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general paediatrics Flashcards

1
Q

why is a Holistic multi-system approach essential in paediatrics

A

More than one problem may exist

More than one system may be involved

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2
Q

at which age do viral illnesses manifest the worst

A

babies

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3
Q

give examples of things that re different when dealing with paediatrics

A

parents there
play is clinically helpful
specialised nursing stuff
treatments differ by age and weight

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4
Q

what things should you consider when making your history age appropriate

A

developmental milestones
intellectual skills
language

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5
Q

what should you always ask the person accompanying a child

A

their relationship tot he child

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6
Q

what things should you enquire about a childs bowel habits

A

frequency, difficulty, pain, blood/ mucus, size/ shape/ appearance

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7
Q

what things are added to history taking with a child

A

birth history
immunisations
development

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8
Q

what can you assess about a childs respiratory system from observation

A

Effort, excess noises made, rate, recession, O2, nebs

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9
Q

what can you assess about a childs cardiovascular system from observation

A

Colour, perfusion of hands

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10
Q

what can you assess about a childs neurological function from observation

A

Alertness, interaction, play, posture, visual tracking (if normal no need to do further)

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11
Q

what can you assess about a childs GI system from observation

A

Feeding, vomit, abdo distension/ movement

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12
Q

what can you assess about a childs MSK system from observation

A

Mobility, limbs movements, posture, splints, mobility aids

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13
Q

what pulses are essential to feel in infants

A

femoral pulses

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14
Q

what examination should not be done in a child

A

rectal

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15
Q

what things can play be used for in a consultation

A

illustrate
distract
see movement

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16
Q

what age range is a neonate

A

<4 weeks

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17
Q

what age range is an infant

A

4 weeks - <12m

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18
Q

what age range is a toddler

A

1-2 years

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19
Q

what age range is a pre school child

A

2-5 years

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20
Q

when is the stage of development in children

A

0-5

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21
Q

when is a child’s brain most connected

A

2 years

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22
Q

what are the key developmental fields

A 
gross motor
fine motor
social and self help
speech and language
hearing and vision
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23
Q

what is the term for a babies first use of words

A

polysyllabic babble

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24
Q

should developmental milestones be correct for premature babies

A

yes - until 2 years

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25
Q

what are some influencing factors on a child development

A

genetics - family react gender
environment
positive early childhood experience
abuse and neglect insult to brain

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26
Q

what are some antenatal things that can affect brain development

A

Infections (CMV, Rubella, Toxo, VZV)

Toxins (Alcohol, Smoking, Anti-epileptics)

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27
Q

what are some postnatal things that can affect brain development

A

Infection (Meningitis, encephalitis)
Toxins (solvents mercury, lead)
Trauma (Head injuries)
Malnutrition (iron, folate, vit D)
Metabolic(Hypoglycaemia, hyper + hyponatraemia)
Maltreatment/ under stimulation/ domestic violence
Maternal mental health issues – social issue

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28
Q

what should you think about when deciding if a child is normal or not

A

Think about each developmental field (deficiency may predominantly affect one area)
What sequence/ pattern has come before?
What skills have been achieved?
What has not yet been achieved?
Is one field falling behind the other - Global delay v.s. specific developmental delay
Are the skills gained age appropriate?

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29
Q

why is a developmental assessment done

A

Reassurance and showing progress
Early diagnosis and intervention
Discuss positive stimulation/parenting strategies
Provision of information
Improving outcomes (pre-school years critical)
Genetic counselling
Coexistent health issues

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30
Q

what are some red flags for developmental issues

A

Loss of developmental skills
Parental/ professional concern re. vision
Hearing loss
Persistent low muscle tone/ floppiness
No speech by 24 months, esp if no other communication
Asymmetry of movements/ increased muscle tone
Not walking by 18m/ Persistent toe walking
OFC > 99.6th / < 0.4th / crossed two centiles/ disproportionate to parental OFC
Loss of skills/ regression

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31
Q

how is the child health programme recorded in the UK

A

red bood

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32
Q

what are the main components of cild health screening

A

Health promotion
Developmental screening (including hearing)
Immunisation

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33
Q

what things are screened for in a baby

A 
Phenylketonuria (PKU)
Congenital Hypothyroidism (CHT)
Cystic Fibrosis (CF),
Medium Chain Acyl-CoA Dehydrogenase Deficiency (MCADD) 
Sickle Cell Disorder (SCD).
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34
Q

by what age doe s baby get their hearing checked

A

1st 2 weeks

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35
Q

what things are discussed in the 6-8 weeks review by GP

A

Identification data (Name, address, GP)
Feeding (breast/ bottle/ both)
Parental concerns (appearance, hearing; eyes, sleeping, movement, illness, crying, weight)
Development (gross motor, hearing + communication, vision + social awareness)
Measurements (Weight, OFC, Length)
Examination (heart, hips, testes, genitalia, femoral pulses and eyes (red reflex))
Sleeping position (supine, prone, side)

