Other things not covered Flashcards
What may difficulty of a child to see the blackboard be?
Severe myopia
What make cause delayed walking problems?
Cerebral palsy
Congenital myopathy
What is the most common facial malformation?
Cleft lip and palate
What causes cleft lip?
Failure of the fronto-nasal and maxillary processes to fuse
What causes cleft palate?
Failure of the palatine processes and the nasal septum to fuse
What are the causes of orofacial clefts?
Genetic
Benzodiazepines
Anti-epileptics
Rubella
How might you prevent cleft lip/palate in a pregnant mother who already had an affected child?
Quit smoking
5mg/day folic acid
Multivitamins
How do you manage cleft lip/palate?
Feeding with special teat before plastic surgery
Lip repair at 3m
Palate repair at 6m
What complications are associated with cleft lip/palate?
Otitis media
Aspiration
Poor speech
What causes neural tube defects?
Failure of closure of neural tube between 3rd and 4th week of development
What are the main risk factors for having a child with a NTD?
Maternal folate deficiency Maternal vitamin B12 deficiency Previous history of having an infant with a neural tube defect Smoking, Diabetes, Obesity, Anti-epileptics
Who should be taking folic acid during pregnancy?
Every pregnant woman up to 12w (400 microg)
Higher dose for those at more risk of NTD (5mg)
What is spina bifida?
Incomplete vertebral arch (spina bifida occulta is covered by skin)
What is an encephalocele?
Where the brain or its coverings poket through the skull
What is anencephaly?
Absent skull vault and cerebral cortex
It is fatal
What is a myelocele?
Nerves lie on surface of back without meninges or covering skin
What is a meningocele?
Meninges protrude through a spinal defect and form a fluid filled sac
What might clicking of the hip in a newborn indicate?
Congenital dislocated hip
What are the four types of nappy rash?
- Ammonia dermatitis - red desquamating rash, sparing skin folds, due to MOISTURE retention
- Candida/thrush - satellite spots beyond main rash
- Seborrhoeic dermatitis - diffuse, red, shiny rash extending into skin folds tends to occur in other seborrheic areas, e.g. cradle cap
- Psoriasis like scaly plaques
How do you Rx nappy rash?
Leave nappy off, barrier cream (e.g. sudocrem), if candida suspected + clotrimazole
How common is obesity in 7 year olds?
7%
How common is obesity in 11 year olds?
20%
15% overweight too
What causes obesity?
Imbalance between energy intake and expenditure
What are some of the causes of obesity?
Diet - fast/processed foods
Exercise (lack of)
Sleep deprivation
Socioeconomic brackground (lower levels of parental education as well)
Genetics (obese parents more likely to have obese children)
Medication
Give examples of medication that can lead to weight gain
Sodium valproate
Carbamazepine
Mitrazipine
Steroids
What are some medical causes of obesity?
Hypothyroidism
Prader-Willi syndrome
Cushing’s
Growth hormone deficiency
What things must you screen for in an obese child?
Co-morbs, e.g. HTN, diabetes, lipids
How much should kids exercise per day?
60m moderate exercise
What are the medium term consequences of childhood obesity?
T2DM, sleep apnoea, orthopaedic problems, NAFLD, psychosocial problems, PCOS, vit D deficiency
What are the long term consequences of childhood obesity?
Atherosclerosis, early onset CV dx, cancers, subfertility, HTN
What is otitis media?
Middle ear inflammation
How does AOM present?
Rapid onset of pain, fever, irritability, anorexia, vomiting after an URTI
What organisms tend to cause AOM?
Strep pneumoniae, H. influenzae, Moraxella, other staphs and streps
What causes the pain in AOM?
Bulging of the tympanic membrane, pain is relieved when membrane ruptures
How do you Mx AOM?
Analgesia
Antibiotics if systemically unwell, immunocompromised or no improvement in 4 days or if <3m old, <2yo with bilateral AOM
(Amoxicillin)
What is glue ear?
Effusion present in middle ear after regression of symptoms of AOM
What is the most common presentation of glue ear in kids?
Hearing impairment noticed by parents
What is the actual problem with glue ear?
Functional impairment of the Eustachian tubes
How can you manage glue ear?
3 month observation period
Autoinflation of Eustachian tube during this period may help
Grommets
