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Pediatrics > Introduction to Pediatrics > Flashcards

Introduction to Pediatrics Flashcards

1
Q

Pediatrics is concerned with?

A

Not only concerned with particular organ systems and biological processes, but also with environmental and social influences which have a major impact on the total development of the child.

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2
Q

what is the cutoff for a pediatric consult in the Philippines

A

17 years, 364 days

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3
Q

where does HPI come from for pediatric patients?

A

Caregiver

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4
Q

Because of the paucity of signs in infants/children,

A

making a diagnosis is difficult.

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5
Q

what is the 5th Vital sign?

A

Weight

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6
Q

A Child’s World

A

(10% nature; 90% nurture)

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7
Q

FACTORS THAT IMPACT THE HEALTH OF THE CHILD

A

● economic conditions
● educational, social, and cultural considerations
● health and social welfare infrastructure
● climate and geography
● agricultural resources and practices (nutritional
● resources)
● stage of industrialization and urbanization
● gene frequencies for certain disorders
● ecology of infectious agents and their hosts
● social stability
● political focus and stability

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8
Q

B. CHILDREN POPULATION IN THE WORLD

A

● Worldwide, children (< 15 years) represent 14%
of the world’s 7.2 billion persons (2015)
● In the Philippines, children < 15 years represent
33.4% of the nation’s 92.34 million population
(NSO, 2010)
● Current Philippine population: 92.34 million (NSO,
2010)

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9
Q

PERINATAL PERIOD

A

20th week of gestation to the first

seven days after birth

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10
Q

NEWBORN/ NEONATAL PERIOD

A

● Birth to 28 days (important when we talk about
infections eg. Early septicemia)
● Very early (<24 hrs), Early (24 hrs to 7 days), Late
(7 to 28 days)
● Average weight: 3 kg (for Filipinos it is 2.5 kg),
Average length: 50 cm

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11
Q

When are the infants most vulnerable to infection?

A

During the neonatal period

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12
Q

INFANCY

A

● Birth to two years old
● Infant proper (0-12 months)
○ Very rapid physical growth and
maturation

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13
Q

What is the Birth weight of an Infant as compared to their birth weight?

A

Triple

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14
Q

Late infant or Toddler (12-24 months)

A 
○ Growth slows down
○ Total weight gain in 2nd year equivalent
to BW
○ Weight: quadrupled (2 years old)
○ Marked improvement in language skills
(50-100 words)
○ Language skills should be developed
before 2 years of age
○ More interested in play = decrease in
appetite
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15
Q

PRESCHOOL

A

● 2 to 5 years old
● Further physical growth deceleration
● Average weight gain: 2 kg
● Average Height increase: 7-8 cm annually
○ It is important to get the weight and height
then plot it in the growth chart to see who
is lagging behind.
● Gross and fine motor skills become more
enhanced.
● Some children are in school during this time
(nursery and pre-kindergarten)
● Bladder and bowel conditioning are achieved.
● Learn about fast food and gadgets

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16
Q

MIDDLE CHILDHOOD

A 
● 6 to 10 years
● Average annual weight gain 3-3.5kg.
● Average height increase is 6-7 cm.
● More independent; perform higher order motor
skills.
● Self-esteem is very important
● Deciduous teeth start to fall
● Lymphoid tissues are normally hypertrophied
with enlarged tonsils and adenoids.
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17
Q

ADOLESCENCE

A 
● 10 to <19 years old
● The transition from childhood to adulthood
● Rapid growth
● Marked psychological and physical growth
○ Early Adolescence
■ 10-13 years old
○ Middle Adolescence
■ 14-16 years old
○ Late Adolescence
■ 17 to <19 years old
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18
Q

when did Modern Pediatrics start in the Philippines?

A

Philippine Pediatric Society (1947)

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19
Q

who is considered as the Mother of the Philippine Pediatric Society

A

Dr. Fe del Mundo (Countless kids)

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20
Q

ORGANIZATION OF THE PROFESSION AND THE GROWTH OF SPECIALIZATION

A 
● American Academy of Pediatrics, 1930
● Indian Academy of Pediatrics, 1963
● Pakistani Pediatrics Association, 1970
● Malaysian Pediatric Association, 1982
● Canadian Pediatric Society, 1922
● Philippine Pediatric Society, 1947
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21
Q

what are the various subspecialties of Pediatrics

A 
● Pediatric Gastroenterology
● Child Psychiatry
● Pediatric Radiology
● Pediatric Surgery
● Pediatric Dentistry
● Pediatric Ophthalmology
● Pediatric Otolaryngology
● Pediatric Hematology and Oncology
● Pediatric Dermatology
● Pediatric Nephrology
● Pediatric Urology
● Clinical Genetics
● Child Protection Specialist
● Pediatric Infectious Disease
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22
Q

Has mortality improved in Phil?

