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Child Health > Week 1 > Flashcards

Week 1 Flashcards

1
Q

What is the cause of RDS?

A

Prematurity=lack of surfactant

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2
Q

What are the commonest causes of illness in infants?

A

Respiratory
GI
Wheeze

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3
Q

What are the commonest causes of illness in pre-school age children?

A

Exanthems
Accidents
SID

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4
Q

What are the commonest causes of illness in school age children?

A

Cognitive disorders
Accidents
Sexual and emotional difficulties

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5
Q

What is PEWS?

A

Paediatric early warning system

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6
Q

What influences normal development?

A

Genetics
Nutrition
Environment

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7
Q

What is a MEDIAN age?

A

Age at which 50% of children will have achieved a milestone

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8
Q

What is a LIMIT age?

A

Age at which 97.5% of children will have achieved a milestone

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9
Q

In what direction does the nervous system develop?

A

Cephalocaudal direction

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10
Q

What are the four areas of development?

A
  1. Gross motor
  2. Fine motor and vision
  3. Language and hearing
  4. Social behaviour and play
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11
Q

What age should a child gain head control?

A

3 months

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12
Q

What are the primitive reflexes?

A
  • Sucking and rooting
  • Palmar and Plantar Grasp
  • ATNR
  • Moro
  • Stepping and placing
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13
Q

When does the parachute reflex develop?

A

5-7 months

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14
Q

Why is social smile so important?

A

Bonding with parent

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15
Q

What is object permanence?

A

Ability to remember something that was temporarily out of sight

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16
Q

Define developmental delay?

A

Failure to attain appropriate developmental milestones for child’s corrected chronological age

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17
Q

What are the patterns of developmental delay?

A

Global

Specific

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18
Q

Name a cause of deviation from normal development?

A

Autism

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19
Q

List two causes of regression from developmental milestones?

A

Rett’s Syndrome

Metabolic disorders

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20
Q

What are the IQ scales for mild and severe learning disability?

A

Mild: 50-70
Severe: less than 50

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21
Q

Name three specific learning disabilities?

A

Dyslexia, Dyspraxia, Dyscalculia

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22
Q

What are the red flags for 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 revision

Loss of skills

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23
Q

What should be done if a child is not walking by 18 months?

A

Check CK for Duchenne’s; wild be highly elevated (1000s)

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24
Q

To have a global developmental delay you must be delayed in how many categories?

A

2 or more

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25
Q

What conditions are associated with downs syndrome?

A

Cardiac: 40% congenital heart disease

Vision: Issues with accommodation

Hearing: brachycephaly

Thyroid: Hypo

Sleed apnea

Growth shortened

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26
Q

What syndromes cause specific motor delays?

A

Duchenne’s
Cerebral palsy
Co-ordination disorders

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27
Q

What syndromes cause specific sensory deficits and associated delays?

A

Oculocutaenous albinism, treacher-collins

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28
Q

How is Duchenne’s inherited?

A

X-linked

Mother is carrier

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29
Q

What is Gower’s manoeuvre?

A

Children with weak pelvic muscles walk up their knees to stand

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30
Q

What are the types of cerebral palsy?

A

Hemiplegic= Arm and leg on one side

Diplegic= both legs only

Quadraplegic= both arms and legs

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31
Q

What is the commonest cause of cerebral palsy?

A

Usually antenatal insult

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32
Q

What conditions are associated with cerebral palsy?

A 
Learning difficulties
Epilepsy
Visual/hearing impairment
Communication difficulties 
Feeding difficulties
Sleep problems 
Behavioural issues
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33
Q

What is oculocutaenous albinism?

A

No pigment in skin, hair, eyes

34
Q

What eye issues are associated with oculocutaenous albinism?

A

Nystagmus
Very sensitive to light
Reduced visual acuity

35
Q

What can cause cerebral visual impairment?

A

Hydrocephalus

Cerebral Palsy

36
Q

What is the autistic triad?

A

Communication
Social Interaction
Flexibility of thought/imagination

37
Q

What is the spectrum of receptive language?

A

No understanding of spoken word -> subtle difficulties in inferencing

38
Q

Why can an autistic childs expressive language be deceiving?

A

Seems to be ahead of receptive but they often say things they don’t understand

39
Q

What challenges do autistic children face in social interaction?

A

Joint attention and referencing

Turn taking

Unable to share pleasure

Not motivated by social approval

Social rules

Empathy

40
Q

What challenges do autistic children face with flexibility of thought/imagination?

A 
Theory of mind
Concrete and literal
Concept of time
Routine
Ritualistic
41
Q

What challenges do autistic children face with sensory issues?

A

Fussy eater
Texture of clothes
Sleep
Hair washing

42
Q

What examinations could be performed on a child presenting with delay?

A 
Observational
Dysmorphism
Head circumference
Systematic
CNS
Vision
Hearing
43
Q

What investigations could be performed on a child presenting with delay?

A

Chromosome, FRAX, oligoarray CGH

Neonatal PKU, thyroid, CK

MRI brain
EEG
Metabolic Studies
Genetic consultation

44
Q

When does reactive attachment disorder present and what is it largely due to?

A

Beyond the age of 5

Pathological care

45
Q

What are three types of pathological care?

A

Persistent disregard for;

  • child’s emotional needs for comfort, stimulation and affection
  • child’s physical needs
  • repeated change in primary care giver
46
Q

What are some medical clues of RAD?

A 
Malnutrition
Growth Delay
Evidence of physical abuse
Vitamin deficiencies
Infectious diseases
47
Q

How common are RAD’s?

