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paediatrics > development, vaccs, blood spot, disability, blood gas, fluids, assessing febrile child > Flashcards

development, vaccs, blood spot, disability, blood gas, fluids, assessing febrile child Flashcards

1
Q

4 areas

A

gross motor
fine motor and vision
speech, language and hearing
social

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2
Q

gross motor milestones

A 
3-6 months rolls, sits supported
9 months pulls to a stand
12 months walks
2 years walks up steps
3 years jumps
4 years hops
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3
Q

fine motor and vision milestones

A

4 months grasps / reaches out for objects / uses both hands
8 months takes objects
12 months scribbles, develops pincer grip
18 months builds with blocks 2/3
3 years tower of blocks 8

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4
Q

fine motor and vision milestones - shapes that can be drawn at what ages

A 
1 scribble
2 straight line
3 circle
3/4 cross
4 square
5 triangle
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5
Q

speech, language and hearing milestones

A

3 months laughs and squeals
9 months babbles, mama/dada
12 months single words
2 years two word sentences
3 years speech understandable
4 years knows colours, can count reasonably
5 years knows meaning of words (over/under)

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6
Q

social milestones

A 
6 weeks smiles spontaneously
6 months finger feeds
9 months waves 'bye-bye'
12-18 months uses cutlery
2 years takes clothes off
3 years puts clothes on, plays with others
4 years dress no help
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7
Q

neonatal blood spot all 9 things

A 
sickle cell anaemia
CF
congenital hypothyroidism
phenylketonuria
homocystinuria
medium chain acyl CoA dehydrogenase deficiency
isovaleric acidaemia
glutaric aciduria type 1
maple syrup urine disease
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8
Q

neonatal blood spot inherited metabolic disorders

A 
phenylketonuria PKU
medium chain acyl CoA dehydrogenase deficiency MCADD
maple syrup urine disease MSUD
isovaleric acidaemia IVA
glutaric aciduria type 1 GA1
homocystinuria HSU
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9
Q

neonatal blood spot non metabolic disorders

A

sickle cell anaemia
CF
congenital hypothyroidism

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10
Q

vaccinations at 8 weeks

A

diphtheria, hep B, haemophilus influenza type B, polio, pertussis, tetanus [6 in 1]
pneumococcal
rotavirus
meningitis B

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11
Q

vaccinations at 12 weeks

A

diphtheria, hep B, haemophilus influenza type B, polio, pertussis, tetanus [6 in 1]
rotavirus

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12
Q

vaccinations at 16 weeks

A

diphtheria, hep B, haemophilus influenza type B, polio, pertussis, tetanus [6 in 1]
pneumococcal
meningitis B

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13
Q

vaccinations at 1 year

A

haemophilus influenza type B, meningitis C [2 in 1]
measles, mumps, rubella [3 in 1]
pneumococcal
meningitis B

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14
Q

vaccinations at 3 years and 4 months

A

measles, mumps, rubella [3 in 1]

diphtheria, tetanus, pertussis, polio [4 in 1 pre school booster]

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15
Q

vaccinations at 12-13 years

A

human papilloma virus (to prevent cervical cancer)

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16
Q

vaccinations at 14 years

A

tetanus, diphtheria, polio [3 in 1]

meningitis ACWY

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17
Q

vaccination 2-10 years (every year)

A

flu vaccine (influenza)

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18
Q

whats WHODAS

A

WORLD HEALTH ORGANISATION
DISABILITY ASSESSMENT SCHEDULE
• A generic assessment instrument for health and disability
• Used across all diseases, including mental, neurological and addictive disorders

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19
Q

WHODAS 6 DOMAINS OF FUNCTIONING

A
  • Cognition – understanding & communicating
  • Mobility– moving & getting around
  • Self-care– hygiene, dressing, eating & staying alone
  • Social– interacting with other people
  • Life activities– domestic responsibilities, leisure, work & school
  • Participation– joining in community activities
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20
Q

quality of life definition

A

The degree to which a person enjoys the important
possibilities of his/her life.
• Being –who one is
• Belonging –how one fits into the environment
• Becoming –How to have purposeful activities in order to achieve ones goals

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21
Q

WHAT DETERMINES DISABILITY ?

