Child Health Disease Profiles Flashcards
(322 cards)
1
Q
what is term baby
A
birth between 37 and 42 weeks
2
Q
what is normal weight for baby
A
2.5-4kg
3
Q
how much weight should babies gain during the 3rd trimester
A
24g per day
4
Q
when does trans placental transfer occur
A
3rd trimester
5
Q
what are transferred in trans placental transfer
A
iron, vitamin, calcium, phosphate and antibodies
6
Q
during contraction the baby is in what environment
A
hypoxic
7
Q
what does prolonged labour reduce
A
fetal reserves
8
Q
how can things like maternal smoking or drug use of mother affect babies for when giving birth
A
placenta insufficiency so difficult for Abby to cope with hypoxia
9
Q
stress baby eperiences during labour increases what
A
adrenaline and cortisol
10
Q
what does first cry/ breath cause
A
alveolar expansion
11
Q
what is a score to measure perinatal adoption
A
Apgar
12
Q
when is there decreased pulmonary arterial pressure and increased Pao2
A
perinatal adaptation
13
Q
what is the calorific intake in the first 24hrs of baby
A
little intake
14
Q
are babies alert immediately after delivery
A
very
15
Q
what is given to newborn babies to prevent haemorrhage disease (disorder of clotting)
A
Vitamin K (prefer intramuscular)
16
Q
if what is present in infection screen you should give vaccination for immediately
A
Hep B
17
Q
Hep B and C, HIV, Syphillis, TB, Group B strep are screened in what
A
infection screen
18
Q
what is an anticipatory method used to monitor babies at risk
A
early warning systems
19
Q
mothers should have what vaccine
A
pertussis and influenza
20
Q
what are some things you want to screen for in newborn
A
cystic fibrosis, hypothyroid and haemoglobiopathies
21
Q
things that increase risk of giving birth early
A
- already had greater than 2 preterm babies
- abnormally shaped uterus
-multiple pregnancy
interval of less than 6 months between pregnancy
-IVF
smoking, alcohol, drugs - poor nutrition, some chronic conditions eg high BP or diabetes, multiple miscarriages or abortions
22
Q
what babies need more help to stay warm
A
preterm babies
23
Q
altered approach to preterm babies
A
delay cord clamping if possible, keep baby warm, gentle lung inflation(PEEP) and oxygen sat monitor
24
Q
what does high surface area to body mass of baby result in
A
more likely to lose heat
25
babies BMR is what in hypothermia
low
26
what occurs usually 6-8 weeks after delivery
retinopathy of prematurity
27
what is early metabolic complication of prematurity
hypoglycaemia and hyponatrermia
28
what is late metabolic complications of preterm
osteopenia
29
do you want apgar score to be high or low
high
30
what is fluid in the lungs that does no clear in newborns
Transient tachypnoea of the newborn
31
2 examples of congenital respiratory disease of the newborn
tracheo-oesophageal fistula and diaphragmatic hernia
32
examples of a rhesus disease
hydrops foetalis
33
some congenital heart disease
tetralogy of allot, transposition of great arteries, coarction of the aorta
34
what are these; hypoxic ishcaemic encephalopathy, microcephaly, spina bifida
neurological illnesses of the newborn
35
renal illness of newborn
potters syndrome
36
muscular illness of newborn
myotonic dystrophy
37
problems related to glucose of newborn
hypoglycaemia
38
error of metabolism in newborns can cause
acidosis
39
potenital management of circulation of newborns
fluids, inotropes
40
early onset neonatal sepsis is acquired when
before and during delivery
41
early onset neonatal sepsis type of bacteria
Group B strep
42
late onset neonatal sepsis organism
coagulase negative staph or staph aureus
43
symptoms of neonatal sepsis
fever
reduced tone and activity
poor feeding
vomiting
44
signs of neonatal sepsis
respiratory distress or apnoea
tachycardia or bradycardia
hypoxia
jaundice within 24hrs
45
when might be a baby be hypoglycaemia
neonatal sepsis
46
does jaundice occur in most normal term babies and ore term babies
yes
47
jaundice is caused by hyperbilirubinaemia that is
unconjugated
48
what hyperbilirubinaemia is always pathological
conjugated
49
is unconjugated hyperbilirubinaemia always pathological
no can be physiological or pathological
50
reasons for physiological jaundice
increased RBC breakdown or immature liver
51
main reason for physiological jaundice in premature babies
immature liver
52
how long does breast milk jaundice take to resolve
