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Health and Society Year 4 > Paediatrics > Flashcards

Paediatrics Flashcards

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1
Q

Define preterm birth

A

Less than 37 weeks

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2
Q

Epidemiology of preterm birth

A

8/100 babies

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3
Q

5 risk factors for preterm birth

A

Hx preterm labour, Smoking, Age, PROM, TVUS

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4
Q

6 signs of preterm birth

A

regular contractions, period pain, show, water breaking, back-ache, cervical dilation

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5
Q

4 investigations for preterm birth

A

VE, blood test, urine test, CTG

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6
Q

6 consequences of preterm birth

A

jaundice, hypoglycaemia, RDS, ventricular haemorrhages, cerebral palsy, NEC

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7
Q

4 ways to manage a preterm birth

A

Tocolytics (atociban, nifedipine)
Abx if suspected chorioamnionitis
Steroids if 24-35w
Cerclage (cervical suture before 24w if <25mm on US or hx of >/=3 preterm cervical dilation

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8
Q

Define low birth weight

A

Less than 2.5kg

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9
Q

Epidemiology of low birth weight

A

7%

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10
Q

10 RF for preterm birth

A
  • prematurity and IUGR are most common causes

- substance abuse (smoking), malnutrition, black, diabetes, hypertension, infection, pre-eclampsia

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11
Q

Monitoring for low birth weight

A

monitored on US at antenatal screening – can do it more regularly if suspected

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12
Q

7 immediate and 4 late consequences of low birth weight

A

Immediate: RDS, intraventricular haemorrhage, PDA, NEC, ROP, jaundice, infection
Later: DM, HTN, cerebral palsy, metabolic syndrome.

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13
Q

2 ways to management low birth weight

A

Tackle risk factors and prevent prematurity

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14
Q

Define Sudden Unexpected Death in Infancy (SUDI)

A

Unexpected and initially unexplained death

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15
Q

What does a SUDI require?

A

Post-mortem and police enquiry

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16
Q

Epidemiology of SUID

A

Most common cause of death in first year of life

>200 babies die/year

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17
Q

5 causes of SUID

A

50% no cause is found

Infection, Genetic/metabolic; Accidental injury; Non-accidental injury (10%)

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18
Q

What happens to siblings following SUID

A

Sibling screen for sepsis/inborn errors of metabolism

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19
Q

5 RF and 3 PF for SUID

A

RF: Sleeping in prone position, smoking, premature, bed sharing, hyperthermia
PF: breast feeding, room sharing, use of pacifiers

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20
Q

6 ways to prevent SUID

A
  • do put baby sleeps on back
  • do keep babies head uncovered
  • do breastfeed baby if possible
  • don’t smoke in the same room
  • don’t sleep in the same bed
  • don’t let your baby get too hot (room temp 16-20)
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21
Q

Epidemiology of asthma in children

A

1/11 children have asthma
Increased in prevalence in 2d half of 20th century, now plateauing
We have highest rates in Europe
13% of carers give up work

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22
Q

3 costs of asthma to the NHS

A

consultations, hospital admissions and meds

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23
Q

Childhood vaccinations at 8 weeks

A

6 in 1: Diphtheria, Tetanus, Pertussis, Polio, Hib and Hep B
Men B
Rotavirus

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24
Q

Childhood vaccinations at 12 weeks

A

6 in 1
Pneumococcal
Rotavirus

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25
Q

Childhood vaccinations at 16 weeks

A

6 in 1

Men B

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26
Q

Childhood vaccinations at 1 year

A

Hib
Men C + B
MMR
Pneumococcal

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27
Q

Childhood vaccinations throughout childhood for elegible groups

A

Influenza annually

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28
Q

Childhood vaccinations at 3 years 4 months

A

Diphtheria, tetanus, pertussis and polio

MMR

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29
Q

Childhood vaccinations at 12-13 years

A

HPV

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30
Q

Childhood vaccinations at 14 years

A

Tetanus, Diphtheria and Polio

MEN ACWY

31
Q

Vaccinations in the elderly

A

65 years: Pneumococcal then influenza annually

70-79: Shingles

32
Q

Vaccinations in pregnant women

A

Influenza

Pertussis

33
Q

Who gets the TB vaccine?

A

Infants in areas with a high TB incidence or who live with a parent/grandparent born in a high incidence country

34
Q

Change in schedule to children born to hepatitis B infected mothers

A

At birth, 4 weeks and 12 months

35
Q

Most common accident in babies and pre-school age

A

At home e.g. falling down the stairs/trapping fingers in doors

36
Q

Most common accident in school age

A

Outside the home e.g. RTA

37
Q

Most common accident in older children

A

Risk taking behaviour

38
Q

Most common age and gender for accidents

A

6-9 year

Male

39
Q

How many children die every year?

A

5000

40
Q

What percentage of accidents are caused by cut injuries/lacerations

A

56%

41
Q

What are the percentages for the highest causes of deaths?

