W20 73 paediatrics/child at risk Flashcards
What are some non-specific disease patterns in young children?
Behaviour change, poor feeding, anorexia, failure to thrive, screaming episodes, fever
What are some specific disease patterns in young children?
Acute stridor - related to creep?
Wheeze - related to asthma?
Non-blanching rash - meningococcal disease?
Swollen face/lips - underlying allergic reaction?
What does normal growth and development of a child depend on?
Health of child, parental size, nutrition of child, genetic profile
Smoker parents, parental age, ethnic background, socio-economic status
What are differences in children’s growth to age five influenced by?
More influences by nutrition, feeding, practices, environment, and healthcare rather than genetics or ethnicity
What does it mean if height and weight are not within a few centiles of each other?
If height is very low and weight is very high, may signify obesity
If height is very high and weight is very low, may signify an underlying endocrine problem
When does a child grow fastest?
First year of life
Primary school
Puberty
What are the 4 main areas of childhood development?
Gross motor
Fine motor and vision
Hearing, speech and language
Social and personal activities of daily living
What are the highest causes of death in UK children under 15?
Cancer, cardiovascular disease, injury and poisoning, congenital and malignant disease, preterm and low birth weight, suicide, chronic disease management
How does obesity harm children and young people?
Emotional and behavioural - stigmatise, bullying, low self esteem
School absence
Health - high cholesterol, high BP, pre-diabetes, bone and joint problems, breathing difficulties
Increased risk of becoming overweight adults
Risk of ill health and premature mortality in adult life
How do you identify a chronically unwell child?
Faltering growth and developmental delay
What might be causing a chronically unwell child?
Chronic inflammatory disease: eg connective tissue, bowel disease
Illness - eg diabetes, atrophic disease
What common childhood illnesses are there?
Hand foot and mouth disease (HFMD)
Herpangina
Scarlet fever
Recurrent mouth ulcers
Diphtheria
What is hand foot and mouth disease and how does it present?
1 or all may be affected:
Oval-gray roofed vesicles with erythematous rims
Hands and feet - on sides of feet and hands, palms, soles
Mouth - buccal mucosa, tongue, lips
Other-common in younger children: papula lesions, buttocks, uppers thighs, knees
Usually occurs beneath age 10 but can be any
What causes HFMD? (Pg705 image)
Coxsackie virus
Usually in the late summer/early autumn
What is treatment of HFMD?
Lesions usually last 7-10days
May need to treat pain and dehydration (from not feeding)
What is herpangina and what is it characterised by?
Characteristic enanthem (rash/small spots on the mucous membranes)
Posterior mouth especially, eg soft palate, uvula, tonsillar pillars
Usually occurs age 3-10
What causes herpangina?
Coxsackie virus
Summer-early autumn
What is treatment for herpangina?
It is self-limited, lesions last 1 week usually
May need to support hydration, treat pain
What is the difference between herpes stomatitis and herpangina?
Herpes stomatitis can affect the whole mouth, including gingiva and buccal mucosa
What is Scarlett fever and what might it present as?
A rash, usually appearing first on the neck and face. Fades by 6th day of infection, affected skin might peel.
Tongue - thick, white coating that peels are 4-5 days - strawberry appearance = papillae protruding through causing this.
Peak incidence = 4-8yeats
What causes scarlet fever?
Group A streptococcus as bacterial infection
What are the acute and delayed complications of scarlet fever?
Acute complications including cervical lymphanitis, otitis media, mastoiditis, meningitis and pneumonia
Delayed complications like rheumatic fever, glomerular nephritis, erythema nodosum (painful nodules on shins)
What is treatment for scarlet fever?
Supportive, penicillin (for bacterial infection)
There are lots of causes for recurrent mouth ulcers, name a few. Pg707 table.
Infection, autoimmune disorders, immune disorders, vitamin deficiencies, neoplastic
Read table for more.
What is diptheria and what does it cause?
Upper airway obstruction - causes sore throat and high grade fever. Pseudomembrane of the tonsils, pharynx and nose which leads to difficulties breathing. Also releases a toxin which causes paralysis of the respiratory muscles.
Complications of diptheria
Myocarditis
Vocal cord paralysis
Guillan Barre syndrome
What greatly reduces diptheria deaths?
Immunisatioon
What can you be immunised against?
Table page 708 - read (more details abt age and site etc):
Common ones - diptheria, tetanus, polio, rotavirus, influenza, MMR, HPV
What is the spectrum of child abuse?
Casual attitudes, carelessness, poor parenting
Neglect, poor physical care, emotional unavailability
Inflicted physical or emotional abuse
Severe, deliberate and persistent abuse
What are the categories of abuse?
Physical abuse - causing physical harm or when a parent or carer deliberately induces illness in a child
Emotional abuse - persistent emotional maltreatment of a child
Sexual abuse
Neglect - persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in the serious impairment of the child’s health or develoment
What are the categories of need (for support)
Main - abuse or neglect is main one
Others include - child’s disability/illness, parent disability/illness, family in acute stress, family dysfunction, socially unacceptable behaviour, low income, absent parenting
