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semester 2 year 2 week 9-16 > paediatrics > Flashcards

paediatrics Flashcards

1
Q

what is difference in kids?

A

size, drug dose, fluid
larger head to body ratio
larger body: surface area( fluid)

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2
Q

difference in airway in children?

A

large occiput, short neck, big tongue, small mouth

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3
Q

difference in breathing in children?

A

higher RR(40-60)
Smaller immature airways
compliant chest wall
diaphragmatic breathing

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4
Q

difference in circulation in children?

A

RV=LV at brith until
pulmonary vascular resistance fall at 6 mo
circulating blood volume by body weight ( small losses significant)
high HR

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5
Q

normal HR in newborns

A

110-160bpm

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6
Q

skin difference in children

A

thin epidermis

increase absorption

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7
Q

MSK difference

A

bone not yet ossified( growth centre), growth plate not fuse yet,

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8
Q

fracture in kids

A

greenstick, Satter Harris ( around growth plates)

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9
Q

immune system in kids

A 
less mature system
immature BBB(more intracranial infection esp new born required LP)
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10
Q

Infectious disease in newborns

A

Group B strep, E.coli

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11
Q

metabolic system in kids

A

high BMR( higher requirement and expenditure)

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12
Q

4 domain in developmental in children

A
  1. motor
  2. speech language
  3. social
  4. cognition
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13
Q

4 things to ask in history in kids

A
  1. oral intake
  2. output
  3. sleep
  4. activity level
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14
Q

sleep time in kids?

A

longer than adults

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15
Q

3 aspects of history to ask

A
  1. ob and birth history
  2. developmental history
  3. immunisation history
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16
Q

adolescent history?

A 
HEADS Screen
home
education 
activity 
drug
sexuality, suicide. mood, safety
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17
Q

causes in irritability in children?

A

dehydration , sleep deprivation, hunger, pain or discomfort, behaviours, CNS infection, fever

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18
Q

pain rating scale

A
  1. Wong becker FACE pain rating scale
  2. numerical ratings cale
  3. FLACC scale( face, legs, activity, cry, consolability)
  4. neonatal pain ax tool
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19
Q

general observation

A

alert, active, playful, dysmorphisms, growth vital signs

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20
Q

how to measure growth

A

weigh, height and head circumference

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21
Q

wide pulse pressure in kids means

A

PDA or aorta regurgitation

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22
Q

narrow pulse pressure

A

aortic stenosis

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23
Q

signs of respiratory distress in children

A

intercostal, subcostal recession, tracheal tug and nasal flaring

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24
Q

gross motor function develop timeline

A 
rolling (by 9mo)
scrawling( by 12mo)
sitting
standing (18mo)
walking(2yo)
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25
Q

language development timeline

A 
babbling(6 mo)
two part babble( 9mo)
1-3 words(1yo)
2 words together(2yo)
understand 2 steps commands(2.5yo)
understand sentence(3yo)
understand complex sentence (5yo)
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26
Q

time range to look at in milestone

A
  • 3rd and 97th percentile (beyond : worry about but still can be normal)
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27
Q

reach for objects in fine motor occur when

A

3-4mo

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28
Q

banging objects together, casting and pointing to objects

A

6-12mo

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29
Q

pincer grip in fine motor when

A

9-12mo

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30
Q

hand dominance occurs when

A

2 yo (should not occur before 12mo)

31
Q

what can children do at 2 yo

A

walking, putting 2 words together, hand dominance, 2 steps commands, interaction with other children

32
Q

2 parts of langue milstones

A

expressive and receptive

33
Q

language milestone development

A

attention and listening skill–> social interaction and play skills–> understanding language–> expressive language– speech pronunciation and fluency skill

34
Q

following commands in receptive language skill happen when

A

one step commands 1yo

two steps command 2yo

35
Q

when will the children star to be understood by strangers

A

4 yo

36
Q

social developmental red flag

A

smile by 6-8 mo

37
Q

turn playing develops when

A

3yo

38
Q

weight, height and head circumference at birth

A

weight: loss 5-10% in first few days(7-10d return to normal)
height: 50cm
head circumference: 35cm

39
Q

risk factors to normal development

A
  • Prematurity
  • Low birth weight
  • Birth injury
  • Chronic illness
  • Vision and/or hearing impairment
  • Low parental education
  • Parental mental illness
  • Social isolation
  • Poverty
  • Lack of access to services
40
Q

