Not Just Small Adults

Question 1

Surface Area and volume

Answer 1

Children have a higher SA:volume ration than adults.

They therefore lose heat and fluids more rapidly than adults
More easily effected by toxins that are absorbed through the skin
More prone to Hypoglycaemia

Question 2

Skin

Answer 2

Thinner than that of adults. It is also less keratinised

Increased absorption of agents through skin

Question 3

Cellularity

Answer 3

Higher rate of cell division than in adults

Assists rapids rate of growth

Question 4

respiratory rate and Heart Rate

Answer 4

Higher than in adults

As a result of this children are more susceptible to agents absorbed via the pulmonary route - Also mean they will respond more rapidly to therapeutic agents administered this way.

Question 5

blood Brain Barrier

Answer 5

Immature

Question 6

Metabolic rate

Answer 6

Higher than in adults

More susceptible to contaminants in food and water
Greater risk of increased loss of water when they are ill or stressed

Question 7

Immune system

Answer 7

Immature

greater risk of infections

MR unconjugated pneumococcal vaccine not given until 12mo as this is when the immune system is robust enough to take it

Chicken Pox is a good question to ask when it comes to assessing the immune system - both cellular and humoral systems required to clear it

Question 8

Psychological differences

Answer 8

Social
Emotional
Cognitive

Question 9

Normal Values for < 1 year

Answer 9

HR - 110 - 160

RR 30-40

Question 10

Normal Values 1 - 2 year

Answer 10

HR - 100 - 150

RR 25 - 35

Question 11

Normal Values 2 - 5 Years

Answer 11

HR - 95 - 140

RR 25 - 30

Question 12

Normal Values 6 - 12 years

Answer 12

HR - 80 - 120

RR - 20 -25

Question 13

Normal Values

Answer 13

HR - 60 - 100

RR 15 - 20

Question 14

What is ketotic Hypoglycaemia

Answer 14

6-7am - Hypoglycaemic episode

Common in 1-2 years who are skinny with incurrent Illnesses

Question 15

Features of ketotic hypoglycaemia

Answer 15

Pale
Unarousable
sweaty

Fed at night then put to bed - over the time they are asleep the baby essentially just runs out of glycogen

Question 16

How does a child’s physiology differ in shock

Answer 16

As they have a lower BP this is maintained for quite some time even in the case of shock UNTIL IT NO LONGER DOES = Rapid deterioration

Do not let the fact that the child’s BP is only little bit low reassure you.

Question 17

Common paediatric conditions not seen in adults

Answer 17

Glue ear
Febrile convulsions
NEC
Croup
Bronchiolitis 
SIDS
VUR

Question 18

Chronic conditions with childhood onset

Answer 18

CF
Asthma (COPD)
Autism 
CP
Gastroschisis
Spina Bifida

Question 19

Fewer Type 1 muscle fibres

Answer 19

airways fatigue easier

Question 20

Soft non-calcified bones

Answer 20

More compliant chest –> recession and in-draw

Question 21

Horizontal Ribs

Answer 21

Less expansion

Question 22

Circulating Blood volume

Answer 22

70-80mls -A small loss can make a huge difference