A

There is a gradual drop in infant mortality

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23
Q

MORTALITY RATE, UNDER 5 (Per 1000 Live Births)

A

● Under 5 mortality rate
○ is the probability per 1000 that a newborn
baby will die before reaching age five.
● The value of mortality rate, under-5 (per 1000
live births) in the Philippines was 28.4 as of 2018.
(Over the past 58 years, this indicator reached a
maximum value of 103.6 in 1960 and a minimum
value of 28.4 in 2018)

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24
Q

UNANG YAKAP

A

to address the high neonatal mortality rate

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25
Q

what are the leading causes of Infant mortality in the Philippines?

A 
 Congenital Pneumonia
 Intrauterine hypoxia and birth asphyxia
 Other congenital malformations
 Diarrhea and gastroenteritis of presumed
infectious origin
 Neonatal aspiration syndromes
 Congenital malformations of the heart
 Disorders related to short gestation and low birth
weight
 Respiratory distress of newborn
 Bacterial sepsis of newborn
 Pneumonia
26
Q

INFANT DEATH RATE

A

● Declined from 18.9 to 12.1

● 36% decrease

27
Q

MATERNAL DEATH RATE

A

● Declined from 1.1 to 0.9

● 18% decrease

28
Q

FETAL DEATH RATIO

A

● Declined from 5.7 to 4.4

● 23% decrease

29
Q

FETAL DEATHS BY AGE OF MOTHER

A

Ages 40-44 pregnancies are most at risk for mortality

30
Q

CHILD MORTALITY, 1-4 YEARS (PHILIPPINES, 2013)

A
  1. Pneumonia
  2. Diarrheas and gastroenteritis of presumed infectious
    origin
  3. Congenital anomalies
  4. Septicemia
  5. Other diseases of nervous system
  6. Accidental drowning & submersion
  7. Dengue fever & DHF
     Dengue is number 7 here because in these years,
    children are minimally exposed to the outside
    world.
  8. Chronic lower respiratory diseases
  9. Meningitis
  10. Leukemia
31
Q

causes of death for AGE 5-9 YEARS

A
  1. Pneumonia
  2. Dengue fever & DHF
  3. Accidental drowning & submersion
  4. Other diseases of the nervous system
  5. Transport Accidents
  6. Congenital anomalies
  7. Leukemia
  8. Meningitis
  9. Septicemia
  10. Diarrheas and gastroenteritis of presumed origin
32
Q

AGE 10-14 YEARS

A
  1. Pneumonia
  2. Accidental drowning & submersion
  3. Other diseases of the nervous system
  4. Transport Accidents
  5. Congenital anomalies
  6. Dengue fever & DHF
  7. Chronic rheumatic heart disease
  8. Leukemia
  9. Septicemia
  10. Nephritis nephrotic syndrome
33
Q

DEVELOPED COUNTRIES

A

malignant disease, cystic fibrosis

34
Q

Neurodevelopmental disorders -

A

language delay, reading difficulties, clumsiness, cerebral palsy

35
Q

Behavioral and emotional disorders -

A

attention deficit hyperactivity disorder, anorexia nervosa

36
Q

Excessive consumption -

A

obesity

37
Q

Drug and alcohol abuse,

A

smoking, teenage pregnancy

38
Q

BOTH DEVELOPED AND DEVELOPING COUNTRIES

A

● Relative socioeconomic disadvantage among the
‘have-nots’ - lack of money, unemployment,
inadequate housing and education
● Lack of family cohesion
● Healthcare - not available or poor quality or
inequality of access

39
Q

DEVELOPING COUNTRIES

A

● The high mortality rate for children, especially infants
● Infection
tuberculosis, HIV
● Malnutrition
● Poor sanitation, water supply, food hygiene
● Road traffic and other accidents
● Developmental and learning problems of organic pathology
● High birth rate
requiring health care relative to population

40
Q

Malnutrition is common among children.

