Child Health

Question 1

What is Dental Caries?

Answer 1

Occur when oral bacteria metabolise sugar and produce acid that demineralises enamel and dentin from the hard coating fo the tooth

Question 2

What is the risk of severe dental caries?

Answer 2

Cause pain and infection that can lead to death and sepsis

Question 3

What is the most common cause of school and work absenteeism?

Answer 3

Dental caries

Question 4

What is the most common non-communicable disease globally?

Answer 4

Dental caries

Question 5

What was the most common cause of hospital admission in children aged 5-9 years old?

Answer 5

Dental caries

Question 6

What is the management for dental caries?

Answer 6

Tooth extraction

Question 7

What are the downsides to tooth extraction?

Answer 7

Time consuming
Expensive
Widely unavailable in low income countries

Question 8

What is the average cost of a tooth extraction?

Answer 8

£836

Question 9

What is the biggest factor associated with dental caries?

Answer 9

Social deprivation - associated with excessive intake of sugar

Question 10

How can dental caries be prevented?

Answer 10

Sugar reduction in the diet and maintaining good oral hygiene.

Reducing sugar intake by 10% of energy intake can minimise the risk of developing dental caries throughout the life course.

Question 11

What population wide approaches are installed to reduce the risk of dental carries?

Answer 11

Fluoridation
Fluoride varnish programmes
Sugar reduction programmes

Question 12

outline some events that can be categorised as adverse childhood experiences

Answer 12

• Experiencing abuse: Physical, sexual, psychological or neglect.
• Witnessing domestic abuse
• Having a close family member or caregiver who misused drugs or alcohol
• Having a close family member or caregiver with mental health problems
• Having a close family member or caregiver who served time in prison
• Experiencing parental separation or divorce on account of relationship breakdown.

Question 13

What is the strength of evidence of the risk level for physical activity, overweight and diabetes with ACEs?

Answer 13

Weak or modest

Question 14

What is the strength of evidence of the risk level for smoking, heavy alcohol use, heart disease, respiratory disease, cancer and poor self-related health?

Answer 14

Moderate

Question 15

What is the strength of evidence of the risk level for mental health, sexual risk taking, problematic alcohol use?

Answer 15

Strong

Question 16

What is the strength of evidence of the risk level for problematic drug use, and interpersonal and self-directed violence?

Answer 16

Very Strong

Question 17

What is the LEAP criteria?

Answer 17

Local
Enjoyable
Practical criteria

Question 18

What is a strength based approach with children?

Answer 18

Allows child to build on positive behaviours

Question 19

What approaches should be adopted when dealing with the family and children in health issues?

Answer 19

• Be opportunistic
• Be Sensitive
• Non-judgemental approach
• Strengths-based approach i.e. allows child to build on positive behaviours
• Focus on barriers of particular importance to the child
• Relate to other children i.e. ideas that have helped other children
• Engage parents and families
• Specific, short term goals
• LEAP criteria: Local, Enjoyable and Practical criteria

Question 20

What is the national child measurement programme?

Answer 20

Measures the height and weight of children in reception and then again in year 6

Question 21

What is offered int he first BMI centile?

Answer 21

Universal presentation
Consultation with frontline healthcare professionals
Public health approaches

Question 22

What is offered in the 2nd centile criterion for BMI?

Answer 22

Intensive and community based time specific public health approaches

Question 23

What are the clinical thresholds for underweight?

Answer 23

2nd percentile

Question 24

What are the clinical thresholds for overweight?

Answer 24

> 91st centile

Question 25

What are the clinical thresholds for obese?

Answer 25

>98th centile

Question 26

What is offered for overweight patients (>91st centile)

Answer 26

Intensive and community based Time specific Public health approaches

Question 27

What is offered in children in the >99.6th centile or >91st centile with co-morbidities/complex needs?

Answer 27

Specialist MDT Weight management clinics Longer term follow up

Question 28

What are the advantages for giving every child a best start in life?

Answer 28

Reduces health inequalities, prevents chronic disease, improves health and wellbeing, increases employment, increase tax revenues and reduces pressure on health system

Question 29

When does physical literacy occur?

Answer 29

8. Physical literacy occurs when and individual has the motivation, confidence, physical competence, knowledge and understanding to value physical activity throughout their life course.

Question 30

How can physical literacy be developed as a child?

Answer 30

When children engage in inclusive, positive, meaningful physical activity experiences that place equal value on both physical and psychological benefits to health and wellbeing

Question 31

What is orexin?

Answer 31

A neuropeptide that regulates arousal, wakefullness and appetite

Question 32

What type of hormone is orexin?

Answer 32

Neuropeptide

Question 33

What is another term used to describe orexin?

Answer 33

Hypocretin

Question 34

What does orexin regulate?

Answer 34

Arousal, wakefullness and appetite

Question 35

Which form of narcolepsy is associated with orexin?

Answer 35

Type 1 narcolepsy

Question 36

What is type 1 narcolepsy?

Answer 36

The sufferer experiences brief losses of muscle tone, is caused by a lack of orexin in the brain due to destruction of the cells that produce it

Question 37

Why does type 1 narcolepsy occur?

Answer 37

Orexin deficit within the brain due to degeneration of productive cells

Question 38

What is an ultra-radian rhythm?

Answer 38

Cycles that repeat within a 24 hour period.

Question 39

What three factors can cause a circadian rhythm shift post adolescence?

Answer 39

Genetics Neuropeptide expression Lifestyle

Question 40

How does ageing affect sleep?

Answer 40

Ageing is associated with the yellowing of the lens and decrease the light that enters the system; also a reduction of melatonin in the elderly (although not in the healthy)

Question 41

What happens to melatonin in the elderly?

Answer 41

Reduction in melatonin

Question 42

Wha happens to the lens during ageing?

Answer 42

Yellowing of the lens and decreased light that enters the system

Question 43

What are the three most common sleep disorders?

Answer 43

Insomnia Obstructive sleep apnoea Sleepwalking

Question 44

What term describes bed wetting in children?

Answer 44

Nocturnal enuresis

Question 45

What can cause nocturnal enuresis?

Answer 45

Sleep deprivation - leading to a rebound in REM sleep which prevents the urge to be from creating an arousal from sleep

Question 46

What is associated with bed wetting (2)?

Answer 46

Stress and anxiety

Question 47

What are the indications of sleep deprivation in childhood?

Answer 47

``` Hyperactivity, behavioural problems at school and an inability to focus. Interpersonal conflict Impulsive behaviours Labile mood Difficulties at school ```

Question 48

What is sleep deprivation associated with in adolescence?

Answer 48

Negative thinking and increased catastrophising

Question 49

What is epigenetics?

Answer 49

Child hood experience (positive and negative) affects the epigenome and gene expression * Temporarily or permanently depending on how easily the gene is turned on or off. * Brain is developing most rapidly in early years so epigenetic expression shapes health and behaviour from this early stage.