Introduction Flashcards
What is the UN definition of a child?
Every human being below the age of eighteen years unless, under the law applicable to the child, majority is attained earlier
What is the age group of most paediatric patients in ARI?
Generally < 16
What are the main differences between children and adults?
Physical
Physiological
Psychological
Pathologies
What centile on a growth chart is the average?
50th
Between what centiles on a growth chart are considered normal?
2nd-98th
How do you define a child as obese?
Using previous positions on growth charts, weight, height etc. - cannot use BMI alone
What are the main physiological differences between children and adults?
Increased surface area:volume ratio
Higher % water content
Fewer metabolic reserves
-> children get cold, dehydrated and hypoglycaemic more easily than adults
What is the typical presentation of ketotic hypoglycaemia?
6-7am hypoglycaemic episode
1-2 year old child
Skinny
Intercurrent illness
What vaccinations are not given to infants due to inability of immune system to remember those particular infections?
MMR
Pneumococcal vaccine
Where does the immunity of newborns come from?
Mother
How can chickenpox be an indicator of a child’s immunity?
If chickenpox is cleared quickly/normally then indicates that immune system is functioning
What are the cardiovascular differences between children and adults?
Children have
- faster pulse
- higher respiratory rate
- lower BP (until very shocked e.g. septic shock)
What is important in determining whether development is normal?
Understanding range of normal
What cause/when are there psychological differences in children throughout development? What do these have implications for?
Terrible twos
Latent phase
Adolescence
Adverse childhood effects e.g. bullying, witnessing domestic abuse
All have implications for history taking and resilience
What conditions are seen in children and not in adults?
Abdominal migraine Bronchiolitis Bronchopulmonary dysplasia Croup Enuresis Febrile convulsion Glue ear Intraventricular haemorrhage Necrotising enterocolitis Non-accidental injury Sudden unexplained death of infants Toddler's diarrhoea Vesico-ureteric reflux Viral induced wheeze
What are some chronic conditions with childhood onset?
Asthma (COPD) Autism Cerebral palsy Cystic fibrosis Gastroschisis Hirschsprungs disease Spina bifida
What are the reasons for reduced child mortality?
Obstetric care Better housing Better nutrition Immunisation Antibiotics NHS (minor effect)
What conditions has immunisation had an impact on?
Measles Diphtheria Polio Rotavirus RSV Chickenpox
Who delivers child health?
Emergency physicians Neonatologists Community paediatricians Orthopaedic surgeons Medical paediatricians Paediatric surgeons General practice
What percentage of acute presentations in paediatrics are aged < 2 years?
> 50%
What percentage of outpatient presentations are aged < 2 years?
40%
What percentage of outpatient presentations are aged > 10 years?
20%
What is the typical acute presentation in paediatrics?
< 2 years old Respiratory Increasing referrals Mostly treated with watchful waiting No evidence of increasing severity
What non-communicable diseases are associated with foetal origins?
Lower birthweight associated with increased non-communicable diseases;
- hypertension
- CHD/stroke
- NIDDM
- renal failure
- asthma
What post-natal factors are associated with non-communicable diseases?
Weight gain/nutrition
Adverse childhood experiences
What are the common acute referrals to RACH?
Acute LRTI Asthma Bronchiolitis Croup Febrile convulsion Fever with unknown cause Gastroenteritis URTI Vomiting Wheeze
What are the common managements of acute admission to paediatrics?
Nothing - watchful waiting Antibiotics Prednisolone Salbutamol Dexamethasone Others