1.5-4 months
53
what is a common cause of jaundice in the first 24 hours of life
neonatal sepsis
54
what could be as a result of high levels of conjugated bilirubin
biliary atresia, Total parental nutrition, hypothyroidism, cystic fibrosis, trisomy 21
55
what is prolonged jaundice in a term baby and in a pre term baby
over 14 days in a term baby or 21 days in a preterm
56
is jaundice in the first 24hrs of life physiological or pathological
PATHOLOGICAL
57
what test to do if got early jaundice
FBC, serum bilirubin level and DCT (Coombs test)
58
tests done for prolonged jaundice
FBC< serum bilirubin level, liver function tests and thyroid function tests
59
treatment for early jaundice
phototherapy, hydration and underlying cause
60
what affects 75% of infants born before 29 weeks
respiratory distress syndrome
61
medical term for lung collapse
atelectasis
62
how does respiratory distress affect co2 levels
hypercapnia
63
respiratory distress affects what in lungs
alveoli
64
signs of respiratory distress
tachypnoea, grunting, intercostal recession (undraping between the ribs), nasal flaring, cyanosis
65
when should respiratory distress then gradually improve
2-4 days
66
management of respiratory distress
maternal steroid and surfactant replacement and ventilation
67
what can cause respiratory distress
acidosis and hypoglycaemia
68
what refers to the withdrawal symptoms that happens in neonates of mothers that used substance in pregnancy
neonatal abstinence syndrome
69
substances that can cause neonatal abstinence syndrome
opiates, methadone, cocaine, cannabis, alcohol
70
CNS symptoms of neonatal abstinence syndrome
irritability, tremors and seizures
71
baby could be --- in neonatal abstinence syndrome
sweating
72
babies with neonatal abstinence syndrome kept in hospital for how long
least 3 days
73
how could a neonate with neonatal abstinence syndrome be supported
quiet and gentle dim environment with gentle handling and comforting
74
neonatal hypoglycaemia is defined as
blood glucose levels below 2.6mmol/L
75
3 signs of neonatal hypoglycaemia
lethargy, jitteriness and seizure activity
76
what helps prevent hypoglycaemia in neonate
early feed and keeping baby warm
77
how warm should keep neonate
36.6-37.2
78
in hypoglycaemia baby would rather enterally feed than
feed baby with IV glucose
79
what do do if neonate is recurrently hypoglycaemic
hypoglycaemia screen
80
what occurs when a baby doesn't receive enough oxygen before, during or just after birth
birth asphyxia
81
causes of brith asphyxia
maternal shock, intrapartum haemorrhage, prolapsed chord or nuchal cord
82
what is nuchal chord
cor dis wrapped around the neck of the baby
83
complication of birth asphyxia
hypoxic ischaemic encephalopathy
84
what is hypoxic ischaemic encephalopathy
multi organ damage due to tissue hypoxia
85
babies with what can benefit from therapeutic hypothermia
hypoxic ischaemic encephalopathy
86
what does therapeutic hypothermia do to babies with HIE
reduce risk of cerebral palsy, developmental delay, learning disability, blindness and death
87
what is floppy baby
neonatal hypotonia
88
baby with low muscle tone is
neonatal hypotonia
89
floppy baby has what features
lack of head control, increased range of movement, frog legged, feels like they ll fall out of your grasp
90
what investigations for neonatal hypotonia
Bloods, neurology review and imaging
91
central neonatal hypotonia has
normal strength
92
anterior horn neonatal hypotonia has
generalised weakness
93
neuromuscular neonatal hypotonia has
weakness in face, eyes an bulbar
94
muscle neonatal hypotonia has
weakness is proximal more than distal eg face
95
nerve neonatal hypotonia
weakness id greater distally than proximally
96
what imaging for neonatal hypotonia
cranial US and MRI
97
would you use next generation sequencing or acqh for blood for neonatal hypotonia
NGS
98
what interventions for neonatal hypotonia
resp and feeding support, physio,
99
treatment for spinal muscular atrophy
RNA targeted therapy
100
difference between neuromuscular and muscle neonatal hypotonia
neuromuscular has normal DTRs and muscle has decreased DTRs
100
difference between neuromuscular and muscle neonatal hypotonia
neuromuscular has normal DTRs and muscle has decreased DTRs
101
what neonatal hypotonia is often describes as alert
anterior horn cell
102
what is a hydrocephalus