A

24% malignancy

14% injuries/poisons

42
Q

Order of external causes of deaths

A

1st RTA
2nd suffocation
3rd drowning
4th smoke/fire, poisons

43
Q

Biggest cause of death in 10-18 year old

A

75% RTA

44
Q

Most common cause of death in pre-term

A

Prematurity (age, smoking, socio-economic status)

45
Q

Most common cause of death at term

A

Congenital

46
Q

% of poisoning that occurs in under 5’s

A

50%

47
Q

3 primary prevention mechanisms for childhood accidents

A
  • modification of product: vehicle child design
  • alter environment: speed limits
  • educating children: public health service
48
Q

1 secondary prevention mechanism to prevent childhood accidents

A

Rehabilitation for burns

secondary prevention is after the accident has occured

49
Q

What age suffer 45% of burns and scalds?

How?

A

Children under 5

In the kitchen (hot water, irons, ovens)

50
Q

3 methods to reduce the risk of burns

A
  • consider sunburn (sunscreen, hat, out of sun)
  • get smoke alarms, don’t smoke near bed/sofa
  • keep hot objects out of their reach
51
Q

6 specific causes of childhood accidents and methods to prevent them

A

Choking: hold them when feeding, cut food into small bits, sit with child
Suffocation: no loose bedding, dispose of plastic bags safely
Falls: careful carrying baby, strap a child in high chair
Poisoning: CO alarms, medicines out of reach
Drowning: never leave baby in bath alone
Road accidents: correctly fitting rear seat every journey

52
Q

3 consequences of poor early health in children

A

Start life in poor health > LD + poor mental health, poor diet
Adolescents > leave school early, physically inactive
Adulthood: mortality risk, physical/mental health, social stigma

53
Q

How many children die every week from cruelty

A

1 child

54
Q

4 RF for child deaths

A

Poverty
Social isolation
Disability
Chronic disease

55
Q

What is the toxic trio?

A

Domestic violence and abuse
Parental mental health
Parental substance abuse

56
Q

What act safeguards children

What is its main motto

A

Children’s Act (1989 > 2004)

Every child matters

57
Q

3 common causes of bruising in children

A

Coagulation disorders (haemophilia, VWD, liver disease, thrombocytopaenia (ITP, ALL,), HDN

58
Q

Common site for bruising in children

A

Bony prominences

59
Q

5 worrying signs of bruises in children

A

Excessive multiple bruises of different ages
Bruise patterns which indicate slapping, gripped tightly, belts
Face, ears, neck, buttocks, trunks, proximal part of lower limbs
Well demarcated/ burn injuries
Spiral/ metaphysis fractures

60
Q

4 worrying signs for abuse in the Hx

A

no explanation, presented late, listen to the child, changing hx

61
Q

How can you distinguish between a fabricated/induced illness

A

discrepancy between hx and presentation, range of symptoms, multiple presentations, exaggerating mild disease

62
Q

7 signs of sexual abuse in children

A
  • recurrent GU symptoms (enuresis, constipation, soiling)
  • abdo pain
  • self harm
  • alcohol/drug misuse
  • pregnancy
  • emotional/behavioural problems
  • sexualized behavior
63
Q

Define neglect

A

Persistent failure to meet child’s basic physical and psychological needs
Poor interactions, poor growth, poor dental health, cleanliness, missed appointments

64
Q

Define emotional abuse

A

Persistent emotional maltreatment such as to cause severe and persistent adverse effects on a child or young persons emotional development.

65
Q

What must you do if you suspect neglect?

A
  • recognize > document > report to senior > designated safeguarding specialist
  • local authority social services by law have to investigate (NSPCCC, police)
  • information can be concerned without consent if public interest/ law
  • give child advice about where they can go for advice and support
66
Q

Statutory responsibility when it comes to children

A
  • must act on any concerns and be open minded
  • learn different cultural/ religious background; make sure your own culture doesn’t distract you.
  • listen to children
  • keep clear records
67
Q

4 critical conditions which might end in paediatric end of life care

A

1 Life threatening condition for which curative treatment may be feasible but can fail e.g. malignancy
2 Conditions where premature death is inevitable, long intensive treatment e.g. CF
3 Progressive conditions without curative options where treatment is palliative and may be go over many years e.g. Batten’s disease
4 Irreversible but non-progressive conditions causing severe disability leading to susceptibility to health complications and likelihood of premature death e.g. severe brain injury

68
Q

Define the doctrine of double effect

A

risk of hastening death is accepted when intention of using the drug it to control symptoms when death in inevitable

69
Q

3 things to consider in childhood palliative care

A

Pain
N+V
Anxiety

70
Q

What does time off school affect in adolescents?

A

exams, social isolation, mental health, dependence on parents, impact employment

71
Q

4 things that might make a child miss their medications

A
  • poor thinking i.e. forgetful
  • feel bulletproof – don’t think about long-term
  • rejection of medical professional/ parental advice
  • bad side effects
72
Q

Define transition

A

purposeful, planned process that addresses psychological, education needs of adolescent with physical/mental condition as they move from child centered to adult centered health care systems

good transition improves outcomes, attendance

73
Q

Talking with VS Talking to children

A

talking with is inclusive, encourages responsibility for themselves, discussion, respect

Health and Society Year 4 (9 decks)

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