CSA Flashcards
varenicline
AKA champix. mimics effects of nicotine.
standard treatment 12 weeks
SE: nausea, insomnia, abnormal dreams and less commonly mood changes
not for
buproprion
AKA zyban.
alters levels of chemicals in brain which seem to relieve withdrawal symptoms associated with stopping smoking.
standard course 8 weeks
SE: dry mouth, insomnia and rarely seizures
not for
downs syndrome characteristics
macroglossia, epicanthic folds, upslanting palpebral fissures single transverse palmar crease
higher incidence of congenital heart defects, GORD, recurrent ear infections and thyroid problems.
screening test for downs
combined test (USS and bloods)- includes nuchal trnaslucency scan and blood tests for serum PAPP-A and bHCG 12 weeks
diagnostic tests
amniocentesis- sample form the amniotic sac using a fine needle. 15 weeks and 1% miscarraige risk.
CVS up to 13 weeks 6 days and carries 2% miscarriage risk
explanation of downs syndrome
genetic disorder where a person inherits and extra copy of one chromosome
additional genetic material changes the finely tuned balance of the body resulting in chararcteristic features and affects the normal physical development.
screening for sickle cell disease and thalassaemias
offered routinely by 10 weeks
sickle cell is most common in people of african-carribean descent.
for a baby to be affected, both parents must have the sickle cell gene.
trait occurs in people with one sickle cell gene and one normal gene. people with sickle cell trait dont usually have any manifestation of the disease but are a carrier of the disease.
explanation sickle cell
affects the normal oxygen carrying capacity of the red blood cells due to a change in the biochemistry of haemoglobin. when sickle shaped cells block small blood vessels less blood can reach that part of the body. this can result in damage to those affected tissues. this is what causes the complications of sickle cell disease
explain cystic fibrosis to pt
have to have 2 CF genes, one from mother and one from father.
a pair of genes on chromosome 7 dont work correctly.
These genes are responsible fo the way cells handle salt and water and they control mucous secretions. when you have CF, water and salt arn’t transported out of cells so efficiently so mucous secretions are thicker than normal
these sticky secretions are difficult to clear from the body, leading to increased lung infections and damage to the digestive system.
investigations for CF
- genetic testing pre-natally. blood tests or scrapings from the inside of the mouth can be used to check for the CF gene in parents
- antenatal testing- CVS from 10 weeks ( only offered thought to have high risk of child with disease)
- after birth sweat test and blood from guthrie heel prick test is routinely screening for CF by checking increased levels of immuno-reactive trypsinogen around 7 days
CF managment
if one or both parents carry teh gene, refer for genetic counselling
PIL
if confirmed need MDT, specialist nurses, physio and dieticians
treatments include
resp:physio, AB,s inhalers and nebs
digestive probs: high fat/ carb diet and enzyme supplements
meningitis explanation
swelling of tissues around the brain and is usually caused by an infection
symptoms develop quickly and urgent treatment is needed with antibiotic injections
if meningitis is suspected when in hospital a sample of fluid may be taken from around the cord to determine the cause
prevention: children can now be routinely immunised against meingococcal group C and haemophilus influenza B
nocturnal enuresis.
1 in 7 children aged 5, 1 in 20 age 10.
Primary nocturnal enuresis - never dry at night.
secondary if bladder control for 6 months, then bed wetting started.
adhd
common condition affecting behaviour. no simple test- if sx, likely referred to specialist to dx and start any rx if necessary,
family support, encourage balanced diet, good nutrition and regular exercise.
d and v.
common in young children esp
