Lecture 2: Early Determinants of Health and Development

Question 1

What is the cause of Down syndrome and the symptoms

Answer 1

Cause : Trisomy 21

Symptoms: distinct physical features, mental retardation, speech problems and slow motor development, increasing with maternal age.

Question 2

What is the cause of Down syndrome and the symptoms

Answer 2

Cause : Trisomy 21

Symptoms: distinct physical features, mental retardation, speech problems and slow motor development. Variability.

Question 3

What is the cause of Down syndrome and the symptoms

Answer 3

Cause : Trisomy 21

Symptoms: distinct physical features, mental retardation, speech problems and slow motor development/muscle tone. Variability tho.

Question 4

What tests are done to screen for chromosomal abnormalities.

Answer 4

Test at 11-14 weeks to look at the thickness of collection of fluid in the nuchal fold just under the neck using ultrasound. More thickness >2.5 mm= higher risk for chromosomal abnormality.

The absence of a nasal bone

More invasive
Chorionic Villus Sampling or Amniocentesis and Blood tests are also done.

Question 5

What is the test done from at 1 and 5 min after birth with 2 marks per category

Answer 5

Appearance: pink
Pulse: rapid 
Grimace: cough, sneeze, crying
Activity: muscle tone
Respiration: breathing

Question 6

What test is done within 48 hours post natally and what is it testing for

Answer 6

Heel prick (Guthrie) test with blood spots on Guthrie card which are analysed to detect metabolic disorders like Phenylketonuria (build up of phenylalanine in the body)

Question 7

What test is done within 48 hours post natally and what is it testing for

Answer 7

Heel prick (Guthrie) test with blood spots on Guthrie card which are analysed to detect metabolic disorders like Phenylketonuria (build up of phenylalanine in the body)

Question 8

When is glucose test done for babies to check for hypo and hyperglycaemia

Answer 8

When the mother has diabetes or gestational diabetes

Question 9

Why do we do a New born test for hearing

Answer 9

The first relationship of bonding with the child is not attempted as at risk parents interpret lack of response due to no hearing as not liking the parent

Question 10

What are the consequences of Low birth weight for babies/preterm babies ?

Answer 10

Underdeveloped organs, immune system, lungs and reflexes (suck and swallow).

• Sleepy, unresponsive, sporadic sleeping, irritable appearance and behaviour can lead to parents being less sensitive and responsive so higher risk for Child abuse

Question 11

What are the average birth weight, length and head circumference

Answer 11

3600 gms, length 52 cms, head circumference: 35 cm

Question 12

Which low weight babies are most at risk for developmental delay

Answer 12

LBW and VLBW babies are usually good outcome but ELBW more at risk of being developmentally delayed

Question 13

What are some preventable risks to development that occur pre natally

Answer 13

• Stress and depression
• poor nutrition
• maternal age and previous obstretric history
• RH blood incompability
• Maternal alcohol, tobacco and other drug use

Question 14

What is a teratogen and what factors determine the outcome of exposure

Answer 14

Environmental agent that causes damage during the prenatal period.
Outcome of exposure depends on the
- genetic makeup of the mother and fetus to withstand harm,
-presence of other negative factors,
-fetus’ age at time of exposure

Question 15

From what time is exposure to teratogens causing what problems in the fetus

Answer 15

Embryonic period (week 3-8) = major structural abnormalities
Fetal period (week 9-36) = physiological defects and minor structural abnormalities

Question 16

What are some prescription drugs that can harm babies prenatally

Answer 16

Thalidomides= upper limb development, DES= reproductive system,
Aspirin= LBW, infant death, poor motor development,
Heavy caffeine intake= premature delivery, miscarriage, withdrawal symptoms

Question 17

What are some infectious diseases that can be passed to the baby

Answer 17

Rubella: embryonic period
AIDs
Herpes viruses
Toxoplasmosis: eye and brain damage

Question 18

What is the impact of alcohol use during pregnancy

Answer 18

Fetal Alcohol Syndrome- leading to organic brain damage and central nervous system dysfunction.

Manifest as
Attention and intellectual deficits, problems with learning, memory language and judgement.
Fine and gross motor problems and microcephaly, specific facial abnormalities

Question 19

What causes the brain damage in FAS babies

Answer 19

Increased brain cell death, reduced cell proliferation, migration errors in neurons in the brain, inhibition of nerve growth factor and disruption of neurotransmitters.

Question 20

What is the direct effects of tobacco use on babies

Answer 20

• Low birth weight, risk for pre term birth
• risk for SUDIS-cot death
• Diabetes
• Child hood blood pressure
• reduction in gray matter

Question 21

What is the CNS functional abnormalities or development problems as a result of tobacco use

Answer 21

• Increased internalising and externalising behaviours at 2
• ADHD and conduct disorders
• Learning and memory problems
• Aggression

Question 22

What is the effect of prenatal methamphetamine use on babies neurobehaviourly and weightwise

Answer 22

• 3.5 times more likely to have lower birth weight

- Neurobehaviour under aroused, low muscle tone and quality of movement, increased stress due to withdrawal,

Question 23

What is Sudden Unexplained Death in Infancy.

Who is more at risk?

Answer 23

It is sudden death of any infant under 1 yrold (often 2-4 months) in which it is unexplained.
Risks are higher in lower SES, ethnic groups, poor prenatal care and mothers and fathers smoking and drug use during pregnancy