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36
Q

by what age do children get their eyes tested

A

before school 4-5 years

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37
Q

are immunisations done later for premature babies

A

no - chronological age

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38
Q

is egg allergy a contraindication of MMR

A

no

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39
Q

should you give a child a vaccination if they are currently unwell

A

no - postpone

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40
Q

what may be side effects of immunisations

A

mild temperature, discomfort

rare anaphylaxis

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41
Q

what are the 3 key parameters of measuring a child

A

Weight (grams and Kgs)
Length (cm) <2 years, height if >2y
Head circumference (OFC) (cm)

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42
Q

are Arm circumference , Skin(fat) folds and knee-heel length routine measurememnt

A

no -

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43
Q

what is the averaged head circumference (OFC)

A

55cm

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44
Q

what is failure to thrive

A

Child growing too slowly in form and usually in function at the expected rate for his or her age

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45
Q

what are some maternal intake causes of failure to thrive

A

Poor lactation
Incorrectly prepared feeds – too little powder
Unusual milk or other feeds
Inadequate care

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46
Q

what are some infant intake causes of failure to thrive

A

Prematurity
Small for dates
Oro palatal abnormalities (e.g. cleft palate)
Neuromuscular disease (e.g. cerebral palsy – high tone burns calories)
Genetic disorders

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47
Q

what are metabolic demand causes of failure to thrive

A 
¥	Congenital lung disease
¥	Heart disease
¥	Liver disease
¥	Renal disease
¥	Infection
¥	Anemia
¥	Inborn errors of metabolism
¥	Cystic fibrosis
¥	Thyroid disease
¥	Crohn’s/ IBD – tend not to be young
Malignancy
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48
Q

what are nutrient loss cause of failure to thrive

A 
¥	Gastro oesophageal reflux/ vomit 
¥	Pyloric stenosis
¥	Gastroenteritis (post-infectious phase)
¥	Malabsorption
Ð	Food allergy
Ð	Persistent diarrhoea
Ð	Coeliac disease
Ð	Pancreatic insuffiency - diarrhoea
Ð	Short bowel syndrome
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49
Q

how would you find a non organic cause of failure to thrive

A

child puts on weight in hospital

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50
Q

what are some non organic causes of failure to thrive

A

Poverty/ socio-economic status
Difficult parent-child interactions
Lack of preparation for parenting/ education
Child neglect
Emotional deprivation syndrome
Poor feeding or feeding skills disorder
Dysfunctional family interactions (especially maternal depression or drug use)
Lack of parental support (eg, no friends, no extended family)
Feeding disorders (eg, anorexia, bulimia- later years)

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51
Q

how much feed should a baby takee

A

140-180 ml/kg/day

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52
Q

why do babies get cold easily

A

bigger surface area to volume ares

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53
Q

why do babies get dehydrated easily

A

high % water

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54
Q

is a childs BP lower or higher than an adults

A

lower

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55
Q

what is a good question to ask to find out about a childs immunity

A

did you have and clear chicken pox - need cellular and humorla immunity

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56
Q

what is the ‘latent’ psychological phase of childhood growth

A

¥ between 6 and age of puberty, child represses all interest in sexuality and develops social and intellectual skills

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57
Q

why is infant mortality dropping

A

Obstetric care, Better housing, Better nutrition, Immunisations, Antibiotics

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58
Q

how long are children normally hospitalised for

A

1-2 days

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59
Q

how old are the majority of acute admissions to hospital

A

<2 - respiratory

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60
Q

when does the majority of brain development occur

A

under 5

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61
Q

what are key performance skills known as

A

milestones

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62
Q

what is the difference between the median age and the limit age

A

Median age -the age at which half the population of children acquire that skill
limit age - The skill should have been acquired and is 2 SD from the mean

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63
Q

list some negative environmental influences that impact normal development

A

maternal infections, toxins, drugs, postnatal infections, malnutrition and maternal mental health disorders

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64
Q

when is developmental delay present

A

when functional aspects of the child’s development in one or more domains (motor, language, cognitive, social, emotional) are significantly delayed compared to the expected level for age’

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65
Q

what is regarded as significant delay of skills

A

greater than 2 SD from population means

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66
Q

what is global developmental delay

A

2 or more domains are affected

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67
Q

what is a learning disability

A

a significant impairment in intellectual functioning and affects the person’s ability to learn and problem-solve in their daily life. It has nearly always been present since childhood. >5 for diagnosis.

