Child Health

Question 1

what is rett syndrome

Answer 1

mostly girls get it
mutation in the MECP2 gene found on the X chromosome
it is a rare genetic disorder that affects brain development, resulting in severe mental and physical disability
4 stages 1-stagnation
2-regression
3-plateau
4-deterioration in movement

Question 2

what are mild learning difficulties

Answer 2

IQ less than 70

Question 3

what are severe learning difficulties

Answer 3

IQ less than 50

Question 4

what is a profound learning diffuclty

Answer 4

IQ less than 20

Question 5

what vaccines are given at 2 months

Answer 5

DTP-diphtheria, pertussis and tetanus,polio-IPV, haeomophilus influenze (as five in one)
rotavirus
Pneumococcal
(Menigococcal B )

Question 6

what is the rash like in measles

Answer 6

erythematous and maculopapular spreads from the head to the trunk
Koplik spots are small red spots with white centres which may appear on the mucous membranes o f the mouth before the rash appears

Question 7

what are the complications of measles

Answer 7

otitis media, pneumonia and diarrhoea

rare complications include encephalitis and sub-acute sclerosing pan-encephalitis

Question 8

where is the rash of rubella usually seen

Answer 8

behind the ears on the face and neck

Question 9

what are complications of rubella

Answer 9

small joint arthritis, thrombocytopaenia and post infections encephalitis, damage to foetus if pregnant

Question 10

why is rubella dangerous for the foetus

Answer 10

it can result in foetal loss or congenital rubella syndrome CRS which affects the eyes eg cataracts, ears ( sensorineural deafness) heart (PDA) and brain microcephaly
if in first 4 weeks-eye anomaly
if weeks 4-8 cardiac anomaly
if weeks 8-22 deafness

Question 11

what type of virus is HPV

Answer 11

a double standed DNA virus

Question 12

babies born to mothers with hepatitis B

Answer 12

should be vaccinated against hep B virus starting within 24 hours after birth and further disease at 1,2 and 12 months post birth

Question 13

what can vancomycin be used to treat

Answer 13

gram positive as it is bactericial

Question 14

how does erythromycin and clarithromycin work on bacteria

Answer 14

they are bacteriostatic, they bind to bacterial ribosomes

Question 15

appearance in fragile X

Answer 15

typically has learning difficulties (IQ less than 70) and delayed milestones with typical features of high forehead, large testicles, facial asymmetry, large jaw and long ears

Question 16

what age can you copy a circle and simple cross

Answer 16

3 years

Question 17

draw a square

Answer 17

four year

Question 18

draw a triangle

Answer 18

5 years

Question 19

imitates sounds

Answer 19

9 months

Question 20

babbles

Answer 20

6 months

Question 21

knows name

Answer 21

12 months

Question 22

knows 5-20 words, points to 2 body parts

Answer 22

18 months

Question 23

complex instructions asks questions

Answer 23

3 years

Question 24

tells stories

Answer 24

4 years

Question 25

simple instructions/50+ words

Answer 25

2 years

Question 26

child age 2-5 HR, BP, RR

Answer 26

HR 95-140, RR25-30 BP 80-100

Question 27

child less than one HR, RR, BP

Answer 27

HR 110-160, RR30-40 BP 70-90

Question 28

child 1-2

Answer 28

HR100-150 RR25-35 BP 80-95

Question 29

child 5-12

Answer 29

HR 80-120 RR 20-25 BP 90-110

Question 30

child >12

Answer 30

HR 60-100 RR 15-20 BP 100-120

Question 31

features of infants compared to adults

Answer 31

``` large head and prominent occiput sitting height is proportionally more relatively large SA to volume high anterior larynx/floppy epiglottis more flexible ribs blood volume 80mls/kg HbF at birth ```

Question 32

appearance of CSF in bacterial meningitis

Answer 32

cloudy, glucose low, protein high, white cells, polymorphs

Question 33

appearance of CSF in viral meinigits

Answer 33

clear/cloudy, 60-80% of plasma glucose, protein normal/raised, lymphocytes

Question 34

TB meningitis appearance

Answer 34

slightly cloudy, fibrin web, glucose low, protein high, white cells high but not as high as viral meningitis and also show lymphocytes

Question 35

what do you give for suspected meningitis in the GP

Answer 35

IM benzylepenicillin

Question 36

what do you give for meningitis in the hospital

Answer 36

IV cefotaxime

Question 37

composition of homemade ORS

Answer 37

6 teaspoons of sugar, half a teaspoon of salt, 1litre of water

Question 38

what are the red flags for development

Answer 38

``` not reaching for objects by 6 months asymmetry 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 re vision/hearing loss of skills ```

Question 39

what is a profound learning difficulty

Answer 39

IQ less than 20

Question 40

severe learning difficulties

Answer 40

IQ less between 50 and 70

Question 41

what is Edward syndrome caused by

Answer 41

trisomy 18

Question 42

what is patau syndrome caused by

Answer 42

trisomy 13

Question 43

what type of mutation is there is fragile X

Answer 43

expansion mutation on the X chromosome

Question 44

systolic ejection murmur attributed to the pulmonic valve and may have splitting of the second heart sound

Answer 44

ASD

Question 45

why do you get physiological splitting of the second heart sound

Answer 45

during respiration the negative intrathoracic pressure causes increase blood return to the right side of the heart increased blood volume in the right ventricle causes the pulmonic valve to stay open longer during ventricular systole, delay in the P2 component of S2

Question 46

before what age is it worrying if you develop a hand preference

Answer 46

12 months

Question 47

hand preference before 12 months could indicate what

Answer 47

cerebral palsy

Question 48

what age do you say 'mama and dada'

Answer 48

9 months

Question 49

what age would you put your hands on bottle when being fed

Answer 49

6 months

Question 50

what is one of the principles of motor development

Answer 50

generalised mass activity changing to more specific controlled movements

Question 51

what are the four areas of development

Answer 51

gross motor, fine motor and vision, language and hearing, social behaviour and play

Question 52

crawl by what age

Answer 52

9 months

Question 53

stairs alternative feet

Answer 53

3 years

Question 54

hops

Answer 54

4 years

Question 55

palmar grasp by what age

Answer 55

6 months

Question 56

scissor grasp

Answer 56

9 months

Question 57

pincer grasp

Answer 57

12 months