Basics (including Play, Adolescent Health and Global Health)

Question 1

According to the UN, what are the 3 basic rights of all children? (3Ps)

Answer 1

1) Protection (from exploitation)
2) Provision (education, healthcare)
3) Participation (freedom of thought)

Question 2

Ninewells’ place service operates on which days?

Answer 2

7 days a week

Question 3

Why is “PLAY” important? (acronym)

Answer 3

P - Participation introduces normality
L - lessens impact of pain and anxiety
A - allows children to work through feelings and fears
Y - yields results as recovery is faster

Question 4

Children’s play teams always aim to reduce the child’s stress levels, true or false?

Answer 4

False - aim is to increase stress short-term to reduce it in long-term.

Question 5

According to WHO, adolescence occurs between which years

Answer 5

10-19

Question 6

According to WHO, youth occurs between which years?

Answer 6

15-24

Question 7

According to the WHO, young people are how old?

Answer 7

10-24

Question 8

Physical development can be measured through which system?

Answer 8

The Tanner Stages

Question 9

Developmental stage can be assessed using STEP; what is this?

Answer 9

S - sexual maturation
T - thinking (presence of abstract reasoning?)
E - education / employment
P - peers

Question 10

In the UK, patients <16 years old can consent AND refuse treatment, true or false?

Answer 10

False - this only applies in Scotland

Question 11

What is the preferred nomenclature for countries?

Answer 11

High, middle and low income

Question 12

What are the top 5 causes of under 5 mortality globally? (5)

Answer 12

1) Preterm birth complications
2) Pneumonia
3) Intrapartum related complications
4) Diarrhoea
5) Neonatal sepsis

Question 13

What’s the largest cause of mortality in <5 year olds in Africa?

Answer 13

Diarrhoea

Question 14

Most common cause of infant mortality related to diarrhoea?

Answer 14

Drinking contaminated water.

Question 15

HIV is present in approximately how many paediatric infections (in 2014) globally?

Answer 15

3.2 million

Question 16

What age do most children with paediatric HIV die?

Answer 16

3-5 years old

Question 17

With appropriate ART, the chance of paediatric death to HIV can be reduced to what %?

Answer 17

<1%

Question 18

What kind of drug is abacavir & what is it used for

Answer 18

Nucleoside reverse transcriptase inhibitor - used in HIV therapy

Question 19

What kind of HIV drug should <3 year olds be started on?

Answer 19

Protease inhibitor (such as kaletra)

Question 20

What kind of HIV drug should >3 year olds be started on?

Answer 20

Non-nucleoside reverse transcriptase inhibitors (e.g. efavirenz)

Question 21

Can HIV patients be given the BCG vaccine?

Answer 21

No (it is live)

Question 22

Can HIV patients be given the nasal flu vaccine?

Answer 22

No - it is an attenuated, live vaccine

Question 23

Can HIV patients be given the injected flu vaccine?

Answer 23

Yes - it is killed (note: nasal spray is live attenuated)

Question 24

Describe the treatment regimen for TB

Answer 24

2 months of PRIEst then 4 months of isoniazid & rifampicin

Question 25

Malaria is which parasite?

Answer 25

Plasmodium parasite

Question 26

Malaria is carried by which vector?

Answer 26

Female Anopheles mosquites

Question 27

How is malaria commonly diagnosed?

Answer 27

Blood film

Question 28

Malaria treatment and prevention is achieved with... How long is it continued for?

Answer 28

Artemisin based combination therapy for 3 days

Question 29

Severe malaria is treated how?

Answer 29

IM or IV artesunate

Question 30

Malnutrition contributes to which % of child deaths?

Answer 30

45%

Question 31

"Severe acute malnutrition" is defined as (3)

Answer 31

1) Mid-arm circumference <11mm 2) <3SD for weight-to-height 3) Oedema of both feet

Question 32

How many % of patients with epilepsy reside in low and middle income countries?

Answer 32

80%

Question 33

What % of epilepsy patients in low and middle income countries do not receive the appropriate treatment?

Answer 33

75%

Question 34

Maternal secondary school education can reduce the chance of subsequent children dying by...

Answer 34

2/3rds

Question 35

An individual has to be at what centile to be overweight (BMI)?

Answer 35

91st (equal or above)

Question 36

An individual has to be at what centile to be classed as obese?

Answer 36

98th centile

Question 37

Which inherited condition causes a constant desire to eat?

Answer 37

Prader-Willi Syndrome

Question 38

How much exercise per day are children recommended to have?

Answer 38

1 hour (at least 3 hours for non-walkers)

Question 39

What's the recommended limit on screen-time for children?

Answer 39

<2 hours

Question 40

The only licensed anti-obesity drug is

Answer 40

Orlistat

Question 41

Orlistat needs what conditions to be prescribed?

Answer 41

Severely obese (>99.6th centile) with comorbidities attending a specialist clinic

Question 42

Passage of pre-formed antibodies from mother to child is a form of which immunity?

Answer 42

Passive immunity

Question 43

In vaccination, what is reduction number?

