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My Child Health > Week 1 > Flashcards

Week 1 Flashcards

1
Q

difference between median age and limit age for a skill?

A

median - 50% have it

limit - 97.5% have it

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2
Q

4 areas of development?

A
  1. gross motor
  2. fine motor, vision
  3. language, hearing
  4. social behaviour and play
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3
Q

when does ATNR stop?

what does it stand for?

A

Asymmetric tonic neck reflex

4ish months unless have CP!!?

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4
Q

babies arms grab forward when their head tips back - what is this called?

A

moro reflex!

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5
Q

red flags occurring at
6 months…
12…
18… (2)

A

6 - doesn’t reach for objects

12 - cant sit alone

18 – can’t walk (limit age) or no speech

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6
Q

red flags without specific age

A

asymmetric movement development
vision concerns
hearing concerns
loss of skills!!

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7
Q

what is the “development trajectory?”

A

global delay predictions – if 6 months behind aged 2, will be 2 years behind when aged 8

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8
Q

name 2 specific sensory deficit delays

A
  1. oculocutaneous albinism

2. treacher collins

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9
Q

Rett’s syndrome

  • gender
  • age of onset
  • symptoms
  • cause
A

Girls
6-18 months
Progressively unable to move = eyes, body movements, speech
Genetic

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10
Q

what is a mild learning difficulty IQ?

A

50-70
severe if below 50
average is 100

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11
Q

leg sign of Duchenne’s

A

big calves - fibrous pseudohypertrophy

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12
Q

what neurological disorder is common in CP?

A

epilepsy - in 1/3

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13
Q

why may a CP child be losing weight?

A

poor feeding ability

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14
Q

when does myelination occur?

A

mainly in first 2 years of life, but some change all the way into 20s

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15
Q

what begins as ectoderm?

A

neural system
skin
hair and nails

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16
Q

what begins as mesoderm?

A

vascular system

bones muscle cartilage

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17
Q

what begins as endoderm?

A

GIT and resp systems

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18
Q

what begins as neural crest cells?

A

peripheral NS

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19
Q

what is the ventricular zone in neural development?

A

the inside lining of cells in the neural tube

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20
Q

what is the direction of myelination of the brain?

A

up and forwards – frontal cortex last!!

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21
Q

function of frontal cortex?

A

planning
controlling behaviour
assessing risk!!

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22
Q

what is holoprosencephaly?

A

failure to divide into 2 lobes

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23
Q

name 4 features of holoprosencephaly

A
  • epilepsy
  • facial deformity
  • one eye! severe
  • affect endocrine systems
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24
Q

early symptoms of Pelizaeus merzbacher? (3)

A

hypotonia
cognitive effects
nystagmus

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25
Q

late symptoms of pelixaeus merzbacher?

A

spasticity / atonia

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26
Q

X linked PLP1 gene condition

A

pelizaeus merzbacher

affects protein that maintains the myelin sheeth normally

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27
Q

2 diseases causing neonatal mortality that could be easily prevented with materal vaccinations / Tx??

A

syphilis and tetanus!!!

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28
Q

measures to improve neonatal health?

A

skilled healthworkers
infection control
antenatal vaccines
drying and rubbing / resus

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29
Q

5 main causes of mortability under 5 - africa

A

diarrhoea + malaria + pneumonia
intrapartum complications
preterm complications

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30
Q

apart from malnuritions, important risk factors for pneumonia in deprived children?

A

overcrowding
indoor pollution - smoke
2nd hand smoke

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31
Q

pneumonia in HIV babies?

A

pneumonocystic jiroveci

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32
Q

what is a top 5 killer globally but not in Africa?

A

NEONATAL SEPSIS

instead of malaria in Africa

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33
Q

what % of HIV isn’t in sub-s Africa?

A

only 10%

34
Q

what % of HIV is MTCTed?

A

90% !!!

35
Q

how do you prevent MTCT of HIV?

A

anti-retroviral-therapy (ART)
it is effective if used well
both mum and baby take it

36
Q

HIV prophylaxis?

A

co-trimoxazole and vaccinations

37
Q

guideline Tx of HIV

A

HAART: Two NRTIs plus one NNRTI or protease inhibitor

38
Q

what is BCG for?

A

TB vaccine

39
Q

what is malaria?

A
  • Plasmodium parasite from female anopheles mosquito
40
Q

most severe form of malaria?

A

P. falciparum

41
Q

what severe symptoms can P.Falciparum malaria cause?

A

cerebral malaria
seizures
coma

42
Q

early signs of malaria

A

fever
pallor
malaise - general

43
Q

blood - clinical signs of malaria

A

anaemia

hypoglycaemia

44
Q

Investigate malaria

A

blood microscopy

rapid diagnostic test (?)

