Lectures of CBM

Question 1

What are the primitive reflexes and when do they disappear?

Answer 1

Standing reflex- Bear some weight in a standing position. Gone by two months

Stepping reflex- Take rudimentary steps on support. Gone by two months

Rooting- Food finding reflex. Turns head to cheek stimulus to move mouth to stimulus. Gone by 3 months of age.

Moro reflex. Startle reflex. Arms go out to side, then return to midline, then cry. Gone by 3-5 months

Galant reflex. Hold baby in a pronate position and stroke along spine. Shifts hips towards side being stroked. Gone by 3-6 months

Asymmetrical tonic neck reflex. Turn head to one side. Results in flexion of harm on head side and extension of arm on face side. Fencer reflex. Gone by 4-6 months of age

Palmar- Palmar reflex is gone by 4-7 months and

Plantar grasp- Plantar is gone by 9-12 months.

Question 2

When does the NIPE take place?

Answer 2

72 hours and 6-8 weeks

Question 3

What is the NIPE composed of?

Answer 3

• Eyes
  
  • Check size and shape of the eye. Look for colobomata. Check for the red reflex. Check range of eye movements. Fix and follow response.
• Heart
  
  • Check for congenital heart disease. Risk factors include maternal T1DM and SLE, maternal antipsychotic medications, Down’s, Noonan’s and Marfan’s syndrome.
  • Some heart defects are detected at the scan at 18-20 weeks.
  • Examination
    
    • Colour
    • RR 40-60 breaths/minutes
    • Use of accessory muscles
    • Brachio-femoral delay
    • Palpate the heart and for heaves and thrills
    • CRT
    • Listen for murmurs
• Hips
  
  • Barlow test
    
    • Going out to the bar
    • Flex hips and knees to 90 degrees. Brings thighs to midline and apply mild pressure in a posterior direction. A positive sign is if they push out.
  • Ortolani test
    
    • Abduction of the hip and pushing of the thigh anteriorly.
• Testes
  
  • Check for undescended testicles

Question 4

What is the heel prick test? What conditions does it test for?

Answer 4

• Sickle cell
• CF
• Congenital hypothyroidism
• Phenylketonuria (PKU)
• Medium-chain acyl-CoA dehydrogenase deficiency
• Maple syrup urine disease
• Isovaleric acidaemia
• Glutaric aciduria
• Homocystinuria

Question 5

Suckling from the breast stimulates the release of __________ from the _______-________ & _________ from the _________-_________

Answer 5

Prolactin from the anterior pituitary gland and oxytocin from the posterior pituitary gland

Question 6

What is the role of prolactin and oxytocin with regards to breast feeding?

Answer 6

Prolactin is important for initiating milk secretion and in maintaining milk production after birth. Prolactin levels are high at night, so night time feeding is important for maintaining milk supply.

Oxytocin is responsible for the ejection of milk by acting on the myoepithelial cells that surround the alveoli and ductules.

Question 7

Whcih immunoglobulin is passed on in breast milk?

Answer 7

IgA

Question 8

What harmful substances can pass through the breast milk?

Answer 8

• HIV
• Alcohol
• Caffeine
• Lithium
• Amiodarone
• Iodine
• Illicit drugs

Question 9

How long does the WHO recommend breastfeeding exclusively?

Answer 9

180 days

Question 10

What is the UK vaccine schedule?

Answer 10

Question 11

What type of vaccine is diphtheria?

Answer 11

Toxoid

Question 12

What type of vaccine is tetanus?

Answer 12

Toxoid

Question 13

What type of vaccine is pertussis?

Answer 13

Antigens

Question 14

What type of vaccine is polio?

Answer 14

Inactivated virus

Question 15

What type of vaccine is haemophilus influenzae?

Answer 15

Conjugate

Question 16

What type of vaccine is hep B?

Answer 16

Recombinant vaccine

Question 17

What type of vaccine is pneumococcal?

Answer 17

Conjugate

Question 18

What type of vaccine is rotavirus?

Answer 18

Live attenuated

Question 19

What type of vaccines are the MMR?

Answer 19

Live attenuated

Question 20

What type of vaccine is BCG?

Answer 20

Live attenuated

Question 21

When does the heel prick test take place?

Answer 21

5-8 days of age

Question 22

What 4 areas are the developmental milestones divied into?

Answer 22

Motor- gross and fine

Hearing and speech

Vision

Social and emotional

Question 23

What important milestones should be reached by 3 months?

Answer 23

Motor - lifts the head above the midline when in a
prone position, brings hand to mouth, opens and
shuts the hands, grasps and shakes hand toys

Hearing and speech - squeals, coos and turns to
sound

Vision - watches faces and follows objects

Social - smiling usually begins at around 6 weeks of
age, starts to enjoy playing with other people

Question 24

What important milestones should be reached by 7 months of age?

Answer 24

Motor – rolling (front to back and back to front), sits
(initially with support and then without), transfers
objects from hand to hand, uses a raking grasp

Hearing and speech – babbling, uses voice to
express joy and displeasure, responds to their name
and ‘no’

Vision – develops full colour vision, distance vision
matures, can track objects

Social – enjoys social play, e.g. peek-a-boo

Question 25

What developmental milestones should be reached by 12 months of age?

Answer 25

Gross motor – reaches sitting position without help, crawls, pulls self to stand and walks holding furniture (‘cruising’), may take a few steps unaided Fine motor – uses a pincer grip, can bang two objects together, pokes with the index finger, scribbles Speech and language – can follow simple commands, says ‘mama and dada’, tries to imitate words Social and emotional – has separation and stranger anxiety, finger feeds independently, will find hidden objects (object permanence), shows understanding through use of objects (e.g. Drinking from a cup, brushing hair, dialling a phone, etc)

Question 26

What is the ASQ?

Answer 26

A questionnaire detailing their childs development

Question 27

What is the difference beween colostrum and mature breast milk?

Answer 27

Colostrum is much higher in protein

Question 28

What is the main sugar in human breast milk?

Answer 28

Lactose