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Child Health Y2 JC > Week 1 > Flashcards

Week 1 Flashcards

1
Q

What are the three main aspects that influence children’s development

A

Genetics
Nutrition
Environment

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2
Q

Define a milestone

A

The median age when 50% of the population achieve a skill

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3
Q

Define a limit age

A

When a skill should have been acquired by 97.5% of children

Past this point we begin to be concerned

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4
Q

What age do we loose primitive reflexes?

A

3-4 months

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5
Q

Name some normal variants of crawling. What is their caviate to walking?

A

Back shuffling
Commando crawling
Butt shuffling

(May take longer to walk)

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6
Q

At what age would expect your child to have control of their head?

A

3 months

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7
Q

What is the natural progression of motor movements of the hands?

A 
Look at them in the midline
Grasp toys in palm 
Scissor grip (three fingers)
Pincer grip (2 fingers)
Tower 3/4 blocks
Tower 6/7 blocks AND scribble 
Tower 9 bricks and copy a circle 
Draw simple man
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8
Q

What is the normal progression of hearing and language?

A

Vocalise, babble, imitate sounds, know name, know 5-20 words and body parts, simple instructions and 50+ words, complex instructions and ask questions, can tell stories

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9
Q

What can lack of a social smile at 8 weeks be a sign of?

A

Autism

The milestone age is 6 weeks the limit age is 8 weeks

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10
Q

What are some of the red flags for a child’s development ?

A 
Asymmetry of movement 
Not reaching for objects by 6 months
Unable to sit unsupported by 12 months
Unable to walk by 18 months
No speech by 18 months
Concerns of vision or hearing
Loss of skills
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11
Q

What is global developmental delay

A

Delay in 2 or more in gross/ fine motor, sppech/language, cognition, social/personal, ADL

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12
Q

What is the autism triad?

A

Communication difficulties, social interactions difficult and dont have flexibility of thought

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13
Q

What questions in terms of perinatal and birth would you ask a mother whose child is have developmental delays?

A 
Was she well during pregnancy 
Premature baby?
Drink while pregnant/ unknown pregnant
Post natal depression 
Meningitis as a child
Head injury?
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14
Q

Define a burn

A

An injury caused by dry heat like hot object, surface or flame. Severity measured by depth

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15
Q

Define a scald

A

Caused by moist heat like hot water, oil or steam. Often blister

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16
Q

What is the classical triad in a shaken child for NAI

A

Bilateral retinal haemorrhages
Subdural haemorrhage
Encephalopathy

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17
Q

What features on a child would make you think an injury was NAI

A 
Present on Non mobile child
Symmetrical 
On non-bony area
Scarf/stocking mark 
On area usually covered like back chest
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18
Q

You suspect cerebral palsy in a child of 18 months. What investigation do you run

A

MRI of the brain

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19
Q

Child is not walking by 18months, what investigation would you always do

A

Creatine kinase for duchennes muscular dystrophy

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20
Q

What are some of the red flags for abnormal development?

A

After infection not doing activities were before
Asymmetry of movement
Not reaching for objects by 6 months (vision, motor skills, autism)
Unable to sit unsupported by 12 months
Unable to walk by 18 months
No speech by 18 months
Concerns of vision or hearing (squinting, not seeing objects/ recognising faces)
Loss of skills

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21
Q

What is global developmental delay

A

If delayed in 2 or more then global developmental delay

Gross motor
Fine motor
Speech and language
Cognition 
Social and personal
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22
Q

If a child has global developmental delay what should you screen for?

A 
Downsyndrome
Heart disease
Vision issues
Middle ear effusions
Thyroid function
Breathing disorders (sleep apnoea)
Look at growth charts

What you investigate depends on what delayed

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23
Q

What are some of the physical characteristics of duchenne muscular dystrophy

A

Large calfs
Lumbar lordosis
Pelvic girdle muscle loss

Gowlers sign

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24
Q

During what time period of pregnancy could trauma to the fetus cause cerebral palsy?

