General child's health

Question 1

Are cardiac arrests more serious in children or adults

Answer 1

Children

Tends to be end point of prolonged problem (not acute problems like MI).

Associated with greater acidosis, circulatory impairment, end organ damage.

Question 2

Until what age are anterior fontanelles in babies palpable

Answer 2

Up to 18 months

Question 3

Until what age are posterior fontanelles in babies palpable

Answer 3

2-3 months

Question 4

General exam: What 3 things must always be examined for in a child’s HANDS

Answer 4

1. Capillary refill time
2. Temperature
3. Clubbing

Question 5

Which areas must pulse be felt from if a child is under 1yo

Answer 5

Brachial pulse

Femoral pulse

Question 6

What is the commonest cause of hypertension in children

Answer 6

Kidney dysfunction
(usually from UTI)

Question 7

Causes of clubbing in children

Answer 7

"	Cyanotic congenital heart disease
"	Lung conditions (including cystic fibrosis)
"	Ulcerative colitis
"	Bronchiectasis
"	Infective endocarditis
"	Neoplasm (tumours)
"	GI conditions: IBD, biliary atresia, Coeliac's, malnutrition
"	Others: TB, thyrotoxicosis

Question 8

General exam: What 3 things must always be examined for in a child’s THROAT

Answer 8

1. Tonsils
2. Dehydration
3. Central cyanosis

Question 9

How long must one wait before deciding that there are no abdominal sounds

Answer 9

3min

Question 10

How often would abdominal sounds be in normal, non-sluggish bowels

Answer 10

At least 3 abdominal sounds per minute

Question 11

Which is the first bedside observation to be affected in an unwell child

Answer 11

Respi rate

Question 12

Which is the last observation bedside to be affected in an unwell child (would indicate child is very sick)

Answer 12

Blood pressure

Question 13

Minimum time period in between giving live vaccines

Answer 13

6 weeks (3 months to be safe)

Otherwise second live vaccine will ruin the effects of the first live vaccine.

Question 14

Common complication of forceps delivery

Answer 14

Clavicle fracture

Question 15

How is the vaccination schedule in a premature baby adjusted

Answer 15

Based on number of weeks from day they were born.

NOT based on corrected age

Question 16

Maintenance fluids for children

Answer 16

• 100ml /kg for first 10kg
• 50ml /kg for next 10kg
• 20ml /kg for everything else

(Tip: divide by 24 for hourly rate before rounding off to easiest amount to give)

Question 17

How much of what fluid to give shocked child

Answer 17

20ml /kg 0.9% NaCl

Question 18

When might you give less fluid in a shocked child

Answer 18

10ml/kg

For renal failure/ cardiac disease

For trauma (high risk of thrombus, fat embolus)

Question 19

Glucose requirements for hypoglycaemic child

Answer 19

5ml/kg 10% dextrose

Question 20

What 5 symptoms should always be asked in any child’s history

Answer 20

• fever
• rash
• feeding changes
• lethargy
• wet, dirty nappies

Question 21

What allergies must be specifically asked about in a child

Answer 21

• drug allergy
• skin allergy
• food allergy

Question 22

What should be asked about in child’s social history

Answer 22

• BINDS
• smokers in house
• social service involvement

Question 23

At what age would a UTI in a child be concerning (and warrant further investigations)

Answer 23

<1yo

Question 24

How much milk does a child normally drink

Answer 24

150ml/kg a day

Question 25

Definition of PROM

Answer 25

Rom >18h

Question 26

Risks of neonatal infection at birth

Answer 26

- PROM - Mum GBS positive (check if adequate a/b coverage) - Maternal fever

Question 27

What questions to ask in history to assess how well child is

Answer 27

Wet nappies per day | If child is waking to feed

Question 28

List the TORCH infections

Answer 28

``` Toxoplasmosis Other: VZV, Syphilis Rubella CMV HSV ```

Question 29

Clinical signs of TORCH infections

Answer 29

- Fever - Jaundice - Anaemia - Purpura, petichiae - Hepatosplenomegaly

Question 30

Expected rate of baby weight gain in first 6 months

Answer 30

Should have x2 birth weight (by 3-6 months) 140-200g a week

Question 31

Expected rate of baby weight gain by 1 year

Answer 31

Should have x3 birth weight 90-140g a week