Developmental screening tests

A

Denver

41
Q

Parent questionnaires

A

– PEDS, ASQ

42
Q

Leading cause of death in children 0-14 years of age

A

injury
Boys > Girls (1.5 time)
Indigenous > Non-indigenous

43
Q

common cause of injury in 0-14

A

<1: breathing, assault

1-14: transport and accidental drowning

44
Q

causes of injury in Infants <12 months

A
  • Drowning (75% bathtubs)

* Thermal injuries

45
Q

causes of injury Children 1-4yrs

A
  • Drowning (60% swimming pools)
  • Thermal injuries
  • Unintentional poisoning
  • Falls (from playground equipment)
46
Q

causes of injury Children Children 5-9yrs

A

• Falls

47
Q

causes of injury Children 10-14yrs

A
  • Unintentional transport injury
  • Intentional self harm
  • Assault
  • Falls
48
Q

cause of injury in adolescents

A

• Intentional self harm

49
Q

ED presentation in children

A

<1: bronchiolitis
1-9: gastro
10-18: abdo pain

50
Q

Developmental delay?

A

Develop fall outside 2 SD below expected range to achieve developmental milestone
Normal development with right succession with delayed compared to age

51
Q

Global impairment

A

Delay or impairment in 2 or more area

52
Q

Specific delay

A

Delay in one area only

53
Q

Atypical development

A

Cerebral palsy, ADHD, trajectory very different

54
Q

Primitive reflexes need to be lost before development

A

Loss by 6-8 wks
Stepping reflex
startle reflex

55
Q

screening development in birth to 8 yo

A

PEDS

56
Q

biological factors in development affecting Developmental myelination

A 
Genetics
Monogenic disorder
Epigenetics
Exposure to toxin
Modification of genomic transcription, Trauma. Nutrition
57
Q

psychosocial factors in development

A

temperament, availability of parent, parenting style, bullying, self-esteem

58
Q

triad of ADHD

A

hyperactivity
impulsivity
poor concentration

59
Q

presentation of autism

A
  1. social communication ( no reciprocal , non-verbal communication, relationship)
  2. repetitive restricted pattern of behaviours ( sameness, adherence, highly restricted, rigid)
  3. hyper or hypo-activity to sensory stimulus
    M>F, 2-4yo
60
Q

Ix for autism

A

ADOS, ADI-R

61
Q

recognition of the serious ill children

A

Skin: mottle, cyanotic, petechiae, pallor
Activity: assistance, ambulating, responsive
Ventilation: retraction, head bobbing, robbing, nasal flaring, slow rate, fast rate, stridor, wheezing
Eye contract: glassy starte, fail to engage
Abuse: unexplained bruising or injuries/ inappropriate parent
Cry: high pitched, cephalic, irritable,
Heat: high fever(>41), hypothemia( <30)
Immune system: sick cell, AIDS, corticosteroids
Level of consciousness(irritable, lethargic, pain , consoling, unresponsive)
Dehydration( hollow eyes, cap refill, god and, voiding, D+V, bilious persistence,dry mucous membrane)

62
Q

toxic appearance

A 
poor interaction with parent
eye contact
poor person 
cyanosis
irritable not constable
63
Q

suspects sepsis

A

cyanosis, rapid breathing, poor perfusion, petechial rash, parental concern, clinician instincts, T>40

64
Q

color in NICE guideline

A

pale, mottle/ ashen, blue

65
Q

activity in NICE

A

no response, appears ill, no wake, weak, high pitched or continuous cry

66
Q

resp in NICE

A

grunting, tachycardia, RR>60, chest indrawing

67
Q

circulation/dehydration in NICE

A

reduced skin turgor

68
Q

other red flag in nICE

A

Age<3. temp>38, non-bleaching rash, balding fontanelle, neck stiffness, status epileptics, focal near signs, focal seizures

69
Q

things to consider in a sick chid

A

abuse, aortic stenosis, TGA, pulmonary atresia, malrotation, lactate, ketone,

70
Q

CEWT scores

A

identify ill children in hospital
oxygen, resp rate
HR, BP

71
Q

Common cause of cardiac arrest in children

A

fluid loss
fluid maldistribution
resp distress
resp depression

72
Q

resp effort

A

stridor: upper airway pathology
wheeze: low airway pathology
grunt: airspace pathology or pneumonia

73
Q

AVPU score

A

alert
response to voice
response to pain
unresponsive

semester 2 year 2 week 9-16 (11 decks)

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