HD: PBL 5 (Child Development and Menopause)

Question 1

What is required for normal language development?

Answer 1

Normal brain development, normal hearing and appropriate language stimulation

Question 2

What are developmental milestones?

Answer 2

Skills that children achieve as they develop which can be tested/measured

Question 3

What are the Denver sub-divisions of development?

Answer 3

Gross motor, fine motor, language and personal social

Question 4

How is the Denver Developmental Screening Test used with a child that presents with a possible developmental delay?

Answer 4

To assess all areas of development to see if they have a general learning disability or a specific problem affecting only one area of development

Question 5

What developmental milestones should be reached at 6 weeks?

Answer 5

Gross Motor - lifts head when prone
Fine Motor - palmar grasp
Language - cooing
Personal/Social - social smiles

Question 6

What developmental milestones should be reached at 6-8 months?

Answer 6

Gross Motor - sits
Fine Motor - visually guided reaching
Language - babbling
Personal/Social - stranger awareness

Question 7

What developmental milestones should be reached at 10-15 months?

Answer 7

Gross Motor - walks
Fine Motor - pincer grasp
Language - first words
Personal/Social - object permanence

Question 8

What developmental milestones should be reached at 18 months- 2 years?

Answer 8

Gross Motor - runs (trying stairs)
Fine Motor - tower of 3 bricks
Language - 2/3 word utterances
Personal/Social - play with toys

Question 9

What developmental milestones should be reached at 3 years?

Answer 9

Gross Motor - climbing stairs (alternate feet)
Fine Motor - tower of 9 bricks and drawing circle
Language - asking questions,
Personal/Social - play with other children

Question 10

What is the role of Children’s Centres?

Answer 10

Offer a range of facilities for young children; those with problems can be referred to an appropriate specialist e.g. SALT, physiotherapist or community paediatrician as these centres work to offer a series of developmental reviews by GPs and health visitors

Question 11

What is a vaccine?

Answer 11

Provides passive immunity, whereby antibodies are administered but the immune system remains unchanged for long-term adaptation

Question 12

What is an immunisation?

Answer 12

Exposure to an attenuated pathogen which causes the development of immune cells to this antigen to provide life-long immunity to infection

Question 13

At what age does menopause usually occur?

Answer 13

52 years

Question 14

What is classed as early menopause?

Answer 14

40-45 years

Question 15

What is classed as premature menopause?

Answer 15

Before 40 years of age

Question 16

What are the short-term symptoms of the menopause?

Answer 16

Changes in menstrual cycle, hot flushes/night sweats, palpitations, headaches, depression, memory loss, panic, urinary frequency, urge/stress incontinence, vaginal dryness, brittle nails and joint/muscle pains

Question 17

What are the long-term symptoms of menopause?

Answer 17

Hyperlipidaemia (IHD), osteopenia and osteoporosis, inelastic skin, easy bruising, prolapse, supressed libido, Alzheimers

Question 18

Why does the menopause increase the risk of osteoporosis?

Answer 18

Greater amount of bone resorption (degeneration) in comparison to bone deposition leading to reduced overall bone mass due to the lack of inhibitory action of bone resorption provided by oestrogen

Question 19

What is Dowager’s hump?

Answer 19

Forward curvature of the spine resulting in a stoop, typically in women with osteoporosis and is caused by the collapse of the front edges of the thoracic vertebra

Question 20

What treatments are available to treat the symptoms of menopause?

Answer 20

Hormone replacement therapy, biphosphates and calcitonin, selective oestrogen receptor modulators and clonidine and venlaflaxine

Question 21

Describe hormone replacement therapy

Answer 21

Oestrogen and progesterone prescribed (if no uterus present only oestrogen) via tablets, patches, gels etc.

Question 22

What are the common side effects of hormone replacement therapy?

Answer 22

Heavy cyclical or irregular bleeding, bloating, fluid retention, weight gain, mastalgia (breast pain), headaches, muscle cramps, abdominal pain and depression

Question 23

What are serious potential complications of HRT?

Answer 23

Increases the risk of breast cancer after 5 years of use, can have thrombo-embolic events such as DVT or PE as a result of treatment

Question 24

How may biphosphates and calcitonin work to manage menopause?

Answer 24

Decrease osteoclast activity to reduce bone resorption –> reduced likelihood of osteoporosis

Question 25

How may clonidine and venlaflaxine be used to treat the symptoms of menopause?

Answer 25

Reduce the vasomotor symptoms e.g. hot flushes

Question 26

When is a women considered to have reached the menopause?

Answer 26

After a year without menstruation (LMP 12 months ago)

Question 27

What are infants routinely vaccinated against?

Answer 27

Diphtheria, polio, tetanus, pertussis (whooping cough), haemophilus influenza type B, pneumococcal, MenB, rotavirus gastroenteritis, rotaverius, MenC, measles, mumps, rubella