cerebrospinal fluid building up abnormally within the brain and spinal chord
103
enlarged and rapidly increasing head circumference and bulging anterior fontanelle
hydrocephalus
104
management of hydrocephalus
ventriculoperitoneal shunt
105
part of the bowel becomes necrotic in neonates
necrotising enterocolitis
106
what can cause necrotising enterocolitis
premature baby being fed too early
107
necrotising enterocolitis symptoms
vomiting green bile, intolerance to feeds, distended tender abdomen with absent bowel sounds and blood in stools
108
gas in peritoneal cavity in necrotising enterocolitis indicates what
perforation
109
what does the abdominal X-ray in neonate with necrotising enterocolitis show
dilated bowel, bowel wall oedema and gas in bowel
110
management of necrotising enterocolitis
nil by mouth and clindamycin and cefotaxime
111
in neonates when bleeding into the ventricles inside the brain
intraventricular haemorrhage
112
what is the most common type of intraventricular haemorrhage
germinal matrix
113
condition that is obliteration of the lumen of the jejunum
jejunal atresia
114
how does jejunal atresia present
abdominal distenson and bilious ( yellow-greenish) vomitting within the first 24 hrs of birth
115
how does jejunal atresia present
abdominal distenson and bilious ( yellow-greenish) vomitting within the first 24 hrs of birth
116
treating jejunal atresia
surgery
117
malrotation presents with -- vomit
green
118
investigation for malrotation is
upper gi contrast and followthrough
119
treatment of malrotation is
surgery
120
what is usually a manifestation of cystic fibrosis
meconium ileus
121
what is meconium ileus
abnormally thick meconium causing obstruction to the distal ileum
122
what is caused by a weakness in muscle around the groin
inguinal hernia
123
cerebral palsy can be from prenatal to less than--- post natally
1month
124
post natal causes of cerebral palsy
meningitis, severe neonatal jaundice and head injury
125
genetic disease that causes muscles weakness and wasting
duchennes muscular dystrophy
126
aetiology for duchennes
defect gene for dystrophin on the X chromosome - X linked recessive
127
how can girls affect duchennes
they can be carriers
128
where do boys develop weakness first
around pelvis
129
what age do boys present with deuchennes
3-5years
130
gowers sign is
deuchennes
131
lack of eye contact and delay in smiling
autism or reactive attachment disorder
132
a child or infant that does not seek comfort from a parent or caregiver during times of threat, alarm, or distress
inhibited reactive attachment disorder
133
- a child who displays excessive familiarity with strangers, indiscriminate sociability or lack of selectivity in their choices of attachment figure
disinhibited reactive attachment disorder
134
can childhood experiences interact with genetics
yes
135
what can differentiate reactive attachment disorder from autism
coventry grid
136
The presence of three or more of the following criteria in the past 12 months with at least one criterion present in the past 6 months:
- Aggression to people or animals
- Destruction of property
- Decietfulness or theft
- Serious violation of rules
conduct disorder
137
some evidence of -- being at greater risk of conduct disorder
twins
138
not recommendeed but can be used in severe cases - drug that can help with impulsivity and aggressive behaviour
risperidone
139
trisomy 21 is what condition
down syndrome
140
what are these signs of:
- hypotonia, brachycephaly (small head with a flat back), short neck, short stature, prominent tongue, flattened face and nose, prominent skin folds, brush field spots (spots in eye)
down syndrome
141
Down syndrome often have recurrent
otitis media
142
what are cardiac defects that occur in 1 in 3 of Down syndrome
atrial and ventricular septal defects, patent ductus arterious and tetralogy of fallot
143
go issues in Down syndrome
hirschsprungs disease and duodenal atresia
144
Down syndrome are predisposed to developing what
diabetes and coeliac
145
what is more common in adults with downs
dementia
146
what is more common in children with downs
leukaemia
147
what occurs in 10-20% of downs syndrome
hypothyroidism
148
what sleeping disorders should you screen for in downs
obstructive sleep apnoea
149
2 genetic causes of severe obesity
prader wili syndrome and barget biedl syndrome
150
