Module 1 PAEDS

Question 1

How does how focus differ from paediatrics to adults

Answer 1

Paediatrics we focus on optimising growth and development
Adults we aim to slow down degeneration and loss of function

Question 2

What is the most prevelant chronic medical condition in the paediatric population?

Answer 2

Developmental disorders

Question 3

Genetics
How does small differences in genetic sequence give massively different phenotypes? Answer is in 3 areas

Answer 3

1. Alternative splicing- mRNA is spliced into different versions, each being translated into a different protein product
2. The role of “non-coding” regions of human DNA, which help regulate where the Time and location in the body are actually transcribed to DNA.
3. Interaction of human genes with one another, which is the focus of genomic field.

Question 4

Give an example of how Nurture on nature can have seemingly dramatic outcomes

Answer 4

Most DNA is shut down + not being read actively. Eg grandparents exposure affects you through mRNA mechanisms.

Based on the reading of the DNA by the mRNA/ history modification.

Down syndrome. Previously Down syndromes level of cognitive function was moderately to severely impaired in all cases.

Today Down syndrome typically receive extensive early intervention and special educational support, their their cognitive and functional capacities are far greater than what they were a generation ago.

Question 5

How are more than 200 very different cell types produced from same genetic material

Answer 5

While every cell has the same genetic material, the portion that is actively transcribed differs across cell types.

Epigenetic mechanisms govern the transcription of the genome

1. Histone modification
2. DNA methylation
3. RNA signalling.
   All affects DNA expression

Question 6

Sensitive periods of development. Eg timing of an insult, and how it may impact

Answer 6

Timing of an insult or event can have minor or dramatic effect eg radiation in 1st tri vs 3rd tri

Question 7

Birth Trauma
How are neonates anatomy adapted to requirements of birth?

What is it not so well designed for?
What are the most sensitive anatomy to birth trauma?

What is the % of newborns who suffer some degree of neuromusculoskeletal issues?

Answer 7

Cervical spine has horizontal facets- better adaptation to bending and compressive forces.

Not so well designed for
Traction or rotational forces
-Weak cervical spine ligaments
-Greater tendency to subluxation
Often no osseus damage evident- 2% clavicles broken in deliveries’

Spinal cord structures and meninges are 8x as vulnerable as the postural connective tissue structures owing to a lack of elasticity during longitudinal traction.
So if there is any evidence of connective tissue injury = 8x the neurological compromise.

70%

Question 8

Birth Trauma
What are the structures that can be damaged in the
1. Head?
2. neck
3. Arm
4. Leg

Answer 8

Head:
-Cephalohaematoma (blood between baby’s scalp and skull -damage blood vessels during devlivery)
-Capita succedaneum (swelling or edema on infants scalp)
-Cranial Bone fracture
-Facial nerve injury
-Intracranial hemorrhage
-leptomeningeal cyst
-retinal haemorrhages

Neck:
-SCM injury
-Other neck muscles eg scalenes
-Joint injury -subluxation or dislocation
-Spinal fracture
-Clavicle fracture
-Brachial plexus nerve injury
-phrenic nerve injury
-Spinal cord injury

Arm:
-Shoulder and other upper extremity joint injury
-humerus fracture

Leg:
-Femur fracture

Question 9

What is the ideal labour time

Answer 9

Between 6 and 12 hours.