Paediatric problems Flashcards
The Ottawa Declaration on the Right of the Child to Health
A child is a human being from the time of birth until the end of the 17th year of life, unless in the country in question children are considered adults at another age.
Care of infants and preschoolers (7)
- Monitoring growth and development
- Disease prevention and damage
- Early detection of deviations
- Encouraging breastfeeding
- Provision of treatment, habilitation and rehabilitation
- Conducting health education with counselling
- Social care
According to recent research on human development which period of life is most important in brain development, learning, behaviour and health?
The period from conception up to 6 years is the most important.
Role of FM in growth and development of a child (5)
- Monitoring of physical and emotional health
- Screening
- Identification of risk factors
- Identification of developmental problems
- Reduce risk by educating parents, giving support and by proper treatment and referral (if necessary)
Development ages (6)
- prenatal period
- infant age
- preschool age
- school age
- puberty
- adolescence
What are the 2 phases of growth?
- from birth - 2y: rapid growth
- from 2y - puberty: constant annual increases
On average, height in children born at term increases by_______% by the 5th month and by more than ________% by the 12th month.
30%
50%
In school age children grow approximately ______ cm per year
6 cm
At birth average head circumference is ________ cm
35 cm
Teeth growth (5)
4-9m: first teeth
1st year: 6 teeth
18m: 12 teeth
24m: 16 teeth
30m: 20 teeth
Child review techniques (4)
- up to 6 months - while lying on the examination table
- 6-12 months in the arms of the mother-leaning on the shoulder
- > 12 months to examine while sitting in parent’s lap
- Ask older children whether they want to sit alone or in their parents’ lap
Normal values for infant (4)
Normal Apgar score (7-10)
(activity, pulse, grimace, skin colour, respiration)
Normal gestation 37-42 weeks
Average weight 3400 gr
Average length 48-54 cm
High fever in children medication route of administration (3)
Body temperature> 37.8 ˚ C orally
Body temperature> 37.2 ˚ C axillary
Body temperature> 38.2 ˚ C rectal
Common causes of febrility in children (7)
- infections
- malignancies
- trauma
- burns
- autoimmune diseases
- chronic diseases
- heat stroke, sunburn etc.
Common causes of febrility in children < 3 months (5)
1) Virosis
2) Respiratory infection
3) Viral gastroenteritis
4) Otitis media
5)Pneumonia
Common causes of febrility in children 3 months - 1year (5)
1) Respiratory infection
2) Otitis media
3) Virosis
4) Gastroenteritis
5) Pneumonia
Common causes of febrility in children 3 months - 1year (5)
1) Respiratory infection
2) Otitis media
3) Virosis
4) Gastroenteritis
5) Pneumonia
Yale scale of observation of fever includes (5)
- cry
- reaction
- state/colour
- hydration
- response
Treatment of fever (6)
- Remove baby from overheated environment
- Get rid of his superfluous clothes
- Plentiful hydration
- Diet
- Antipyretic administration
- Shower with lukewarm water
Alcoholic friction? NO!
Treatment of fever medication (5)
Paracetamol (supp. a 120 mg, syrup 5 ml/120 mg, tbl.)
Ibuprofen (syrup 5 ml/100 mg,tbl.)
Diclofenac-Na
ASA do not use!
Metamizol-Na- do not use!
Febrile convulsions
- in children 6m-6y
- often + family history
- usually attacks occur when the temp rises rapidly are not correlated with the current temp elevation
- more common in boys
- etiology unknown
Infections seen with febrile convulsions
Benign: upper respiratory tract, otitis media, roseola infantum, gastroenteritis, pneumonia
Serious: meningitis, encephalitis
Typical febrile seizures characteristics
- generalised, clonic-tonic and non focal
- less than 15min
- isolated, one attack in 24h
- baby is neurologically normal after the attack
Emergency seizure management
- Put the child in a lateral position and give Diazepam rect. a dose of 0.5 mg / kg.
- If convulsions do not stop, repeat the same treatment twice more after 10 and 20 min.
- CAUTION! POSSIBLE DEPRESSION OF THE BREATHING!
- If you do not have rectiola or microclysis, take amp. Diazepam (10 mg in 2 ml) and open it.
- Take a small syringe of 0.5 mg / kg amp. and add 1-2 ml of 0.9% NaCl.
- Introduce the resulting solution 1-2 cm into the anus of the baby and squeeze out.
Exanthem subitum/ Roseola infantum
- HHV 6
- symptoms: sudden fever baby does not look sick
- complications caused by high fever
- non-specific treatment
Erithema infectiousum/ 5th disease
- parvovirus B19
- usually winter and early spring
- children feel moderately week, after a few days rash occurs
- red cheeks (slap face look)
- 1-2 days later a rash on the hands and feet
- skin changes disappear in 7 days
Hand-Foot-Mouth syndrome
- coxsackie virus (5, 10, 16)
- oral lesions in 90%
- rash: macules ,than oval vesicles
- locations: palms, soles, mouth
- lasts about 7 days
- no therapy is needed
Scarlet fever
- streptococcus pyogenes erythrogenic toxin
- fever, sore throat, nausea, vomiting, abdominal pain
- diffuse cervical lymphadenopathy
- white tongue with red papillae
Sore throat score
- Absence of cough
2.Temperature> 38 C
3.Cervical linfadenopathy
4.Tonsillary exudate
if the sum of o-1 is a viral infection
if the sum is 2-3 - chances for a bactrial inf. increase.
if the sum of 3 - do swab and antibiogram (chance sh for bak.inf they are about 33%)
if the sum is 4- need to do a swab and antibiogram (chances for bac.inf. are about 50%)
Rubeola
- highly contagious
- acute otitis media
- can induce miscarriage, stillbirth or congenital anomalies in the first trimester of pregnancy
- lymphadenopathy
- rash (face, neck, body)
- dg is made with serological test
Morbili virus
smallpox first appears on the face and in front of the ears, then spreads to the neck and lips for 24-36 hours
dark red macules and confluent papules
rash lasts about ten days
Koplik spots/ sign
Koplik’s spots (also Koplik’s sign) are a prodromic viral enanthem of measles manifesting two to three days before the measles rash itself.
Varicella
- highly contagious, few days after and before
- spring
- incubation 9-21 days
- macules, papules, vesicles and crucifixes
- trunk, face, neck, extremities (in that order)
- lesions occur at all stages of disease
Varicella complications (5)
very serious in adult children and adults
secondary skin infections
encephalitis
pneumonia
Rey’s Syndrome (especially when using high temperature salicylate)
hepatitis
