Sick Child

Question 1

Define premature?

Answer 1

Born before 37 weeks

Question 2

Define extremely premature?

Answer 2

Born before 28 weeks

Question 3

Define neonate?

Answer 3

Birth to 24 days

Question 4

What determines normal, low, very low and extremely low birth weight?

Answer 4

Normal = 3.5kg
Low = 2.5kg
very low = 1.5kg
extremely low = 1kg

Question 5

How many months old does a baby double their birth weight?

Answer 5

6 months

Question 6

How can you quickly estimate a babies weight with their age?

Answer 6

(age in years + 4) x 2

Question 7

What coloured measuring device can be used to estimate weight of a child?

Answer 7

Breselow Tape

Question 8

What position is best for a child in order to keep airways open

Answer 8

Neutral - not hyperextended or hyperflexed

Question 9

Why are the airways difficult to manage in babies?

Answer 9

large head, short neck, large tongue, soft floor of the mouth, easily compressed

Question 10

Age group are obligate nasal breathers?

Answer 10

under 6 months

Question 11

Signs in the ribs that a child is in RDS?

Answer 11

Subcostal recession, intercostal recession, sternal recession, ribs collapse in, marked abdominal breathing

Question 12

What is total blood volume /kg in infants compared to adults?

Answer 12

80/90ml/kg in infants

50/60mo/kg in adult male/female

Question 13

Main reason for hypoglycaemia being more common in babies?

Answer 13

Higher metabolic rate

Question 14

Most common reasons for mortality in infants under 1 years old?

Answer 14

Trauma, congenital abnormalities, SIDS (smoking), infections

Question 15

Narrowest part of infants airway?

Answer 15

Cricoid cartilage

Question 16

What is the RR of a child under 1?

Answer 16

30-40 bpm

Question 17

What is the RR of a child 1-2 years old?

Answer 17

25-35

Question 18

What is the RR of a child 5-12 years old?

Answer 18

20-25

Question 19

When examining a childs breathing in ABCDE what are you looking at?

Answer 19

wheeze/stridor/grunting
crepitations
Accessory muscles
Intercostal recession/subcostal recession/prominent diaphragmatic breathing
Hyperinflation
Head bobbing/nasal flaring/apnoea
RR
Air entry/trachea central/bilateral entry/expansion efficiency
Oxygen sats

Question 20

Normal HR of a child up to 2 years old?

Answer 20

110-160

Question 21

Normal HR of a child 2-5 years old?

Answer 21

95-140

Question 22

Normal HR of a child 5-12 years old?

Answer 22

80-120

Question 23

How can you estimate a childs BP?

Answer 23

(Age x2) + 85

Question 24

Average systolic BP for a child under 1?

Answer 24

70-90

Question 25

Average systolic BP for a child 1-2

Answer 25

80-95

Question 26

Average systolic BP for a chid 2-5?

Answer 26

80-100

Question 27

How can you tell whether cyanosis is a cardiac cause over respiratory?

Answer 27

``` Cardiac murmurs or arrhythmias gallop rhythm absent femoral pulses hepatomegaly normal respiratory effort - no resp symptoms Cyanosis despite oxygen ```

Question 28

Decorticate vs decerebrate posturing?

Answer 28

Decorticate causes flexed arms, extended legs | Decerebrate causes extended arms and legs

Question 29

Cheyne Stokes breathing?

Answer 29

progressively deeper, and sometimes faster, breathing followed by a gradual decrease that results in a temporary stop in breathing

Question 30

Cushings triad indicates what? what are the 3 symptoms?

Answer 30

Cushings triad is when the brain is herniating through the foreman magnum. Indicated by bradycardia, hypertension, irregular breathing