what genetic cause of obesity causes visual and renal impairment
barget biedl sydrome
151
what is responsible for at least 1/4 of all pneumonia deaths in HIV infected infants
pneumocystis jiroveci
152
can breast feeding prevent pneumonia
yes
153
what is the leading cause of death in under 5 globally
diarrhoea
154
diarrhoea causative organisms
rotavirus, e.coli
155
what is diarrhoea usually caused by
faeces infected water or food
156
management for diarrhoea
oral rehydration solution and zinc supplements
157
glucose and sodium creates osmotic pull for
water
158
where is the oral rehydration solution mostly absorbed
jejunum
159
what is the % of babies born with HIV with HIV infected mothers without intervention
15-45%
160
when can HIV transmission occur
pregnancy, delivery, breastfeeding
161
intervention if mum got HIV
- maternal lifelong antiretroviral treatment
-screen and treat other sexual transmitted diseases
- infant prophylaxis with co-trimoxazole for 6 weeks
162
what is the clinical presentation of abby with HIV
recurrent or severe childhood illnesses eg otitis media, diarrhoea
163
what is the test for HIV in babies under 18 months
PCR for HIV DNA or RNA
164
what is the test for HIV in babies greater than 18 months
antibody test
165
what immunological count for HIV to stage
CD4+
166
should all children with HIV get treatment regardless of clinical stage
yes
167
what is HAART
2 NRTIs and 1 NNRTI or protease inhibitor
168
what is a NRTI
nucleoside reverse transcriptase inhibitor
169
example of NRTI
abacavir
170
what is a NNRTI
non- neucleoside reverse transcriptase inhibitor
171
example of a NNRTI
efavirenz
172
example of a protease inhibitor
kaletra
173
what is a complication of the treatment for HIV and how can it be resolved
Immune reconstitution inflammatory system (IRDS) and with NSAIDs
174
do most children infected with M. tuberculosis develop tb
no
175
what does developing tb depend on
competence of the immune system to resist multiplication of the infection
176
risk factors for tb
HIV, malnutrition and household contact
177
tb length of cough or fever
greater than 2 weeks
178
what is the primary site of infection in tb
ghon focus
179
where is the ghost focus in the lung
periphery of mid zone
180
military shadowing is
military tb
181
what tb test is low yield in children
ziehl Neelson stain
182
what is the Mantoux tuberculin skin test used to detect
tb
183
what tb test is not used in children under 5
interferon gamma release assays
184
latent tb treatment
RI for 3 months or I for 6 months
185
what is the parasite that causes malaria
Plasmodium from female anopheles mosquito
186
what is the parasite that causes the most severe malaria as it crosses the blood brain barrier
P. falciparum
187
what is the clinical presentation like for malaria
very variable
188
what is the management for malaria
aremisinin- based combination therapy for 3 days
severe malaria - artesunate IV or IM
189
what is a protein energy malnutrition from only having carbs resulting in oedema
Kwashiokor
190
malnutrition resulting in low body weight
marasmus
191
diagnosing severe acute malnutrition
- mid-arm circumference less than 115mm
- weight for height under 3 SD
-oedema of both feet
192
when can malnutrition patients be treated as outpatients
have an appetite and are clinically well and alert
193
some treatment for outpatients fo malnutrition are
investigate cause, vitamin A, de- worm, Therapeutic food and check vaccinations
194
examples of ready to use therapeutic food
peanut butter, dried milk, vitamins and minerals
195
what should be given immediately on admission if severely malnourished
feed or glucose due to risk of hypoglycaemia
196
when is the only time to use IV route for rehydration in malnutrition
shock
197
what is not suitable for severely malnourished children
oral rehydration solution
198
giving iron early in malnutrition aggregates what
infection
199
is primary or sensory epilepsy more common
secondary
200
bronchiolitis is most commonly due to
RSV ( respiratory syncytial virus)
201
bronchiolitis generally occurs in children under
1
202
croup causes what
oedema in the larynx
203
croup is commonly caused by what virus
parainfluenza
204
barking cough
croup
205
does croup have runny nose, sneezing mucus in throat and watery eyes
no but bronchiolitis does
206
mild croup is treated with
corticosteroid eg dexamethasone
