Children & Young People

Question 1

What are the four domains of development?

Answer 1

Gross motor
Vision and fine motor
Hearing, speech and language
Social, emotional and behavioural

Question 2

At what age would you expect a child to be smiling spontaneously?

Answer 2

6 weeks

Question 3

At what age would you expect a child to be walking?

Answer 3

Unsteadily by 12 months
Steadily by 15 months

(Delayed if longer than 18 months)

Question 4

At what age would you expect a child to be sitting upright without support?

Answer 4

6 - 8 months

Delayed if later than 9 months

Question 5

When would you expect a child to be running and jumping?

Answer 5

2.5 years

Question 6

At what age would you expect a child to be tracking an object with their eyes?

Answer 6

6 weeks

Question 7

At what age would you expect a child to use a mature fine pinser grip?

Answer 7

10 - 12 months

Question 8

At what age would you expect a child to use a palmar grasp?

Answer 8

4-6 months

Question 9

At what age would you expect a child to draw a line, circle, cross, square and triangle?

Answer 9

Line 2 years
Circle 3 years
Cross 3.5 years
Square 4 years
Triangle 5 years

Question 10

At what age would you expect a child to build a three block tower, a tower of 6, a tower of 8, a bridge?

Answer 10

3 block - 18 months
6 block tower - 2 years
8 block tower - 2.5 years
Bridge - 3 years

Question 11

At what age would you expect a child to use two to three words, and simple nouns other than mama or dada?

Answer 11

12 months

Question 12

At what age would you expect a child to use 6-10 words and respond to questions such as Where i your nose (by pointing)?

Answer 12

18 months

Question 13

At what age would you expect a child to use simple 2-3 word phrases e.g. give me teddy?

Answer 13

20-24 months

Question 14

At what age would you expect a child to drink from a cup using two hands?

Answer 14

12 months

Question 15

At what age would you expect a child to use a spoon to get food to their mouth?

Answer 15

18 months

Question 16

At what age would you expect a child to be engaging in participative play and sharing?

Answer 16

2.5 - 3 years

Question 17

At what age would you expect a child to be independent with peeing and pooing?

Answer 17

Urine 3 years
Bowel movements 4 years

Question 18

At what age would you expect a child to be cawling?

Answer 18

7 - 10 months

Question 19

What is routine antenatal care?

Answer 19

10 checks with midwife for nulliparous women, 7 for parous women.

US scan 11-14 weeks (dating scan)
US scan 18 - 20 weeks (anomaly scan)

Question 20

What is assessed at the 11-14 week antenatal scan?

Answer 20

To confirm the pregnancy is developing normally

To estimate the due date

To check the position of the placenta

To screen for chromosomal abnormalities

To confirm the number of babies

To measure the chance of developing pre-eclampsia

Question 21

What is assessedat the 18 - 20 week (anomaly or morphology scan) antenatal scan?

Answer 21

To check for abnormalities in the fetus’s development and appearance

To confirm the number of fetuses

To determine the gestational age

To locate the placenta

To detect soft markers of aneuploidy

To identify maternal pelvic pathology

Question 22

True or false, women can refuse to have antenatal HIV, Syphylis, Hepatitis B screening for their child?

Answer 22

True

Question 23

In what position should pregnant women sleep after 28 weeks?

Answer 23

On their side, left or right.
Sleeping on your back increases the risk of still birth

Question 24

What is aneuploidy?

Answer 24

Having an abnormal number of chromosomes

Question 25

What 7 conditions are tested for on the heel prick test?

Answer 25

Cystic fibrosis (CF) Sickle cell disease (SCD) Congenital hypothyroidism (CHT) Phenylketonuria (PKU) Medium-chain acyl-CoA dehydrogenase deficiency (MCADD) Maple syrup urine disease (MSUD) Isovaleric acidaemia (IVA) Glutaric aciduria type 1 (GA1) Homocystinuria (HCU)

Question 26

What is travel advice for pregnant women?

Answer 26

Risk of VTE is higher therefore if long haul flight (>4hours) then advise hydration and regular movement breaks + consider compression stockings. Some flights restrict flying towards the end of pregnancy, so advise to check with the flight provider. Travel vaccinations - avoid live virus/bacterial vaccines unless necessary travel to high risk zones in which case consider with caution. Avoid Zika virus zones: South and Central America the Caribbean the Pacific islands Africa Asia

Question 27

Where is Zika virus endemic, and why should these areas be avoided by pregnant women?

Answer 27

South and Central America the Caribbean the Pacific islands Africa Asia Zika is transmitted by mosquitoes. Can cause microcelphaly and abnormal brain development.

Question 28

What dairy products are safe in pregnancy? Why should certain dairy products be avoided?