A

34-42 weeks

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25
Q

Child presents with loss of pigmentation of the skin, hairs and eyes, also has nystagmus and photophobia. What is the diagnosis?

A

Oculocutaneous albinism

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26
Q

What is the autistic triad?

A

Poor Communication
Poor Social interaction
Loss of flexibility of thought and imagination

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27
Q

What are some of the sensory issues with autism

A

Fussy eater
Dont like hair washing/ cutting
Loud noises
Specific textures of clothes

(May find a heavy backpack comforitng)

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28
Q

What are some of the questions you should ask a mom about her pregnancy and birth when presenting with a child with developmental delay

A 
Well during pregnancy?
Premature child?
Drink while didnt know pregnant?
Post natal depression?
Meningitis child?
Head injury?
Birth type?
Any issues with birth?
Have to go to the special care unit?
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29
Q

What indicates that a boy is in puberty

A

Testicular volume 4ml

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30
Q

What is true central precocious puberty in males and females?

A

Reaching puberty before 8yrs for girls and before 9 yrs for boys

In females; breast development before 8

In girls; testicular volume >4ml before 9yrs

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31
Q

What development do you use to stage if a boy has entered puberty?

A

Testicular volume

Pubic hair

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32
Q

What development do you use to stage if a female has entered puberty?

A

Breast development

Pubic hair distribution

33
Q

What is the treatment for precocious puberty?

A

Give GnRh to block puberty onset to encourage final growth height before epiphyseal plates fuse

34
Q

On the BMI chart on what centiile is it considered to be at risk of overweight/

A

> 85th centile

35
Q

On the BMI chart at what centile do you worry about obesity

A

> 95th

36
Q

If a child is overweight or obese, what is the maximum healthy weight loss a month?

A

0.5-1kg

37
Q

For a child under 5yrs and walking how much physical activity should they get a day ?

A

180 minutes

38
Q

What are some of the pharmacological options for obesity in children and young people

A

Orlistat 120mg

39
Q

What is the daily requirement for vitamin A

A

350-400mcg

40
Q

What is the daily requirement for vitamin C

A

25-30mcg

41
Q

What is the daily requirement for vitamin d

A

7-8.5mcg

42
Q

?What is the daily requirment intake for sodium

A

0-12 months <400mcg (1gsalt)

1-3yrs <800mcg (2gsalt)

43
Q

How long is recommended for exclusive breast feeding?

A

6 months of life

44
Q

At what stage should weaning be introduced?

A

6-9motnhs

45
Q

Until what age should whole nuts and seeds be avoided?

A

5 years

46
Q

From waht age should babies be introduced to drinking from cups or beakers?

A

6 months

47
Q

What are the top 5 causes of child mortality?

A 
Preterm complications
Pneumonia
Intrapartum related complications (asphyxia)
Diarrhoea
Neonatal sepsis
48
Q

Women presents with reccurent colds, oral thrush, cervical lymphadenopathy and persistent fever. She has recently moved from subsaharan africa and engaged in unprotected sex. Likely diagnosis?

A

HIV

49
Q

If the mother is positive for HIV at what time periods do you check for HIV in the baby?

A

Test child at 6 weeks
9 months
18 months
6 months post cessation of breast feeding

50
Q

What is the treatment for HIV in the mother

A

Anti-retrovial therapy like abacavir and lamivudine

BUT if have TB then must treat first

51
Q

Man presents with chronic cough, night sweats, cervical lymphadenopathy and weight loss. You do an x-ray that shows apical consolidation. What is the next investigation and likely diagnosis?

A

Microbiology for acid fast bacilli

TB

52
Q

You are working in africa and a young women prsents with fever, pallor and fatigue. She sleeps without an insecticidal net. What is the likely diagnosis and treatment?

A

Malaria from plasmodium parasite

Artemisinin based combination therapy for 3 days

53
Q

What is reactive attachment disorder (RAD)?