207
treatment for severe group
dexamethasone, oxygen, adrenaline
208
what kind of wheeze would be heard throughout the chest in acute asthma
expiratory wheeze
209
how can the chefs sound in acute asthma attack
tight
210
peak flow is what in kids SEVERE acute asthma attack
less than 50%
211
resp rate of severe asthma attack
1-5 years old is GREATER THAN 40
older than 5 years is GREATER THAN 30
212
heart rate in acute severe asthma attack in kids is
1-5 years is GRATER THAN 140
older than 5 years is GREATER THAN 125
213
MILD ASTHMA ATTACK IN KIDS TREATMENT
SALBUTAMOL INHALERS 4-6 PUFF EVERY 4 HRS
214
ACUTE ASTHMA PNEUMONIC FOR TREATMENT
OSHITMAN
215
what causes sputum to fill the airways and alveoli
pneumonia
216
what is the most common viral cause of childhood pneumonia
RSV
217
what is the cough like in kids pneumonia
wet and productive
218
a high fever in kids is greater than
38.5
219
what are bronchial breath sounds
harsh breath sounds that are equally loud on inspiration and expiration
220
dullness to percussion is caused by
lung tissue collapse and or consolidation
221
what is focal coarse crackles caused by
air passing through sputum
222
signs of pneumonia in kids
bronchial breath sounds, focal coarse crackles, dullness to percuss
223
when would you take blood cultures in kids pneumonia
if signs of sepsis
224
first line in kids pneumonia
amoxicillin
225
in kids pneumonia what is used if allergic to penicillin or to cover atypical
macrolide eg erythromycin
226
what is the most common rhythm disturbance in kids
SVT
227
4 types of SVT in kids
a fib, paroxysmal SVT, atrial flutter, wolff Parkinson white syndrome
228
what is the heart rate in SVT
150-270
229
SVT presents with
palpitations
230
gram neg or pos that cause the majority of organisms responsible for paediatric infective endocarditis
positive
231
what may be auscultated in paediatric IE
new or changing heart murmur
232
joint pain and headaches can be symptoms in
paediatric IE
233
when should you start antibiotics in infective endocarditis
after you have obtained culture then transition to specific antibiotics based on culture results
234
what is gastroenteritis
inflammation all the way from the stomach to the intestines
235
is gastroenteritis most commonly viral or bacterial
viral eg rota or norovirus
236
gastroenteritis causes
nausea, vomiting, diarrhoea
237
wha should you ensure in gastroenteritis treatment
remains hydrated while waiting for diarrhoea and vomiting to settle
238
where is the pylorus
from the stomach to the first part of the small intestine
239
projectile vomiting that most commonly occurs after the baby is fed
pyloric stenosis
240
congenital pyloric stenosis most commonly occurs when
between 2-12 weeks
241
will vomit from pyloric stenosis have bile in it
No so vomit will be milky
242
signs in congenital pyloric stenosis
dehydration
peristalsis across the abdomen
may feel abdominal mass
243
investigation in congenital pyloric stenosis
US
244
what is the surgery for pyloric stenosis
Pyloromyotomy
245
volvulus results in
bowel obstruction
246
congenital malrotation predisposes to volvulus where
midgut
247
meconium ileum can predispose to what kind of volvulus
segmental
248
investigation for volvulus
air
249
do babies have constipation or diarrhoea in volvulus
constipation
250
what can the stool be like in volvulus
bloody
251
what results in narrowing of the lumen resulting in a palpable mass in the abdomen and obstruction to the passage of faeces
intussusception
252
redcurrant jelly stool
intussusception
253
where is the mass on intussusception
right upper quadrant
254
target sign on ultrasound
intussusception
255
what is air reduction the management for
intussusception
256
symptoms of intussusception
severe, sharp well localised abdominal pain
pale, lethargic and unwell
vomiting
257
inflammation of the appendix
appendicitis
258
what is the main differential for an acute abdomen presentation in a child
appendicitis
259
where does appendicitis pain begin
central
260
where does appendicitis pain move down to
right iliac fossa
261
classic features in appendicitis
anorexia, nausea and vomiting and moderate temperature
262
tenderness in mcburneys point
appendicitis
263
what is rovings sign in appendicitis
palpation of the left iliac fossa causes pain in the RIF
264
feeling every bump on the way to hospital so pain on movements suggests