A

○ 26.2% 0-5 years are underweight for age

○ 27.9% 0-5 years are short for age (8,000 kids malnourished Pampanga, 2014)

41
Q

Decreased prevalence of Vitamin A deficiency

A

(from 40.1% in 2003 to 15.2% in 2008) because of vitamin A supplementation provided by government programs. Midwives giving vitamin A supplementation

42
Q

WHO GUIDELINES TO OPTIMAL INFANT FEEDING

A
  1. Breastfeeding directly at mothers breast
  2. Expressed breast milk from the mother
  3. Expressed breast milk from a donor
    o if a mother cannot directly breastfeed a child
  4. Artificial infant milk (formula milk).
    o There are milk banks, infant milk is
    pasteurized and fed to sick neonates
43
Q

Dollars spent by Filipinos to formula

feed their babies.

A

922 million

44
Q

11,000 dollars spent on funerals

A

of 16,000 child deaths. That could have been prevented if they were breastfed.

45
Q

cost of out-patient treatment
for acute respiratory infections. That could have
been prevented if they were breastfed

A

1.2 million dollars

46
Q

spent on hospitalization costs for

formula-fed infants

A

557,000 dollars

47
Q

what is the main reason for the cessation of breastfeeding

A

Inadequate milk flow

48
Q

10 commandments to avoid MalNutrition

A 
● Eat a variety of foods.
● Breastfeed the baby during the first 6 months after
birth; afterward, complementary foods may be
given as well.
● Eat fruits and vegetables every day.
● Eat fish, meat, and other protein-rich food.
● Drink milk; eat Calcium-rich food.
● Ensure clean and safe food and water.
● Use iodized salt.
● Limit salty, fatty, and sweet foods.
● Maintain the appropriate body weight.
● Be active. Avoid alcohol. Don't smoke.
49
Q

An expanded program of immunization (EPI)

A

BCG, DPT, OPV, Hepatitis B, measles, rotavirus and Hib

50
Q

ORS

A

for diarrheas

51
Q

UFC

A

An intervention designed to meet the major demands for child health in both urban and rural areas

52
Q

Low-cost comprehensive child care

A 
focusing
on:
○ Treatment of common childhood illnesses (Acute Respiratory Illnesses, Diarrheas, Malnutrition, and Micronutrient Deficiency)
○ Primary prevention through:
■ Growth Surveillance
■ Immunization
■ Promotion of Breastfeeding, ORT, and
Family Planning
■ Environmental Sanitation
■ Counselling mothers on health matters,
safety and protection of child’s
psychosocial environment, and how to
set priorities for health
○ Identification of at-risk children, and prompt
management of recognized problems or
diseases, and its possible complications
○ Promotion of parent-child relations
53
Q

what are the objectives of IMCI

A

○ Reduce deaths, and the frequency and
the severity of illness and disability
○ Contribute to improved growth and
development

54
Q

exposure time for tech per age

A

○ 0-2 years = No exposure to technology
○ 3-5 years = 1 hour per day
○ 6-18 years = 2 hours per day

55
Q

Who are the kids that are at most risk of emotional, behavioral, and social problems?

A

> 3 hours a day of tech exposure and no exercise

56
Q

Underweight children

A

■ Have low weight for age
■ Easiest to address
■ Increasing food intake will
usually address it

57
Q

Stunted children

A 
■ Are short for their age
■ Reflects chronic undernutrition
■ Effects become irreversible by
age 5
■ Affects 3M Filipino children under
5 years old
58
Q

Wasted children

A 
■ Are short for their age
■ Reflects chronic undernutrition
■ Effects become irreversible by
age 5
■ Affects 3M Filipino children under
5 years old
59
Q

THE UNITED NATIONS CONVENTION ON THE

RIGHTS OF THE CHILD

A

● Survival rights: the child’s right to life and to the
most basic needs (food, shelter and access to
health care)
● Developmental Rights: to achieve their full
potential - education, play, freedom of thought,
conscience and religion. Those with disabilities to
receive special services.
● Protection rights: against all forms of abuse,
neglect, exploitation and discrimination.
● Participation rights: to take an active role in their
communities and nations (for empowerment)

60
Q

The role of the pediatrician in the community as:

A 
○ an educator
○ a consultant
○ a coordinator
○ a health planner
○ a counselor
○ a group worker

Pediatrics (2 decks)

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