A

1% in all children

5% in children in care

48
Q

How can remission be achieved in RAD?

A

Child experiences an appropriately supportive environment

49
Q

Describe inhibited RAD

A

Continually fail to initiate and respond to social interactions, often meet interactions with avoidance, hyper vigilance or ambivalence. Don’t seek comfort from care giver when distressed.

50
Q

Describe disinhibited RAD?

A

Inability to display appropriate attachments

Excessive familiarity with strangers

51
Q

What is the difference between Inhibited and disinhibited RAD?

A

Disinhibited RAD is more enduring into adulthood

52
Q

Why is attachment important?

A

Important for healthy personality development;

  • conscience
  • self-reliance
  • logical thinking
  • coping with frustration and stress
  • handle fear or threat to self
  • trusting others
53
Q

List some causes of attachment issues

A
  • frequent changes in care giver
  • extended separation from caregiver
  • moves in institutions
  • trauma
  • inexperienced parents
  • neglect
  • abuse
  • ASD
54
Q

List some alarming symptoms in very young children?

A
  • persistent and medically unexplained colic
  • poor eye contact
  • difficulty tracking
  • no reciprocal smile response
  • delayed GM skill development
  • difficulty being comforted
  • resists affection
  • appear stiff (tactile defensiveness)
  • poor sucking response when eating
55
Q

List some alarming symptoms in older children?

A
  • lack of self control/impulsive
  • speech and language delay
  • lack of conscience/remorse
  • lack of understanding of social boundaries
  • indiscriminate affection
  • avoids/overseeks physical contact
  • hyperactive
  • destructive
  • food issues
  • on guard
  • prefer to play alone
56
Q

What is anger a result of in RAD?

A

Repeated humiliation and abuse of power, feeling shame

57
Q

How does RAD result from neurobiological changes?

A

Childhood experiences and genetics influence the brain structure due to cortisol insult, changing the pathways in the brain and causing behavioural changes

58
Q

What are the differential diagnosis of RAD?

A

Conduct disorder
Depression
ASD
ADHD

59
Q

What is the difference between RAD and conduct disorder?

A

conduct disorder can form some relationships with peers and adults and respond in an appropriate way

60
Q

What is the difference between RAD and depression?

A

inhibited RAD can appear withdrawn but RAD children are more resistance to help

61
Q

What is the difference between RAD and ASD?

A

ASD children are less flexible than RAD

62
Q

What is the difference between RAD and ADHD?

A

ADHD perpetuates across all settings and can still make relationships

63
Q

What are effective treatments for RAD?

A 
Family therapy
Individual therapy
Play therapy
medication for comorbid conditions
Special education intervention
64
Q

Describe ODD

A

repetitive and persistent pattern of behaviour in which the basic rights of others or major age-appropriate norms or rules are violated

65
Q

When is ODD regarded as a mental disorder?

A

if there is risk of harm to self or others

66
Q

How does ODD present?

A

three or more of the following;

  • aggression to people or animals
  • destruction of property
  • deceitfulness or theft
  • serious violation of rules
67
Q

Where is ODD typically detected?

A

most are picked up by criminal justice system

68
Q

What are the consequences of ODD?

A

-serious impairment in social, academics or occupational function
school
->family
->criminality
->health, social services, criminal justice system involvement
->mental health co-morbidity

69
Q

What mental health comorbidities are found in ODD?

A 
RAD
ADHD
Reading and other learning difficulties
Depression
Substance misuse
Deviant sexual behaviour
70
Q

What are the stages of ODD?

A

Mild to moderate- restricted to family environment

Severe- unsocialised or socialised

71
Q

What is socialised ODD?

A

more covert antisocial acts or better availability to avoid getting involved in crime; more intelligent = good liars

72
Q

What is un-socialised ODD?

A

predominately violent behaviour and more likely to be dealt with by criminal justice system

73
Q

How is ADHD characterised?

A
  • inattention= inability to concentrate
  • hyperactivity= fidgety
  • impulsivity= end up in trouble without considering consequences
74
Q

What is the difference between ADHD and ODD?

A

ODD= purposefully destructive

ADHD= unintentionally destructive, and largely genetic

75
Q

What are some causes of CD?

A

Genetics
Brain injury
Environmental

76
Q

What are the family factors which can make ODD more likely?

A

1) families with parents with mental illness and intellectual difficulties
2) drug and alcohol problems; limited capacity to focus on child
3) domestic violence; associate this with normal relationships
4) single parent families; struggle to give child enough time

77
Q

What are the intra-familiar predictors of antisocial behaviour?

A

1) lack of house rules- no set routine for meals and other activities
eating in front of TV

2) lack of clarity as to how children are to behave
sometimes if parents had difficult upbringing they don’t know what behaviour is normal in their child

3) lack of effective contingencies
good-cop-bad-cop

4) lack of technique to resolve crises within family
seeking help from outside

5) lack of supervision of child is associated with delinquency

78
Q

What is the role of anger in ODD?

A
  • protect from pain
  • adrenaline rush makes them feel powerful, alive, excited
  • sense of identity
79
Q

What are the treatment options for ODD?

A
  • parent/foster training is suitable in children under age 11
  • child focussed programmes where child is aged between 9 and 14 years (social and cognitive problem solving programmes)
  • multimodal interventions to young people aged between 11 and 17 years (multisystemic therapy that provides intensive support to the young person and their family)
80
Q

When is medication used in ODD?

A

extreme cases or comorbid conditions;

  • risperidone (atypical antipsychotic)= challenging behaviour
  • ADHD
  • Depression-SSRIs

Child Health (1 decks)

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