peritonitis
265
what are these signs in: tenderness in mcburneys point, rovings sign, guarding on abdominal palpation, rebound tenderness, percussion tenderness, painful movements
appendicitis
266
treatment in appendicitis
appendectomy
267
what is the main investigation in appendicitis
mainly clinical based on presentation and raised inflammatory markers but can do US if uncertain
268
urinary tract includes
urethra, bladder, ureters and kidneys
269
UTI are more common in
girls
270
investigation in UTI
urine clean catch sample with microbiology
271
what should all children under 3 moths with a fever should start
IV ANTIBIOTICS
272
oral antibiotics can be considered when child's over
3 months
273
what is pyelonephritis
infection affecting kidney function
274
what brings blood to the scrotum
spermatic chord
275
what is epididymoorchitis
bacterial infection of the epididymis progressing to testes
276
where is the appendix testis located
upper pole of the testis
277
what is a hydrocele
collection of fluid within the tunica vaginalis that surrounds the testes
278
soft and smooth and non tender swelling of one of the testes
hydrocele
279
hydrocele investigation
transilluminate
280
difference between simple and communicating hydrocele
connection with peritoneal cavity in communicating
281
soft lump in the inguinal region
inguinal hernia
282
part of the bowel pushes through a weakness in the abdominal muscles
inguinal hernia
283
how to manage inguinal hernia
surgery
284
empty scrotum means
undescended testes
285
management in undescended testes
wait 3- 6 months as in most cases the testes will descend in this time
286
what is prepuce
foreskin
287
is foreskin retractable in most newborns
no
288
retractibility of f skin increases with what
age
289
does non retractable forekin need intervention
no
290
what is chronic inflammatory process which affects the foreskin but can also extend on to the glans and external urethral meatus
Bxo balanitis xerotica obliterans
291
there is keratinisation of the tip of the foreskin in what
Bxo balanitis xerotica obliterans
292
management for Bxo balanitis xerotica obliterans
circumcision
293
fskin cannot be returned to its original position after being retracted
paraphimosis
294
urethral meatus is located at abnormal site
hypospadias
295
inflammation of the brain
encephalitis
296
most common cause of encephalitis
HSV
297
encephalitis symptoms
altered consciousness, unusual behaviour
298
investigations for encephalitis
lumbar puncture and imaging
299
treatment for encephalitis
antiviral medications
300
what medication treats HSV and VZV
aciclovir
301
what is meninges
lining of the brain and spinal chord
302
what is meningitis
inflammation of the meninges
303
mengiitis organism in neonates is
Group B strep
304
bacterial organsim in meningits for children and adults
Neisseria meningitidis (meningococcus) and Streptococcus pneumoniae (pneumococcus)
305
- Fever
- Neck stiffness
- Vomiting
- Headache
- Photophobia
- Altered consciousness and seizures
meningitis
306
non blanching rash can be present in
meningitis
307
does absence of rash exclude meningitis
no
308
investigation for meningitis
lumbar puncture
309
bacterial meningitis management
- Under 3 months - cefotaxime plus amoxicillin
- Above 3 months - ceftriaxone
- If penicillin allergic: chloramphenicol
- Steroids e.g. dexamethasone are also used in bacterial meningitis to reduce the frequency and severity of hearing loss and neurological damage
310
does viral meningitis tend to be more severe than bacterial
no viral is milder
311
treatment for viral meningitis
aciclovir
312
what seizures occur in children with a high fever
febrile
313
what is the most common cause of syncope in children
vasovagal episode
314
breath holding attacks typically occur between
6-18 months and most outgrow by 4/5 years of age
315
reflex anoxic seizures occur when
child is startled eg minor bump to head
316
heart stops beating for no longer than 30 secs in what seizures
reflex anoxic
317
tendency to have seizures
epilepsy
318
what are seizures
transient episodes of abnormal electrical activity in the brain
319
investigations for epilepsy
EEG and MRI brain
320
can control fever with what
paracetamol and ibuprofen
321
vasovagal episode is triggered by
emotional or orthostatic stress eg prolonged standing, sight of blood