45
Q

treating malaria

  • what?
  • duration
  • route
A

ACT (artemisinin based combo therapy)
3 days only!!
oral

46
Q

treating severe malaria

A

IM / IO Artesunate until can tolerate oral

47
Q

how would you treat a well but malnourished child?

A

vaccinate (at risk)
deworm - may be the cause
Vit A
High energy food

48
Q

what neurological condition can be caused (later) by malaria?

A

epilepsy!!

49
Q

what is a Z score

A

number of SD away from the mean

50
Q

what is constitutional growth delay??

A

mature late so have short stature, delayed puberty and young bone age

51
Q

precosious puberty ages

A

girls - 8

boys - 9

52
Q

investigate delayed puberty growth ?

A 
FSH/LH/testost/oestrogen
genetic investigation
MRI for pituitary tumour
USS of uterus
dynamic function testing
53
Q

investigate delayed growth (not puberty specific)

A 
GH/IGF1 levels
genetic investigation
bone age
pituitary tumour MRI
dynamic function testing
54
Q

what bit of tissue stimulates neurulation ?

A

notochord !!

55
Q

what kind of vaccine is for whooping cough and thyphoid (whole cell)?

A

INACTIVATED

suspension of killed organisms

56
Q

what are the two subtypes of subunit vaccines?

A

toxoids - diptheria/tetanus/pertussis

polysaccharides - pneumococcal and typhoid

57
Q

what kind of vaccine is for pneumococcal?

A

inactivated - subunit - polysaccharides

58
Q

what kind of vaccine is for toxins such as diptheria and tetanus?

A

inactivated - subunit - toxoid

59
Q

how are conjugate vaccines made?

A

polysaccharide plus immunogenic proteins

60
Q

2 examples of a conjugate vaccine?

A

Hib (flu B)

MenC

61
Q

what vaccines are used for flu?

A

either live virus …

or inactivated conjugate vaccine for flu B.

62
Q

what allergy risks are a problem in vaccination?

A

allergy to the vaccine
to eggs
to latex

63
Q

when is the hexavalent vaccine given?

A

3 times!
2 + 4 + 6 months
it is 6 vaccines in 1

64
Q

why is rotavirus vaccine important?

A

most common cause of diarrhoea in young children

65
Q

how often are children vaccinated for flu?

A

annually from aged 2

66
Q

who gets the PPV23 vaccine?

A

65 year olds - pneumococcal polysaccaraide vaccine

67
Q

who gets the shingles vaccine?

A

people aged 70

68
Q

who gets meningitis commonly? - what age

A

under 5s

late teens - early 20s! - shifting to university age

69
Q

skin sign of meningitis

A

pale / mottled / rash

70
Q

signs of meningitits - limbs

A

cold extremities
mottled/pale skin
limb / joint pain

71
Q

signs of meningitis - relating to head and brain

A 
seizures
very sleepy
confused / delirious
severe headache
dislike bright lights
stiff neck!
72
Q

systemic symptoms of meningitis

A

short of breath
fever
vomitting

73
Q

preventing malaria?

A

LLIN = long lasting insecticidal nets
vaccine to come?
anti malarial medications

74
Q

What is the definition of Conduct Disorder?

A

“a repetitive and persistant pattern of behaviour in which the basic rights of others + major rules are violated”

75
Q

what 4 features occur in Conduct disorder?

A
  1. aggression to people / animals
  2. destruction of property
  3. deceitfulness + theft
  4. serious violation of rules
76
Q

what other “comorbidities” can occur with CD? (5)

A
  • RAD
  • ADHD
  • Depression
  • Substance misuse
  • Deviant sexual behaviour – rapist or victim
77
Q

how likely is an ADHD parent to have an ADHD child?

A

60% likely to pass on

78
Q

what causes CD?

A 
it is multifactorial
GENES + ENVIRONMENT
brain injury included
proven by twin studies
parenting + situation too
79
Q

what features are included in RAD? (reactive attatchment disorder)

A

emotional + physical needs neglected due to poor parenting / orphan
ASD is common
Medical + emotional signs
Detectable by 2 months and can be improved

80
Q

diff between inhibited + disinhibited RAD?

A

inhibitied = doesn’t seek comfort when scared / threatened. doesn’t initiate interaction

disinhibitied = overly familiar with strangers
+ doesn’t make selective attatchements

81
Q

name a few red flags of RAD in younger children

A 
unexplained colic !!
poor sucking technique
poor social smile + eye contact + extreme emotion
stiff + defensive
delayed milestones
82
Q

a few red flags of RAD in older children

A 
no conscience
avoids / overseeks physical contact
aggression
*food issues*
doesnt understand social boundaries
S and L delays

My Child Health (5 decks)

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