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CPS miscellaneous Flashcards

1
Q

School age children and digital media

  • potential benefits
  • risks
A

Pros: can be educational, play with peers, make friendships, lower depression risk at 1hr vs. no screen time
Cons: increase conduct problems, depressive sx, unsupervised content, impair problem solving, disrupt efficiency, depressive sx and sedentary activities

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2
Q

Adolescents and digital media

  • pros
  • cons
A

Pros:
- psychosocial benefits, social connectedness, support to explore identify, action video games may have benefits
Cons:
- anxiety, depressive sx, lower academic scores, greater impulsivity, risky behaviours online

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3
Q

Digital media and negative impact on PHYSICAL health (4)

A
  1. distractedness - e.g. driving
  2. displace physical activity
  3. weight/obesity
  4. sleep
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4
Q

4Ms for screen use

A
  • Manage screen use
  • Encourage meaningful screen use
  • Model healthy screen use
  • Monitor for signs of problematic screen use
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5
Q

Psychosocial aspects of obesity

A
  • bullied
  • neglect, maltreatment
  • associated with stressers
  • inadequate sleep = RF
  • weight bias
  • depression, social isoaltion
  • decreased self-esteem
  • behavioural problems
  • dissatisfaction with body image
  • reduced quality of life
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6
Q

Health consequences of childhood obesity

A 
insulin resistance
T2DM
dislipidemia
HTN
OSA
non-alcoholic steatohepatitis
poor self esteem
lower HRQOL
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7
Q

RFs for children being less active

A 
older children
female
Indigenous
"overscheduled" 
those who do not like sport
youth with disability
public housing
extremes of climate
local crime rates
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8
Q

Physical activity guidelines by age

- 1-4 yrs

A

1-4 yrs: 180min/day (structured and unstructured activity

<2 yrs: no screens
2-4 yrs: less than 1 hr per day

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9
Q

Physical activity guidelines

5-11 and 12-17

A

60 min MVPA daily

  • 3+days / week of vigorous and
  • 3+ days / week of muscle strengthening
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10
Q

Physical activity 10-12 yrs and screen

A

Screen < 2yrs

Physical activity: at least 60 min of moderate-to-vigorous-intensity activity daily

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11
Q

Malignant brain edema syndrome (second impact syndrome)

A
  • complication of head injury
  • loss of autoregulation in brain’s blood supply –> cerebrovascular congestion, increased ICP with progression to herniation, coma and death
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12
Q

Risk factors for prolonged recovery from concussion

A
  • previous head injuries
  • history of migraines or headaches
  • mental health issues
  • sleeping difficulties
  • learning disability
  • ADHD
  • younger age
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13
Q

If concussion symptoms persist longer than several weeks consider

A
  • neuroimaging and formal neuropsych testing
  • multidisciplinary team
  • active rehab with subthreshold activity
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14
Q

Risks of screens and early development

A

Association between heavy screen exposure and language delays, cognitive development, executive function, attention
Reduces amount and quality of parent-child interaction
Inability of young children to distinguish between reality

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15
Q

Mitigating negative impacts of screen time

A
  • watch educational, age-appropraite with adults
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16
Q

Screen time
< 2yrs
< 5 yrs

A

<2: screen time not recommended
2-5 yrs: <1hr /day
screens should not be routine part of child care, daily screen free times e.g. meals, avoid screens for >1 hr before bedtime

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17
Q

Risk factors for lead exposure

A
  • older neighbourhood, lead pipes, paints,
  • proximity to industrial waste site, old buildings, busy roadway or airfield
  • costume jewelr, candles, importe dpainted toys
  • food: imported surgar, candy, food prepared or stored in containers with lead, wild game shot with lead bullets, vegetables that accumulate lead
  • hobby/occupation: lead mining and smelting, edemolistion, renovations, hunting, pottery glazing
    Family: mother exposed to elad before or during pregnancy, lived in a country with higher lead
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18
Q

Symptoms of lead exposure

A

Asymptomatic or subtle

- cog delay, inattention, hyperactivity, speech delay, hearing impairment, poor balance