BIOPSYCHOSOCIAL MODEL examples

A

bio - genetic vulnerabilities
psyc - self esteem
social - family circumstances

22
Q

Primitive reflexes examples / when they diminish

A

moro - drop baby arms spread out
grasp - stroke palm, baby grasps
Galant - stroke spine, baby turns to that side
normally present in the term infant and diminish over the next 4 to 6 months of life.

23
Q

Postural reflexes examples / when they diminish

A

positive support reflex, Landau, lateral propping and parachute emerge at 3 to 8 months of age.

24
Q

pedigree signs

A

look up

25
Q

respiratory acidosis features

A

pH - low
pCO2 - high
HCO3 - normal

Respiratory depression
Guillain-Barre
hyperventilation

26
Q

respiratory acidosis with metabolic compensation

features

A

pH - low/normal
pCO2 - high
HCO3 - high

27
Q

respiratory alkalosis features

A

pH - high
pCO2 - low
HCO3 - normal

Anxiety
Hypoxia

28
Q

respiratory alkalosis with metabolic compensation

features

A

pH - high/normal
pCO2 - low
HCO3 - low

29
Q

metabolic acidosis features

A

pH - low
pCO2 - normal
HCO3 - low

DKA

30
Q

metabolic acidosis with respiratory compensation

features

A

pH - low/normal
pCO2 - low
HCO3 - low

31
Q

metabolic alkalosis features

A

pH - high
pCO2 - normal
HCO3 - high

D+V

32
Q

metabolic alkalosis with respiratory compensation

features

A

pH - high/normal
pCO2 - high
HCO3 - high

33
Q

high base excess

A

A high base excess (> +2mmol/L) indicates that there is a higher than normal amount of HCO3- in the blood

may be due to a primary metabolic alkalosis or a compensated respiratory acidosis.

34
Q

low base excess

A

A low base excess (< -2mmol/L) indicates that there is a lower than normal amount of HCO3- in the blood

suggesting either a primary metabolic acidosis or a compensated respiratory alkalosis.

35
Q

anion gap

A

(positive anions k/na) + (negative anions hco3/cl)

normal 3-11

36
Q

Mixed respiratory and metabolic acidosis features

A

pH - low
pCO2 - high
HCO3 - low

multi organ failure

37
Q

Mixed respiratory and metabolic alkalosis features

A

pH - high
pCO2 - low
HCO3 - high

excess vomiting and diarrhoea

38
Q

fluid calculations - estimate of weight

A

(age+4) x 2

39
Q

fluid calculations - maintenance fluids

A

first 10kg - 100ml/kg
second 10kg - 50ml/kg
every other kg after - 20ml/kg

rate in ml/24hrs

40
Q

fluid calculations - fluid deficit

A

Deficit(%) x 10 x Wt(kg)

41
Q

fluid calculations - rate of rehydration

A

maintenance + fluid deficit

42
Q

fluid bolus

in DKA

A

20 mls/kg 0.9% sodium chloride

10 mls/kg 0.9% sodium chloride

43
Q

assessing febrile child traffic light categories

A 
colour
activity
respiratory
circulation and hydration
other
44
Q

assessing febrile child traffic light - colour

low, intermediate, high risk

A

low - normal
intermediate - pallor
high - pale, blue

45
Q

assessing febrile child traffic light - activity

low, intermediate, high risk

A

low - smiles, responds normally
intermediate - decreased, no smile, not responding as normal
high - non responsive, dosnt wake

46
Q

assessing febrile child traffic light - respiratory

low, intermediate, high risk

A

intermediate - nasal flaring, tachyponea RR>50 SATS O2 <95 in air
high - grunting , recessions, tachyponea RR>60

47
Q

assessing febrile child traffic light - circulation and hydration
low, intermediate, high risk

A

intermediate - tachycardia, CRP>3, dry mucous membranes, reduced urine output
high - reduced skin turgor

48
Q

assessing febrile child traffic light - other

low, intermediate, high risk

A

intermediate - temp >39, fever >5 days, rigors, swelling

high - buldging fontanelle, non blanching rash, neck stiffness, seizures

49
Q

assessing dehydration
mild
moderate
severe

A

Mild (<5%)
• Thirst
• Dry lips
• Restlessness, irritability

Moderate (5-10%)
• Sunken eyes
• Reduced skin turgor
• Decreased urine output

Severe (>10%)
• Reduced consciousness
• Cold, mottled peripheries
• Anuria

50
Q

fluid composition

A

0.9% sodium chloride + 5% glucose

paediatrics (13 decks)

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