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Paediatrics > General Medicine and Ethics > Flashcards

General Medicine and Ethics Flashcards

1
Q

What is included in a maternal/antenatal history?

A

Maternal health during pregnancy
Mode of delivery - including inducing and instruments used
How long was the gestation?
How heavy was the newborn?
Any postnatal problems? (time of Neo ward?)

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2
Q

What is included in the PEWS chart for a chid?

A

Temperature, respiratory rate, heart rate, oxygen saturation, capillary refill and AVPU level

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3
Q

What is Shaken Baby Syndrome?

A

If a baby is forcefully shaken, his or her fragile brain moves back and forth inside the skull. This causes bruising, swelling and bleeding. Shaken baby syndrome usually occurs when a parent or caregiver severely shakes a baby or toddler due to frustration or anger.

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4
Q

What are the further investigations for Shaken Baby Syndrome?

A

Skeletal Survey to look for fractures. Finger tip bruising may suggest that there are posterior rib fractures.

Ophthalmology review to assess for retinal haemorrhages- this could suggest shaken baby syndrome.

Metabolic testing to exclude glutaric aciduria as this is associated with intracerebral haemorrhage.

Detailed testing of blood coagulation e.g. von Willebrands factor (this should be repeated later as can rise to normal levels in the acute phase).

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5
Q

What are the 4 types of abuse to children (and an extra possible type)?

A

Physical, emotional, sexual, neglect (and factitious/induced injury)

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6
Q

What signs in a history convince you that an injury is Accidental?

A

Mechanism of injury goes with history

All stories are consistent

No delay in seeking medical help

Appropriately concerned parent

One-off injury

Injury consistent with child’s age and personality

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7
Q

What signs in a history convince you that an injury is Non-accidental?

A

The mechanism of injury is not consistent with the actual injury/no mechanism of injury is offered

Inconsistent stories

Child confession

Delay in seeking medical help

Inappropriate reactions from parents

Recurrent injuries

Injury inappropriate for child’s age

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8
Q

What type of fractures might indicate an Accidental Injury?

A

Linear skull fractures

Long bone fractures in >5yrs old

Specific type of fracture e.g. 4% supracondylar fractures are due to abuse Vs non-supracondylar humeral fractures are highly associated with abuse

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9
Q

What type of fractures might indicate Non-accidental injury?

A

Metaphyseal fractures

Posterior rib fractures

Fractures of different ages

Complex skull fractures

Long bone shaft fractures in non-mobile child

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10
Q

What does this image show?

A

Finger bruising

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11
Q

What does this image show?

A

Cigarette bruns

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12
Q

What does this image show?

A

Glove-stocking scalding mark

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13
Q

What does this image show?

A

Slapped Cheek

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14
Q

What is a body map?

A

It is a pictoral document used to map bruises and marks on a childs body if they have come in with an injury.

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15
Q

What is the gross motor ability of a newborn?

A

Moves head from side to side

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16
Q

What is the gross motor ability of a 6/7 month old?

A

Sits up alone (no support)

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17
Q

What is the gross motor ability of a 12 month old?

A

Standing alone (no support)

18
Q

What is the gross motor ability of a 15-18 month old?

A

Walks independently

19
Q

What is the gross motor ability of a child >2 years old?

A

Runs and jumps

20
Q

What is the vision and fine motor ability of a 2 week old child?

A

Following faces

21
Q

What is the vision and fine motor ability of a 6/7 month old?

A

Transfering objects from one hand to another

22
Q

What is the vision and fine motor ability of a 9 month old?

A

Pincer grip and pointing

23
Q

What is the vision and fine motor ability of a 15-18 month old?

A

Immature grip of pencil

Random Scribbles

24
Q

What is the vision and fine motor ability of a child >2 years old?

A

Drawing

25
Q

What is the personal and social ability of a 6 week old?

A

Smiles at faces

26
Q

What is the personal and social ability of a 6/7 month old?

A

Feeding self

Fears strangers

27
Q

What is the personal and social ability of a 12 month old?

A

Waves at people

Drinks from a cup

28
Q

What is the personal and social ability of a 15-18 month old?

A

Feeds self

Helping with dressing

29
Q

What is the personal and social ability of a child >2 years old?

A

Parallel play with other children (won’t share and won’t interact)

30
Q

What is the hearing, speech and language ability of a newborn?

A

Stills/Alerts to noise or bell

31
Q

What is the hearing, speech and language ability of a 7 month old?

A

Monosyllabic babbling

32
Q

What is the hearing, speech and language ability of a 12 month old?

A

Uses 2-3 words

Understands their name

33
Q

What is the hearing, speech and language ability of a 15-18 month old?

A

Uses 6-10 words

Points to at least 2 body parts

34
Q

What is the hearing, speech and language ability of a child >2 years old?

A

Can say 3-word to 4-word sentences

Understands two joined commands

35
Q

What is gestational correction?

A

Correcting age for weight, height and head circumference according to whether a child was born before full term.

For example, if a child is born at 33 weeks’ gestation (40 weeks 33 weeks = 7 week difference), then add 7 weeks onto each milestone, so if they’re expected to use a pincer grip at 12 months, then the child born prematurely (at 33 weeks) would be expected to use a pincer grip at 12 months + 7 weeks, so roughly 14 months

36
Q

What is the fluid maintenance formula for paediatrics?

A

First 10kg - 100mL/kg - e.g. 10kg equals 1000mL (1L)

Next 10kg - 50mL/kg - e.g. 10kg equals 500mL

All kgs over 20kg, 20mL/kg

Therefore, a child who is 50 kg would be calculated as 1000mL + 500mL + 600mL = 2100mL (2.1L)

37
Q

How do you work out how much fluid to give in fluid resuscitation?

A

% dehydration x weight (kg) x 10 = fluid deficit (what needs to be replaced)

% dehydration = { [weight when well (kg) - current weight (kg)]/[weight when well (kg)] } x 100

38
Q

What should be asked in an paediatric history, relating to pregnancy?

A

How many weeks gestation was the child when born?

Where there any problems during pregnancy?

Where there any problems during the birth?

What type of birth? Instruments used?

What was the baby’s birth weight when born?

Is the child developing well?

Up to date immunisations?

39
Q

What needs to happen before a child receives a vaccination?

A

The child needs to be bathed, to make sure their skin is clean.

40
Q

What is a Mongolian Blue Spot?

A

Flat bluish- to bluish-gray skin markings

Paediatrics (10 decks)

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