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19
Q

Investigation if suspect lead exposure

A
  • blood lead level
  • CBC
  • ferritin
  • calcium, protein, albumin
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20
Q

Health risks of climate change

A
  • heat and cold related morbidity and mortality
  • natural hazards and extreme weather events
  • air pollution
  • contaminated water sources
  • infection risks from insects, ticks, rodents
  • increasing UV radiation
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21
Q

Azithromycin indications

A
  • 2nd line for life-threatening beta-lactam allergy for acute strep pharyngitis
  • considered for pneumonia from atypical bacteria
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22
Q

Factors associated with fatalities from OTC cough and cold meds in children

A
  • age < 2yrs
  • use of med for sedation
  • use in daycare setting
  • combining 2+ meds with same ingredient
  • failure to use a measuring device
  • product misidentification
  • use of products intended for adults
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23
Q

Cough and cold meds/treatment showing little benefit

A
  • cough and cold meds
  • humidified air
  • NSAIDs
  • antihistamines
  • echinacea
  • zinc
  • vitamin C
    (honey pretty much only thing potentially beneficial)
24
Q

Role for medical cannabis

A
  • anecdotal evidence and biological plausibility for refractory epilepsy
  • risks with cannabis
25
Q

Folate for pregnant women

A
  • 0.4-1mg folic acid at least 2-3 months before conception
  • if fam hx of NTD: at least 5mg of folic acid at least 2-3 months before conception and continuing 10-12 weeks post conception
26
Q

Factors known to increase risk of NTDs

A
  • birth of previous child with a NTD (#1)
  • family hx of NTD
  • maternal obesity
  • maternal hispanic origin
  • use of some anticonvulsants
  • pregestational or gestational diabetes
27
Q

Unique challenges for pharmacare for youth

A
  1. vulnerable population
  2. unique medication needs
  3. regulatory neglect
  4. drug therapies provide significant return on investment that may not be captured
28
Q

Vanessa’s Law (Bill C-17)

A

Amendments to Food and Drug Act to enhance med safety:

  • strengthening oversight
  • improved reporting systems for A/E,
  • increased transparency
29
Q

Challenges with compounding

A
  • meds can be weaker, less stable, potent, sterile, bioavailable which can lead to significant concentration related or dosing errors
  • may have unpleasant taste leading to poor adherence
  • exposure to potentially hazardous substance = risk to patients/caregivers
30
Q

Reducing risk of ATV injuries

A
  • youth < 16 yrs should NOT operate ATV
  • youth operators shoudl wear a government certifed helmet, eye protection, protective clothing and footwear,
  • single rider ATVs shoudl not take on passengers
  • should not operate with alchol
  • should complete approved training course
31
Q

Children < 3 at high risk of mechanical airway obstruction because

A
  • airway still developing
  • eating can be difficult
  • do not consistently chew
  • swallowing is underdeveloped
  • lack experience aborting potential choking episodes
  • put more things in their mouth
32
Q

1 unintentional injury death by age group

  • <1 yr
  • > 1
A

<1 = threat to breathing

1-4, 5-9, 10-14, 15-19: motor vehicle traffic crash

33
Q

1 unintentional injury hospitalization

A

<1, 1-4, 5-9, 10-14, 15-19: fall

34
Q

Ethical issues in advanced care planning

A
  1. respect for autonomy
  2. beneficence
  3. non-maleficence
35
Q

3 requirements of informed consent

A
  1. capacity
  2. adequate information (what a reasonable person would want to know)
  3. voluntary and free of coercion
36
Q

To have “capacity” in medical decision making…

A

need to understand:

  1. nature and consequences of the medical problem
  2. risks and benefits of proposed treatment
37
Q

Appropriate genetic testing for chidlren

A
  1. to confirm a medical diagnosis in a symptomatic child
  2. to enhance monitoring, prophylaxis or treatment in an asymptomatic child e.g. familial hyperlipidemia, MEN
    (dont do reproductive decision-making in child until old enough to participate in decision-making)
38
Q