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68
Q

what age are learning disabilities diagnosed at

A

> 5

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69
Q

what are some common syndromes that cause developmental delay

A

Down’s syndrome, Fragile X syndrome and Williams syndrome

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70
Q

list some features of Williams syndrome

A

elfin facies, supravalvular AS, MR.
The dysmorphic facial features consist of a broad forehead, medial eyebrow flare, strabismus, flat nasal bridge, malar flattening, a short nose with a long filtrum, full lips, and a wide mouth

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71
Q

what are some common problems that affect the motor domain

A

Delayed maturation
Cerebral palsy
Developmental coordination disorder – tie shoes, buttons etc.

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72
Q

what are some common problems that affect the sensory domain

A

Deafness
Visual impairment
Multisensory impairment

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73
Q

what are some common problems that affect the language/cognitive domain

A

Specific Language Impairment

Learning Disability

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74
Q

what are some common problems that affect the social/communication domain

A

Autism
Asperger syndrome
Elective mutism

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75
Q

what parent concerns are sensitive predictors of developmental problems

A

speech, language, fine motor skills, or global function

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76
Q

what parent concerns are NOT sensitive predictors of developmental problems

A

gross motor

self help

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77
Q

list some primary care assessment tools of developmental delay

A

λ ASQ (ages and stages questionnaire)
λ PEDS (Parents evaluation of developmental status)
λ M-CHAT (Checklist for autism in toddlers)
λ SOGS-2 (Schedule of Growing Skills) - Information of child’s development across a range of areas
0-5 Years, 9 key areas, Separate cognitive score can be derived. Easy for anyone to do.

78
Q

list some secondary care assessment tools of developmental delay

A

Griffiths mental development scales
Bayley scales of infant development
Wechsler preschool and primary scales of intelligence

79
Q

list some red flags for developmental problems

A 
•	Loss of developmental skills
•	Concerns regarding vision
•	Concerns re hearing
•	Floppiness
•	No speech by 18-24 months
•	Asymmetry of movement
•	Persistent toe walking beyond 3 years of age
Head circumference >99.6th C or < 0.4th C
80
Q

list some red flags for things a child should be able to do

A

• Sit unsupported by 12 months
• Walk by 18months (boys) or 2 years (girls): Check creatinine kinase for MD
• Walk other than on tiptoes
• Run by 2.5 years
• Hold objects in hand by 5 months
• Reach for objects by 6 months (no interest)
Points to objects to share interest by 2 years

81
Q

what should you have a high index of suspicion for when investigating developmental delay

A

abuse and neglect

82
Q

what percentage of children with developmental delay have vision or hearing disorders

A

13-50% vision

18% hearing

83
Q

list some benefits of investigating developmental delay

A

Lessens parental blame
prevents co-morbidity by identifying factors likely to cause secondary disabilitys
Appropriate genetic counselling – next children
Address concerns about possible causes e.g. events during pregnancy or delivery
Potential treatment for a few conditions

84
Q

what are the 4 stages of receiving bad news

A

Shock > anger > disbelief > acceptance

85
Q

what are some effects on the family of a child with developmental delay

A

Emotional Social isolation

Financial implications Implication for sibling

86
Q

when does a child have additional support needs

A

if they need additional support with their education.

87
Q

why may a child need additional learning support

A

λ Difficulties with mainstream approaches to learning
λ Disability or health needs, such as motor or sensory impairment, learning difficulties or autistic spectrum disorder.
λ Family circumstances e.g. young people who are carers or parents.

88
Q

what is an Individualised Educational Plane (IEP)

A

IEP is a detailed plan for a child’s learning. It contains some specific, short-term learning targets for the child and will set out how those targets will be reached.

89
Q

are IEPs legal documents

A

Not legal documents.

90
Q

what is a Co-ordinatd support pain

A

detailed plan of how child’s support will be provided

91
Q

is a CSP a legal document

A

yes - aims to ensure all the professionals who are helping the child, work together

92
Q

which children get a co-ordianted support plan

A

λ Complex or multiple needs
λ Needs likely to continue > 1 year
λ Support required by > 1 agency.

93
Q

what does GIRFEC stand for

A

Getting it right for every child

94
Q

what law are child’s plans associated with

A

Children and Young People Act 2014

95
Q

what children receive a childs plan

A

if a child or young person needs some extra support to meet their wellbeing needs such as access to mental health services or respite care, or help from a range of different agencies.

