Nutrition and Public Health Flashcards

1
Q

Exclusive breast feeding is recommended for the first __1_ of an infant’s life. Solids can be started at __2__ but definitely not before __3__. Cows milk (FULL FAT) can be introduced at __4___

A

1) 6 months
2) 6 months
3) 4 months
4) 1yr

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2
Q

Advantages and reasons to breast feed?

A
Immunological features
Anti-infective agents  
Growth factors
Modulators of intestinal growth
Reduction in diarrhoea
Reduction in respiratory infection
Colonic function
Reduction in atopic disease
Greater likelihood of higher IQ at 7½ years
Lower obesity risk for baby in later life
Lower maternal breast cancer risk
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3
Q

Breast feeding for more than ____ months is protective against obesity

A

4

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4
Q

Do you get most overweight children to lose or maintain weight? Explain?

A

Get most children to maintain weight as their BMI will come down as they grow taller. If very overweight however will encourage to lose 0.5-1 kg a month

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5
Q

What age is BMI valid for? What is used before this?

A

BMI only valid for children over 2

Under 2 can use the centile line graph on back of growth charts

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6
Q

What centiles mean overweight and obesity?

A

≥ 91st centile - overweight

≥ 98th centile - clinical obesity

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7
Q

Define infant mortality rate?

A

Infant mortality is the death of young children under the age of 1. This death toll is measured by the infant mortality rate, which is the number of deaths of children under one year of age per 1000 live birth

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8
Q

Malaria is caused by the _____ spread by the _____

A

Plasmodium parasite

Female Anopheles Mosquito

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9
Q

What is TB?

A

Bacterial infection from mycobacteria tuberculosis

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10
Q

Describe the bacteria that causes TB?

A

Gram postive bacilli

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11
Q

What are the 3 options when become infected with TB?

A

1) Breathe in TB and immune system clears TB- No infection
2) Breathe in TB, stop spread but cannot clear it. Latent TB.
3) Breathe in TB and cannot control infection. Become ill. Active TB>

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12
Q

Symptoms of TB?

A
Productive cough > sometimes haemoptysis
Weight loss
Fever
Night Sweats
Most commonly pulmonary symptoms but it is a systemic disease
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13
Q

CXR of TB?

A

Enlarged lymph nodes. In very poorly controlled TB will see lots of little dots all over the lungs (miliary TB)

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14
Q

Positive stain red for acid fast bacilli?

A

Tuberculosis

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15
Q

Describe tests for TB?

A

Sputum- stains done immediately for identification (Zhiel Neelson or Auramine). Zhiel Neelson turns acid fast bacilli red.
Culture can take up to 3 weeks but is good for identifying drug sensitivities.
PCR is good for differentiating between TB and non-TB mycobacteria but can detect dead organisms
On biopsy see caseating granulomas (necrotic)

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16
Q

Treatment of Active TB?

A

2 RIPE 4 RI

Two months: Rifampicin, Isoniazid, Pyranzamide and Ethambutol
Four months: Rifampicin and Isoniazid

17
Q

Latent TB Treatment?

A

2 drugs for 3 months: rifampicin and isoniazid

Isoniazid for a further 3 months

18
Q

Rifampicin side effect?

A

Stains body secretions pink/ orange Liver enzymes elevated. Oral contraception not effective.

19
Q

Isoniazid side effect?

A

Occasionally allergic reactions or hepatitis

20
Q

Pyranzamide side effect?

A

May cause hepatic toxicity

21
Q

Ethambutol side effect?

A

Problems with eyesight

22
Q

What causes oedema in malnutrition?

A

Lack of protein (Kwashiorkor)

23
Q

Caseating granulomas vs non caseating granulomas?

A
Caseating= TB
Non-caseating= not TB potentially sarcoidosis or other cause
24
Q

Describe the difference between active and passive immunity?

A

Active: produced by contact with pathogen/ antigen. BY NATURAL INFECTION OR VACCINE
Passive: Given antibodies from the outside, passive is good if can’t give someone a vaccine but only has a short time window EG TRANSPLACENTAL IgG or ARTIFICIALLY GIVEN

25
Q

Describe types of vaccine?

A

Live: Attenuated organism e.g. MMR, rotavirus, flu
Inactivated: Suspensions of killed organisms e.g. pertussis, subunit e.g. Toxoids (diphtheria) or polysaccharides (pneumococcal) or conjugate (polysaccharide attached to immunogenic proteins) e.g. MenC

26
Q

Describe 5 contraindications to vaccines?

A

1) Confirmed anaphylaxis to something in vaccine
2) Live vaccines contraindicated in immunosuppression or pregnancy
3) Yellow fever or flu vaccine is contraindicated in egg allergy
4) Severe latex allergy
5) If acute or evolving illness should defer until resolved

27
Q

Explain herd immunity?

A

Protects unvaccinated individuals by having a sufficiently large proportion of the population vaccinated. Vaccinated individuals stop transmission. Proportion required to immune is mathematically based on factors in disease.

28
Q

Explain what public health notification act means?

A

Legal duty of medical practitioners to notify health board on clinical suspicion of specified diseases or a ‘health risk state’ posing significant public health risk

29
Q

What diseases need notification in writing within 3 days if clinically suspected?

A

Tetanus, Mumps, Rubella

30
Q

What diseases need urgent phone call and notification in writing within 3 days if clinically suspected?

A

Whooping cough, diphtheria, polio, meningococcal infection, Haemophilus influenza B, Measles

31
Q

When can a child drink semi skimmed milk and skimmed milk?

A

Semi skimmed at 2

Skimmed at 5

32
Q

Who should get vitamin D supplements?

A

Breast feeding and pregnant women
All infants and young children aged 6 months- 5yrs
Those on formula do not need supplements unless take less 500 ml a day
Breast fed infants from 1 month if mum hasn’t taken supplements in pregnancy

33
Q

Should you try and estimate age of bruises?

A

No