Risk factors for CA-MRSA infection

A
  • overcrowding
  • frequent skin-to-skin contact
  • activities that lead to abraded /compromised skin surfaces
  • sharing contaminated personal items
  • personal cleanliness and hygiene
  • limited access to health care
  • lower SES
  • exposure to abx
39
Q

Factors contributing to increased rates of CA-MRSA in Indigenous populations

A
  1. overcrowding (10x more frequent on reserve and for Inuit)

2. homes not having potable water

40
Q

Consequences of early childhood caries

A
  • association with other diseases e.g. RTIs, AOM (weak relationship)
  • painful, altered chewing, eating and sleeping
  • early tooth loss can lead to speech difficulties, poor self esteem
  • increased risk of decay in primary and permanent teeth
  • malalignment and crowding of teeth
  • association with obesity
  • may require treatment under GA
41
Q

Single greatest risk factor for early childhood caries

A
  1. poverty!
    other RFs: crowding, family size, nutrition, health behaviours, parenting practices, parent’s oral health, dietary factors (prolonged bottle use or sugar-containing drinks, sugary snacks), environmental tobacco and maternal smoking status
42
Q

OCAP principles of self-determination in health research with Indigenous ppls

A

Ownership
Control
Access
Possession

43
Q

Reporting incidence of inhalant abuse is challenging because

A
  • lack of recognition
  • social stigma
  • changing trends
  • apparent regional differences
  • differences in survey methods
  • older kids stop reporting because ?less socially acceptable ?forgot
44
Q

Inhalant abuse is correlated with

A
  • reduced family support
  • deviant fam environments
  • poor school performance
  • poor self-esteem and suicidality
  • psych conditions
  • other substance abuse
  • substance abusing family and peers
45
Q

Discrepancy in injuries in Indigenous vs. non-indigenous due to

A
  • lower incomes
  • less education
  • higher unemployment
  • more rural
  • more likely to live in unsafe housing
  • more likely to encounter shortages in health care resources
  • historical inequities/cultural alienation/residential school
  • depression, alcohol, substance use, rick-taking behaviours
  • lack of culturally appropriate injury prevention programs
46
Q

6Es in injury prevention

A 
Education
Empowerment
Enabling
Engineering
Enforcement
Employment
47
Q

Risk factors for scabies

A 
poverty
overcrowding
bed-sharing
families with many children
malnutrition
reduced access to health care
some Indigenous communities/resource poor communities
48
Q

Features of scabies infection

A
  • prurutiic rash
  • worse at night
  • characteristic locations (e.g. fingers, wrist, elbows, armpits, genitals or breasts)
  • sx in other household members
    +/- burrows
49
Q

Scabies management

A 
1st line: 
5% permethrin cream
- neck to toes 
- reapply after 7 days
(for babies, head to toe)
- treat all household members, launder all linens
50
Q

Living conditions contributing to high rates of TB in Indigenous populations

A
  • crowded and poor quality housing (moulds, air pollutants)
  • food insecurity
  • barriers to health care access
51
Q

Unique challenges for Indigenous youth smokers

A
  • parents/siblings smoking

- family support is important factor in quitting

52
Q

Low vitamin D

- impacts of fetus/long term effects

A 
Long term:
- decreased bone density
- worse asthma
- T1DM
- enamel defects in teeth
Short term: hypocalcemia, rickets, small size, dental
53
Q

Factors affective Vitamin D sufficiency

A
  • exposure to sunlight
  • skin pigmentation
  • clothing
  • use of sunscreen
54
Q

Vitamin D recommendations for:

  • pregnant moms
  • prems
  • term infants
  • term infants in northern communities (>55th parallel)
A 
Pregnant: ~1000-2000
Prem: 200 IU/kg/day 
to 400IU/day
Term: 400IU/day
Term in North: 800IU/day October to April
55
Q

Risk factor for all hockey injuries

A
  • bodychecking or policy permitting
  • age (older age)
  • session-type (game>practice)
  • level of player (higher level)
  • player position (goalie=protective)
  • size esp if <25th percentile
  • previous hx of injury

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