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LS YEAR 4 Paediatrics > pRRAPID, fluid, prescribing, other random stuff > Flashcards

pRRAPID, fluid, prescribing, other random stuff Flashcards

1
Q

types of abuse

A

emotional -frozen, watchful apperance, expressionless, abnormally affectionate to strangers
NAI- bruises, burns, bites, head injuries, suspected fractures
physical neglect- dirty, sores, unkempt, ftt
sexual - anogenital bruising and tears, pregnancy, STI

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2
Q

history

and investigations

A 
- how the injury was acquired 
past medical history
development and behaviour
social and family history
physical examination

photographs of bruises etc and measurements
skeletal survey
pregnancy test and cultures
bloods-rule out haematologicall cause

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3
Q

risk factors for abuse

A 
parent- anger issues, indiffiences, intolerance or overanxious, MHX 
alcohol and drug abuse 
step parents
Domestic violence 
social isolation 
young parental age
poverty
unsavoury neighbourhood
multiple close spaced births
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4
Q

child health surveillance

A

in 2009 department of health - healthy child programme

promoting health lifestyle and protection from serious diseases through screening and immunisation

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5
Q

what is screened for at maternal blood test

when does this occur

A

0-10 weeks

sickle cell and thalasemmia

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6
Q

when is downs screened for

A 
11-13 weeks 
biochemical screening 
AFP, HCG, Oestriol 
can be done alone or with NIUCHAL TRANSCULENCY 
offered to all!!!
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7
Q

what can be offered if positive

A

Chorionic villus sampling and aminocentesis

invasive testing

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8
Q

congenital animaly screen

A

USS scan at 18-20 weeks
looking for cleft palate, NTD, heart defects
lung manfnormation or renal obsturction

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9
Q

screening at birth

A

otoacoustic emissions

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10
Q

when is new born assessment done

A

within 72 hours

and at 6 weeks

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11
Q

when is Guthrie test done

A

day 5-8

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12
Q

what is screened at at school and when

A

vision growth obesity when entrying

obesity at 11 years old

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13
Q

what is a phenylketonuria tested with

A

a pheynlketonuria assay over Guthrie test

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14
Q

what is medium chain acyclcarnithine deficiency

A

fatty acid oxidation defect can lead to significant hypoglycaemia in illness
can be detected by mass spectrum and is a preventable cause of sudden death in infancy
frequent feeds prevents need for fatty acid breakdown

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15
Q

when is karptyping done

A

any time after birth

specific gene testing

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16
Q

key features of newborn and 6-8 week exam

A

congenital cataracts with fundoscope
heart disease by cvs exam
iundensdended testses-palpation
DDof Hip -barlow and ortolani

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17
Q

sudden infant death syndrome definition

A

sudden unexplained death < 1years old
apparently occurring during sleep
which remains unexplained after investigation autopsy and review of circumstances of death

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18
Q

triple risk model

A 
1994 
when three risk factors are present 
- low birth weight and or premturity
development period 1-3 months
exogenous stressor e.g. cigarette smoke, sleeping prone, temptature, infection
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19
Q

what is legal requirement with prescribing

A

age of child when under 12
if less than 5ml, oral syringe should be subbed

DO NOT EXTROPOLATE FROM ADULT DOSES

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20
Q

age ranges

A 
preterm born before  37 weeks 
neonate birth to 1 month
infant 1 month to 12 months 
child 1 year to 12 year
adolescents 12 year plus
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21
Q

classification of mild moderate ad nd severe dehydration

A

1-5% weight loss
6-10% body weight loss
>10 % body weight loss secvere

symptoms
mild to mod 2 of more of :
restlessness, sunken eyes, irritability, thirsty/drinks eagerly

clinical features of severe
2 or more
abnormally sleepy 
sunken eyes
drinking poor or not at all
22
Q

skin tugor pinch test

A

normal skin fold retracts immediatel
mild to mod -slow skin fold visible for less than 2 second
sever -very slow, skin fold visible for longer than. 2 seconds

23
Q

red flags

and shock

A

same as before

deterioration, reduced skin tumour
dry mucus membranes
reduced tears dn urien output

shock

mottled skin
pale 
Cold extremities
tachycardia or tachypeonaema
weak peripheral pulses 
prolonged cap refill
hypotension 
sunken frontenalle
24
Q

fluids

maeintence fluids

A

100ml/kg for 1st 10 kg
then 50ml/kg for 2nd 10kg
then 20ml/kg for rest
0.9% saline and 5% dextrose

25
Q

bolus

A

20ml per kg

0.9% saline

26
Q

fluid deficit

A

% of dehydration x weight (kg) x 10

27
Q

when is bolus not needed

A

in DKA

28
Q

overall maintenance fluid

A

maintenance fluid + fluid defict and take away bolus

29
Q

if mild pain what can be given

A

< 3 months -paracetmol

if over 3 months can have paracetamol and ibuprofen

30
Q

if mod to severe pain

A

morphine

31
Q

what is calculation for bolus

A

20ml/kg

32
Q

what about calculation for mainentence fluid

A

first 10kg 100ml
2nd 10kg 50ml
any remaining 20ml
for 24 hr

33
Q

how to calculate rate

A

total maintenance fluid per 24 hour

/24 for hr

34
Q

dehydration %

A

well weight- new weight/weight well *100

35
Q

fluid deficit

A

% dehydration x kg x 10

36
Q

key thing to remember

A

need to give BOTH fluid deficit and maintenance if shocked

37
Q

maintenance needed when

A

when inadequate intake

nil by mouth

38
Q

dehydration when

A

when signs of dehydration

39
Q

key thing with shock

A

do bolus first

then consider maintenance and dehydration fluids

40
Q

oral rehydration

time over

A

50ml/kg

over 4 hr

41
Q

EMLA cream for

A

bloods

and also post circumcision pain

42
Q

pain relief in children

A

<3 months only paracetmol

if over 3 months can use ibroprufen as well

43
Q

which pain relief to avoid

A

aspirin risk of reyes

44
Q

pinch test skin tugor

A

normal-skin folds retract immediately
mild mod dehydration -less than 2 seconds for skin fold visibles
severe -longer than 2 seconds for visible folder

45
Q

what to give with morphine

A

stool softener and stimulant lax to prevent constipation

46
Q

when can cows milk be introduced

A

1 year

47
Q

when can honey be introduced

A

1 year also

48
Q

when can weaning start

A

6 months with pureed foods

49
Q

when can logt foods and juices and mash food and meals

A

juices, soft foods 9months
mash food and meals at 12 months
often most start before

50
Q

why should honey not be given before

A

BOTULUM TOXIN risk

51
Q

importance of breastfeeding In first few days

A

colostrum release of yellow watery milk high in IgG

52
Q

things to do with bottle milk

A

sterilise bottle, add cooled boiled water and powder together, shake and rewarm feed when needed

LS YEAR 4 Paediatrics (24 decks)

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