Answer 28

Pasteurised products are safe unless they have been mold ripened with a white coating e.g. brie, or camembert. These are safe however, if heated to be steaming hot! Unpasteurised dairy is to be avoided, unless it has been cooked to the point of being steaming hot. Unpasteurised dairy products carry the risk of listeria contamination which increases the risk of miscarriage, and still birth.

Question 29

What meats should be avoided in pregnancy and why?

Answer 29

Raw or undercooked meat Liver and liver products All types of pâté, including vegetarian pâté Game meats such as goose, partridge or pheasant Caution with cold cured meats such as salami, prosciutto, chorizo, peperoni (unless these are cooked to a high heat). Caution with undercooked poultry, pork, sausages and burgers. Risk of toxoplasmosis which increases risk of miscarriage Game meats contain lead shot Liver contains Vit A; too much of this can cause developmental problems e.g. spina biffida or cleft palate.

Question 30

True or false, "laid in britain" and British Lion Hen Eggs (with lion stamp on) are safe to consume raw in pregnancy?

Answer 30

True. These eggs are far less likely to have salmonella Eggs that have been cooked thoroughly are safe in pregnancy

Question 31

When is newborn hearing screening done? What does it check for?

Answer 31

Ideally in the first 5 weeks No later than 3 months Checks for hearing loss AKA Automated otoacoustic emission (AOAE) test It is not compulsory but it highly recommended 1 in 1000 babies have permanent hearing loss at birth

Question 32

What growth chart is used for preterm infants?

Answer 32

Neonatal and Infant Close Monitoring (NICM) is used for anyone born <37 weeks If >32 weeks and before 37 weeks, plot all measurements in the preterm section until 42 weeks gestation. Then plot on the 0-1-year chart using gestational correction - basically, deduct the number of weeks preterm from the actual age to plot the growth. Gestational correction continues until 1 year of age unless born <32 weeks, then its 2 years! A separate low birth weight chart is used for infants born <32 weeks

Question 33

On growth charts, how do you describe a marked plot's relation to centile lines?

Answer 33

If within 1/4 of the centile, then it is "on the centile" if > than this then it is described as "between two centiles". NB: Growth charts plot the average size for a child of equivalent maturity with optimal growth.

Question 34

What do centiles mean on growth charts?

Answer 34

The % of individuals you would expect to be below that level e.g. 91st centile means 91% of individuals would fall below that measurement.

Question 35

How many centile drops would be concerning for weight?

Answer 35

A drop of 2 or more centiles would be concerning for weight

Question 36

True or false, some neonatal weight loss is expected in the first week post birth

Answer 36

True. However, 80% regain this weight by the second week. A weight loss of more than 10% is not normal and should be investigated.

Question 37

When are babies measured by height rather than length?

Answer 37

At 2 years of age you chart height rather than length. NB: There is a slight discrepancy between length and height centiles on growth charts. This is because, when standing up the spine is compressed slightly which results in slighly reduced height vs length.

Question 38

True or false, you can predict adult height based on infant growth charts?

Answer 38

True. Adult height prediction is ~ within 6cm of the adult's true height.

Question 39

How often should infant height/length and weight be charted?

Answer 39

Once a month up to 6 months Once every 2 months 6 - 12 months Once every 3 months 12 months onwards

Question 40

How often should a child's head circumference be measured?

Answer 40

At birth 6-8 week check Any other time if concerns about growth

Question 41

What is a club foot? How is it corrected?

Answer 41

Congenital abnormality Inverted foot with plantar flexion which is NOT passively correctable AKA Talipes equinovarus Treated with Ponseti method (non-surgical) - involves progressive casting and realignment of the foot. Night time braces are often used until age 4. 15% relapse. Affects 1 in 1000 babies. 50% of cases are bilateral. 2x as common in males.

Question 42

True or false, if scarlet fever is suspected in a child, the local health protection team (HPT) should be informed?

Answer 42

True. It is a notifiable disease. You do not need to wait for swab results or confirmation. If suspected it should be reported.

Question 43

What is the common pathogen responsible for Scarlet fever? What age is scarlet fever most common?

Answer 43

Group A Haemolytic Streptococci (usually Strep pyogenes) Peak incidence is 4 years old Typical range 2 - 6 years old

Question 44

How does Scarlet fever present? What is the treatment?

Answer 44

Rash ('sandpaper texture') - spares palms/soles Fever Strawberry tongue Malaise Penicillin V for 10 days Azithromycin if penicillin allergy

Question 45

When can children with scarlet fever return to school?

Answer 45

24 hours after starting antibiotics

Question 46

What is the most common complication of scarlet fever?

Answer 46

Otitis media Others include: - Rheumatic fever (20d post) - Acute glomerulonephritis (10d post)