W1 - Journey of the Newborn Flashcards
what are the 6 things needed for a screening test
- Important health problem
- Natural history of disease understood
- Treatment available
- Latent stage of the disease
- Test for the condition
- Acceptable test
what are the screening sessions children get from birth to 18yrs
when is the newborn physical examination carried out
1-3 days after birth
when is newborn bloodspot done
5-8 days
what is tested for in the newborn bloodspot
- Congenital hypothyroidism
- Cystic fibrosis
- Sickle cell disorder
- Inherited Metabolic Diseases (IMDs)– Phenylketonuria – MCADD
what is congenital hypothyroidism
1 in 4,000
- Inadequate thyroxine– poor growth – serious, permanent, physical and mental disability
- Early thyroxine treatment– for normal growth and development
what is cystic fibrosis
1 in 2,500
- GI and Respiratory system – poor weight gain & frequent chest infections
- Early treatment – high energy diet, medications, physiotherapy
what is sickle cell disease
1 in 1,900
- Inherited disorders affecting RBCs – Pain and damage, serious infection, death
- Early treatment helps prevent serious illness, immunisations and antibiotics, parent education
what is MCADD (MEDIUM-CHAIN ACYL-COA
DEHYDROGENASE DEFICIENCY)
1 in 10,000
– problems breaking down fats
- Early diagnosis – Identify before suddenly and seriously ill– allow normal development– dietary input
what is phenylketonuria (PKU)
1 in 10,000
autosomal recessive
– unable to process phenylalanine
* low phenylalanine diet
- causes irreversible, mental disability
when is newborn hearing testing done
> 28 days
when is the first visit from the health visitor
10-14 days
what will the health visitor check/cover on the first visit
- growth & development
- breastfeeding, weaning, safety
- postnatal depression
- common infections in childhood
- behaviour difficulties
when is the first physical examination check
6-8 weeks
what will the physical examination involve
- Weighing and plotting
- General physical examination
- Heart, hips, eyes (testes in boys)
- Coincides with maternal check up
what immunisations are offered at 2 months
DTaP/IPV/Hib
Rotavirus
Men B
Hep B
what immunisations are offered at 3 months
DTaP/IPV/HiB - diptheria, pertusses, polio, haemophilus influenzae type b
PCV - pneumococcal
Rotavirus
Hep B
what immunisations are offered at 4 months and 3 years
DTaP/IPV
MMR
what immunisations are offered at 4 months
DTaP/IPV/HiB - diptheria, pertusses, polio, haemophilus influenzae type b
Men B
Hep B
what vaccines are offered at 12 months
HiB/MenC
MMR
PCV
Men B
what vaccinations are offered at 2, 3 and 4 years + school years
annual flu vaccine
what is checked at the 8-12 month review
- Growth
- Developmental Milestones
- Health
- Safety promotion
what is monitored at the 2-2.5year review
General development
* movement, speech, social skills, behaviour, hearing, vision
* Growth, healthy eating and keeping active
* Managing behaviour and
encouraging good sleeping habits
what is monitored at the 4-5 year review
- weight and height
- vision, hearing and dental
- Alert to risk signs of child abuse
what vaccine is offered at 12-13years of age
HPV x2
what vaccines are offered to 13-18yr olds
tetanus, diptheria, polio
MenACWY
what 5 things are most commonly found to be a problem in the newborn physical examination
heart, hips, eyes, testes, skin
what heart problems are found on newborn examinations
congenital cardiac disease
- check pulses, heart, o2 sats
what hip problems are found in the newborn
Developmental dysplasia of hip (DDH)
concerns or family history ultrasound scan indicated
what is the most common form of hip displacement
99% are posterior displacement
what eye problems are found in the newborn physical checks
cataracts and congenital abnormalities
- ophthalmoscope - movement and red reflex (retinoblastoma)
what does a new onset convergent squint indicate
a brain tumour
what testes abnormalities are commonly found on newborn checks
undescended testes
what is worse bilateral or unilateral undescended testes
disorder of sexual disorganisation
unilateral - 1 may just be late - watch and wait
what skin problems are commonly found in newborn examinations
- preauricular skin tag
- Milia
- eczema
- congenital dermal melanocytosis (sacral blue spot)
- strawberry haemangioma
- erythema toxicum
- imperforate anus
why is it really important to document a congenital dermal melanocytosis
in the future people may query bruising and child abuse
what does a strawberry haemangioma look like
how do you treat a strawberry haemangioma
probanolol
what does erythema toxicum look like
what is the prognosis of erythema toxicum
benign, watch and wait
what is an imperforate anus
the anus does not develop and the backside is sealed
- required surgery to form an anus
