Answer 26

Physical
Emotional
Sexual
Neglect

Question 27

Name 4 common sites for NAI

Answer 27

Cheeks
Ears
Eyes
Neck

Question 28

What type of fractures in infants are highly suspicious of abuse?

Answer 28

Rib fractures

Question 29

Give 4 signs of neglect

Answer 29

Dirty clothes
Head lice
Nappy rash
Poor dentition

Question 30

Name 3 things which would prompt a child protection investigation

Answer 30

• Disclosure by child
• Concern from carer
• Change in behaviour