96
Q

what will a childs plan contain information about

A

why a child or young person needs support
the type of support they will need
how long they will need support and who should provide it.

97
Q

what age are adolescents

A

11-25 years - ends when individual is stable in society

98
Q

what are some social changes in adolescence

A

Developing self-identity – desire for social acceptance, identity exploration, sexual identity
Seeking independence and responsibility - Less acceptance of authority figures/ advice
Greater focus on peer groups
drive to become independent from parents – can be tough during transitions
drive to ‘fit-in’ with peers

99
Q

what are some emotional changes in adolescents

A

increased self-consciousness
Growing ability to regulate emotions - Early adolescence: seemingly spontaneous outbursts, greater reliance on amygdala
Emotional outbursts can be triggered by barriers to development
Increase in connections between amygdala and other brain areas during adolescence

100
Q

when do most mental health disorders develop

A

1/2 of all MH disorders develop by 14 years, 3/4 by 20’s

101
Q

which area has the most radical changes during adolescence

A

pre-frontal cortex

102
Q

what is the pre- frontal cortex responsible for (changes in adolescence)

A

Responsible for high level cognitive function

Characteristic of adult behaviours/ abilities

103
Q

describe how the pre-frontal cortex functions in early adolescence

A

Here and now focus not long term abstract concepts
Bullet-proof mindset, Risk taking,
Winging it,
Impulsivity, egocentricity (difficulty seeing from another persons view) Difficulty controlling emotions

104
Q

describe how the pre-frontal cortex functions in adulthood

A

Planning, Organising, Decision making, Reasoning, Emotion regulation, Abstract thinking, Inhibiting inappropriate behavior, social interaction

105
Q

are mortality rates higher 0-10 or 10-20

A

10-20 - suiceide, fighting, RTA

106
Q

why do adolescents have worse chronic disease control

A

¥ Different priorities to health professionals
¥ Different thought processes/ability to process long term outcomes
¥ Both chronic disease and adolescence are emotional journeys with a need to restructure identity is a very hard challenge

107
Q

which age group have the highest graft failure rates

A

adolescents

108
Q

should you see adolescents patients on their own or with parents

A

on their own - easier if standard practice or follow up appointments

109
Q

what tool can be used to asses motivation of adolescents to take medication

A

decision matrix

110
Q

what are the right questions to ask an adolescent in their social history

A 
HEADSS
Home
Education/ employment 
Activities
Drugs / alcohol 
Sexuality 
Suicide/ self harm
111
Q

when should the transition process from paediatric to adults begin

A

11-12 years

joint appointments

112
Q

what tool can be used to help in the transition between paediatrics and adult medicine

A

ready steady go questionnaires

113
Q

how many more times are disabled children likely to be abused

A

3x

114
Q

who is the names person for a child from birth to school and after

A

health visitor then head teacher

115
Q

what act is GIRFEC part of

A

children and young people act 2014

116
Q

who must be informed when there are grounds of concern for a child

A

social work

117
Q

which agency decides if someone goes on the child protection register

A

social work

118
Q

list some alarm bells for physical abuse

A

Late presentation – old fractures, healing of old scars
History changes on repeating – always write down what is said
History inconsistent with findings

119
Q

can you age bruises

A

NO - don’t know force or vascular areas

120
Q

where on a baby is bruising abnormal

A

areas covered such as bum - don’t cruise, don’t bruise

121
Q

what is pattern bruising in a child likely to be

A

Non accidental injury

122
Q

how do you investigate abnormal bruising

A

CT head, ophthalmology, skeletal survey

blood - exclude leukaemia

123
Q

are rib fractures in children common

A

NO - compliant area

124
Q

why are spinal fractures in babies abnormal

A

not yet mobile so can’t sustain injury

125
Q

why is an opthomologist necessary in abusive head trauma

A

80% retinal haemorrhage

126
Q

list some indicators for sexual abuse

A

disclosure, sexualized behavior, STI’s, pregnancy

127
Q

who carries out examination of child with suspected sexual abuse

A

Joint Paediatrician/Forensic Medical Examiner

Video Colposcope + General Physical Examination + Developmental Assessment

128
Q

what are the 3 main ways that fabricates and induced illness occur

A

o Fabrication of signs and symptoms including the child’s past medical history
o Fabrication of signs and symptoms and falsification of hospital charts records specimens and bodily fluids
o Induction of illness by a variety of means – administer poison, insulin