Answer 43

The number of new cases which will be reduced by introduction of vaccine programme (e.g. R=1, 1 case will appear in a given time)

Question 44

MMR is a live vaccine, T/F?

Answer 44

True

Question 45

Rotavirus vaccine is live, T/F?

Answer 45

True

Question 46

The yellow fever vaccine contains which allergen

Answer 46

Egg Yolk

Question 47

In the Scottish immunisation programme, how many pathogens are protected against?

Answer 47

14

Question 48

The human brain begins development at which week post-conception?

Answer 48

3rd week

Question 49

The embryonic period of development lasts from when to when?

Answer 49

Week 0-9 of pregnancy

Question 50

During the embryonic period, the embryo is comprised of which layers?

Answer 50

Epiblast and hypoblast

Question 51

The hypoblast will eventually develop into what structure

Answer 51

Placenta

Question 52

In Scotland, if a child refuses a medical procedure what is the next step as a doctor?

Answer 52

Seek legal counsel

Question 53

What is "infant mortality rate"?

Answer 53

Probability of a child born on a certain year to die before reaching 1 year old (not technically a rate)

Question 54

What are the top 5 causes of <5 year old death in Sub-Saharan Africa?

Answer 54

1) Pneumonia 2) Preterm complications 3) Intrapartum Complications 4) Diarrhoea 5) Malaria

Question 55

Pneumonia deaths are less than HIV deaths, T/F?

Answer 55

False (pneumonia vastly more)

Question 56

How more likely are you to die if you are born in sub-Saharan Africa compared to other low-income countries?

Answer 56

14x

Question 57

How many of <5 year old deaths in sub-Saharan Africa are easily treatable/ preventable?

Answer 57

50%

Question 58

How many deaths of <5 year olds in sub-Saharan Africa are linked to malnutrition?

Answer 58

45%

Question 59

What are the 6 WHO strategies to reduce the number of preventable <5 year old deaths globally?

Answer 59

1) Immediate & Exclusive Breastfeeding 2) Skilled antenatal, birth and postnatal care 3) Access to nutrition and micronutrients 4) Family informed of red-flag symptoms 5) Water, sanitation and hygiene 6) Immunisations

Question 60

What % of children born to HIV+ mothers are infected at birth?

Answer 60

15-45%

Question 61

T/F: HIV cannot be contracted through the placenta.

Answer 61

False - it can be transmitted this way, at birth or via breastfeeding

Question 62

What are the WHO's 3 strategies to prevent HIV transmission from mother to infant?

Answer 62

1) Maternal lifelong ART 2) Screen & treat other STDs in mother 3) Infant prophylaxis for at least 6 weeks after birth or throughout all breastfeeding stage. (test child at: birth, 6 weeks old & 6 weeks post-breastfeeding)

Question 63

How does HIV present in children?

Answer 63

As a "mimic" with recurrent common illnesses (e.g. otitis media), recurrent candidiasis, recurrent severe infections (e.g. meningitis), low-grade fever and chronic parotitis. Other classical symptoms include PCP, Kaposi's sarcoma and failure to thrive.

Question 64

How is HIV diagnosed in those <18 months old?

Answer 64

PCR on blood sample for HIV DNA & RNA

Question 65

How is HIV diagnosed in those >18 months old?

Answer 65

Serology on blood (rapid)

Question 66

What's the criteria for testing infants for HIV? (2)

Answer 66

If the prevalence is >1% or if they have been potentially exposed

Question 67

What is the WHO recommended treatment for children with HIV?

Answer 67

2 NRTIs plus one of either NNRTI (>3 years old) or protease inhibitors (<3 years old) Co-trimoxazole prophylaxis

Question 68

What's a side effect of HIV treatment? How is it treated?

Answer 68

Immune reconstutional syndrome - treat with NSAIDs

Question 69

How is diarrhoea treated in low-income countries?

Answer 69

1) ORS (in mild & moderate dehydration) | 2) Zinc supplements

Question 70

How is TB diagnosed in children?

Answer 70

Mainly by IFN-gamma release assay, chest X-ray and Mantoux test. Acid-fast bacilli in sputum is low yield in children.

Question 71

How is BCG prevented?

Answer 71

Pre and post-exposure isoniazid.

Question 72

How many polymorphisms does each person have?

Answer 72

3,000,000

Question 73

What would be the test for a child with poor muscle tone, excess skin at neck, small ears and mouth, upward pointed eyes?

Answer 73

Karotype (Down's)

Question 74

What genetic tool is used to screen for 10Mb deletions?

Answer 74

FISH

Question 75

What genetic tool is used to look for single point mutations which can cause a disease?

Answer 75

PCR with next gen sequencing

Question 76

aCGH is useful to detect changes at which minimum size?

Answer 76

100,000 bp

Question 77

What is the drawback of aCGH?

Answer 77

Can only detect unbalanced translocations

Question 78

If you have a chromosomal translocation (e.g. papillary thyroid cancer) what is the screening tool of choice?

Answer 78

aCGH