A

Disturbed and developmentally inappropriate social relatedness, associated with pathological care typically before 5 years

54
Q

What are the two types of RAD?

A

Inhibited

Disinhibited

55
Q

What is inhibited reactive attachment disorder?

A

Where a child fails to initiate and respond to social interactions in a developmental way

They present as unpredictable, avoid social contact, hypervigilant, highly ambivalent, dont seek comfort from caregivers

56
Q

What is disinhibited reactive attachment disorder?

A

Where a child has an inability to display appropriate selective attachments (whose safe and dangerous)

Older kids are impulsive, speech delays, dont understand social boundaries OR overseek comfort, hyperactive, food issues, prefer to play alone

57
Q

What is conduct disorder (oppositional defiant disorder)

A

Where there are repetitive and persistent patterns of behaviours that violate the basic rights of others, rules, and age appropriate norms. Common in those with parents mental illness, alcohol problems, domestic violence.

58
Q

What three criteria do you need to diagnose conduct disorder (oppositional defiant disorder)

A

Aggression to people/ animals e.g bullying, fights, cruel to other physically, forced someone sexually

Destruction to property incl fire

Deceitfulness or theft

Serious violoation of rules

Must be in the last 12 months, with one in the last 6months

59
Q

How can you distinguish between conduct disorder (oppositional defiant disorder) and RAD

A

In conduct disorder they are still able to form satisfying relationships with peers and adults

60
Q

What is the treatment for conduct disorder?

A

Parent training, child focused programmes, multimodal interventions, medication (RISPERIDONE) only for extreme impulsive e and aggressive behaviours

61
Q

What is the ADHD triad\?

A

Inattention
Hyperactivity
Impulsive

(Also inable to regulate emotions and learning difficulties)

62
Q

How can you distinguish between ADHD and RAD?

A

ADHD difficulties are more persistent and across different settings and are more able to initiate and maintain relationships

63
Q

What is the neurobiology behind RAD?

A

High levels of cortisol (stress) in the immature brain can cause neurone pathways to be formed that are fight and flight due to excessive stimulation of neglect.

64
Q

What is the genetic issue with digeorge syndrome?

A

Chromosome 22 has a bit missing

65
Q

Kabuki makeup syndrome is a genetic issue with what?

A

Mutation in MLL2

66
Q

What is the genetic normal defined as?

A

The most common form of gene sequence

67
Q

What is array genomic hybridisation a test for?

A

Imbalanced chromosome deletions or additions

Sensitive test that looks at chunks of genes

NOT FOR BALANCED TRANSLOCWTIOS

68
Q

What does next generation sequencing look at?

A

Mutations at base level

69
Q

What is a de-novo mutation?

A

Where neither parent has the mutation but the child has it.

More likely as paternal age increases

70
Q

By what age should a child be able to walk? (Milestone and limit)

A

11 months milestone

18 months limit age

71
Q

What is the limit age for reaching for objects?

A

6 months

72
Q

What is the limit age for sitting unsupported?

A

12 months

73
Q

What is the limit age for being able to form words

A

18 montns

74
Q

Give some examples of vaccine-preventable infections that require to be reported to public health if diagnosed?

A 
Cholera
HUS (haemolytic ureamic syndrome)
Ecoli
Measles
Polio
Whooping cough 
Diptheric
Hib
Rubella
Tetanus
75
Q

What is the time period for reporting an infection to public health after diagnoising it?

A

3 days in writing

OR if urgent (like ecoli) then same day

76
Q

What is the treatment for TB?

A

RIPE

Two months rifampicin and pyrazinamide, isoniazid and ethanbutol

Then further 2 months of isoniazid and rifampicin

77
Q

What is the carrier for the plasmodium parasite?

A

Mosquitors

78
Q

What is the treatment for malaria?

A

Artemisinin based combination therapy (ACT) for three days

Orally

Child Health Y2 JC (2 decks)

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