Midterm Pt 2

Question 1

Failure to thrive

Answer 1

Baby is not gaining weight properly or has fallen 2 percentile from previously established growth rate

Question 2

Wasting

Answer 2

Acute loss of weight, failure to gain at expected rate

Question 3

Stunting

Answer 3

Reduction of height over years; seen with chronic malnutrition

Question 4

Kwashiorkor

Answer 4

Protein malnutrition

Question 5

Marasmus

Answer 5

Caloric malnutrition; severe wasting

Question 6

Childhood obesity USA

Answer 6

20% of 6-19 year olds

Question 7

Childhood obesity in GA

Answer 7

40% of 6-19 year olds

Question 8

Childhood obesity risk factor

Answer 8

3x increased with one obese parent

10x increased with both parents obese

Question 9

Hypoglycemia

Answer 9

Hunger, weakness, shakiness, sweating, drowsiness, headache, behavioural changes

Question 10

Folic acid deficiency in mom

Answer 10

Birth defects in 1st 3-4 weeks of development

Question 11

Child abdominal issues

Answer 11

GI, respiratory and skin problems; consider milk allergy

Question 12

Intussusception

Answer 12

MEDICAL EMERGENCY; Knot in bowel. MC under 2 yrs old

Question 13

Intussusception symptoms

Answer 13

Episodic uncontrollable crying, inactivity/irritability, pallor, vomiting, rectal bleeding, tender palpable abdominal mass

Question 14

Appendicitis

Answer 14

MEDICAL EMERGENCY; Pain in peri-umbilical region - increased by movement or cough - anorexia, nausea, tenderness at McBurney’s point and low grade fever

Question 15

Acute gastroenteritis

Answer 15

Risk for dehydration (10% fluid loss)

Question 16

Rotavirus

Answer 16

Vomiting in first 24 hours (80-90% px) and low grade fever then profuse watery diarrhea lasting 4-8 days

Question 17

E. coli

Answer 17

Mild and self limiting diarrhea; possibly bloody, abdominal cramping and pain

Question 18

Salmonella

Answer 18

2 forms in childhood: gastroenteritis and enteric fever

Question 19

Botulism

Answer 19

Spore; dry mucous membranes, nausea and vomiting, diplopia, descending paralysis, difficulty with swallowing and speech; 12-36 hours after ingestion. Hypotonia and constipation in infants

Question 20

Shaken baby syndrome

Answer 20

Leading cause of brain injuries (subarachnoid and subdural hemorrhage) often with history of colic , feeding problems, irritability and crying

Question 21

Signs of child abuse

Answer 21

Bruising, retina injury, cigarette burns, fracture of long bones and other suspicious injuries

Question 22

Raised index of suspicion

Answer 22

Child or someone else tells you of abuse; injuries don’t match explanation; change in behaviour of child; infant with failure to thrive, hygienic neglect, skin conditions, thin extremities, prominent ribs, gluteal atrophy; secondary enuresis, encopresis, constipation or recurrent abdominal pain

Question 23

Suspicious statements

Answer 23

“I know of someone who is being abused”

Question 24

Energy consumption

Answer 24

Pregnancy: 2nd and 3rd trimesters +300 kcal
Breastfeeding: +500 kcal

Question 25

Infant growth

Answer 25

Adequate infant growth on breast milk alone for 6 months

Question 26

Advantages of breast feeding

Answer 26

Convenience, immediately availablility at proper temperature, economical, free of contaminating bacteria, less likely to overfeed, protective for mom, builds intimacy

Question 27

Breastmilk antibody

Answer 27

IgA (both colostrum and breastmilk)

Question 28

Colostrum

Answer 28

Thin, yellow fluid secreted a few days before and after parturition; filled with antibodies from mom

Question 29

Indications for breastmilk via bottle

Answer 29

Premature, ill or weak infants, twins, cleft lip/palate, mastitis, inverted nipples or cracked/fissured nipples

Question 30

Contraindication to breastmilk consumption

Answer 30

Acute or chronic maternal illness

Question 31

Benefits of breastfeeding

Answer 31

Lower incidence of allergy, ear infections, respiratory diseases, GI illness, SIDS and decreased cholesterol levels as adult

Question 32

Difficulty latching

Answer 32

Jaw issues, too low or too high palette, poor suckling reflex

Question 33

Risser’s sign

Answer 33

Iliac crest epiphyseal plate closure from the caudad end toward the cephalic end. Staged 1-4, 5 indicates closure and skeletal maturity

Question 34

Scoliosis

Answer 34

Adam’s test: structural scoliosis will not straighten with forward bending but functional scoliosis will

Question 35

Fever

Answer 35

Most common reason parents call paediatrician; oral, forehead, ear, axilla and rectal (99 degrees)