HD PBL 5

Question 1

Which injections should be given at 8 weeks?

Answer 1

• diphtheria, tetanus, pertussis, polio, HiB, Hep B
• pneumococcal
• meningococcal B
• rotavirus

Question 2

Which injections should be given at 12 weeks?

Answer 2

• diphtheria, tetanus, pertussis, polio, HiB, Hep B

- rotavirus

Question 3

Which injections should be given at 16 weeks?

Answer 3

• diphtheria, tetanus, pertussis, polio, HiB, Hep B
• pneumococcal
• Men B

Question 4

Which injections should be given at 1 year?

Answer 4

• Men C + HiB
• Men B
• Pneumococcal
• MMR

Question 5

What causes whooping cough? What is the incubation period?

Answer 5

• Caused by Bordetella pertussis

- Incubation period is 10-14 days

Question 6

What are the S+S displayed during the catarrhal stage of whooping cough?

Answer 6

• malaise
• fever
• nasal discharge
• conjunctivitis
• sore throat

Question 7

What are the S+S displayed during the paroxysmal stage of whooping cough?

Answer 7

• prolonged cough with inspiratory whoop
• cyanosis
• vomiting
• subconjunctival haemorrhages

Question 8

How is whooping cough treated?

Answer 8

Clartithromycin (oral macrolide) - give within 21 days

Question 9

Describe herd immunity.

Answer 9

Reduced infection/disease in the unimmunised population as a result of immunisation of a proportion of the population

Question 10

In terms of neonatal screening, when is the physical exam done and what are you looking for?

Answer 10

• within 72 hours and again at 6-8 weeks
• looking for:
  1. cataracts
  2. congenital heart defects
  3. developmental dysplasia
  4. undescended testes

Question 11

When is the hearing screening done in neonates?

Answer 11

4-5 weeks

Question 12

When is the neonatal blood spot screening performed? What conditions can be detected?

Answer 12

• perform 5-8 days
• detects:
  1. congenital hypothyroidism (TSH)
  2. cystic fibrosis (immunoreactive trypsinogen)
  3. sickle cell disease
  4. phenylketonuria
  5. isovaleric acidaemia
  6. medium-chain acyl-CoA dehydrogenase deficiency (octanoyl carnitine)
  7. glutaric aciduria type 1
  8. homocystinuria (pyroxidine is unresponsive)
  9. maple syrup urine disease

(cute cats sometimes pee in my grandmother’s handbag, meow)

Question 13

Define SIDs. When does it most often occur?

Answer 13

SIDs = sudden death of an infant (<1 y/o), whcih reamins unexplained after thorough investigation
- leading cause of infant death
Peak incidence = 1-3 months

Question 14

What are strong risk factors for SIDs? What are the other risk factors?

Answer 14

Strong risk factors:

• sleeping in prone position
• co-sleeping
• smoking
• formula feeding

Other risk factors:

• male
• prematurity/LBW
• overheating
• lack of immunisation
• lower socioeconomic status
• maternal drug use

Question 15

What is MCAAD and what complication can arise with this disorder?

Answer 15

• disorder of fatty acid metabolism
• the body is incapable of breaking down medium chain fatty acids
• cannot use fats for ATP generation in starvation
• means that there is continuous breakdown of glucose
• can lead to severe hypoglycaemia, hypoketonuria and death

Question 16

What is the inheritance pattern for MCAAD?

Answer 16

Autosomal recessive

Question 17

How is MCAAD diagnosed?

Answer 17

Raised octanoyl carnitine

Question 18

What is the rate of SIDs in England and Wales?

Answer 18

0.3 deaths per 1000 live births

Question 19

Name 3 other possible causes of infant mortality.

Answer 19

Any from:

• Lethal congenital malformations Infections
• Rare inherited conditions
• Accidents
• Non-accidental injury and infanticide

Question 20

What does CONI stand for?

Answer 20

Care of the next infant