129
Q

list some differences in children’s airway compared to adults

A
  • Large head to body size
  • Short necks – find vessels
  • Large tongue – easy to compress
  • Obligate nasal breathers
  • Nasal passages easily obstructed blocked airway
  • Compressible floor of mouth and trachea
  • High anterior larynx
130
Q

list some differences in at the lungs and airways of children and adults

A

• Small total surface area for air tissue interface
• Lower airways small- easily obstructed
• Diaphragmatic breathing (tire easily)
• Fewer type I (slow twitch) fibres- easy fatigue
• Soft non-calcified bones- v. compliant chest wall- recession and in-drawing (more cartilage chest has less room for expansion)
Horizontal ribs- less expansion

131
Q

list some differences in the respiratory physiology of children and adults

A

• Higher metabolic rate/ oxygen consumption
o Respiratory rate higher and gradually falls
• Oxygen dissociation curve shifted left in neonates (HbF predominance)
o Neonates tolerate slightly lower saturations
• Immature lung vulnerable to insult
• Apnoea may occur in babies easier as a response to colds and viral infections

132
Q

list some differences in the cardiovascular physiology of children and adults

A

• Circulating blood volume- 70-80 ml/kg
o Small loss can make a big difference – only take small volumes
• Circulation changes from in-utero to ex-utero
o PDAs/ PFO may remain open for several months
o Pulmonary pressure has to fall to allow PFO to close
• ECG features vary with age
• Stroke volume increases with size - Heart rate higher (150bpm) and gradually falls
• Systemic vascular resistance progressively rises from birth
o Blood pressure lower and rises (60/40)
o Special cuffs/ charts needed for different ages
• Falling blood pressure is a late sign
o Relatively maintained cf. adults
• Bradycardia (<60) indicates life threatening pathology (but may be seen in anorexia)

133
Q

why are babies more susceptible to infections

A

weaker immune system

134
Q

what are some circulation changes form in-uter to ex-utero

A

o PDAs/ PFO may remain open for several months

o Pulmonary pressure has to fall to allow PFO to close

135
Q

what is a babies HR

A

150bpm then drops with age

136
Q

what is a babies blood pressure

A

60/40 - slowly rises

137
Q

if a childs HR <60 what is this

A

severe bradycardia

138
Q

do babies have a higher oxygen consumption than adults

A

yes - higher metabolic rate

high repspiriaty rate

139
Q

why is the oxygen dissociation curve left in babies

A

HbF predominates

140
Q

why is apnoea more common in children

A

response to colds nd viral infections

141
Q

what about a babies breathing makes them tire easily

A

diaphragm - fewer type 1 slow twitch fibres

142
Q

are 90% O2 sats normal in a baby

A

yes

143
Q

what is the most likely cause of a bilateral wheeze with no crepitations

A

viral induced wheeze

144
Q

what is a infants respiratory and heart rate

A

HR - 110-160

RR - 30-40

145
Q

what is a pre school childs HR and RR

A

HR - 95-140

RR- 25-30

146
Q

what is a primary school childs HR and RR

A

HR - 80-120

RR - 20-25

147
Q

what is the treatment for viral induced wheeze

A

multi-dose salbutamol

148
Q

what is the commonest cause of death from 5-50

A

trauma

149
Q

why are children more at danger for accidents

A

can’t process audio-visual cues, can’t read written warnings, climbing, inquisitive nature, playing, risky behaviour

150
Q

list some fractures that are exclusive to children

A

buckle fracture of distal radius
toddler fracture of tibia
greenstick fracture
growth plate/ epiphyseal injuries

151
Q

what are the 2 most common fractures in childhood

A

buckle fracture of radius

clavicle fracture

152
Q

how is a buckle fracture of the distal radius obtained

A

fall onto outstretched hand

153
Q

what makes the clavicle heal better

A

membranous calcification

154
Q

what is different about xray the clavicle for a fracture

A

only need 1 view

155
Q

how are toddlers fracutre of tibia obtained

A

torsional force applied to tibia, start walking, fall, and twists ankle, tibia tender

156
Q

are burns a cause of acute shock

A

no - look for other cause

157
Q

what makes the fact that children are smaller more susceptible to more serious injuries

A

Relatively greater amount of energy is absorbed for the same force of impact

158
Q

why is heat loss from an injury more significant in children

A

Large surface area:volume ratio

159
Q

what features of the childs skelton makes it more susceptible to injury

A

Incompletely calcified – Soft, Springy, Deforms rather than breaks, Poor at absorbing energy, Provides less protection for vital organs e.g. liver and spleen (bounce and squish)

160
Q

why are children more susceptible to shearing and de-gloving

A

less elastic tissue

161
Q

why does hypoglycaemia develop earlier in children with an injury

A

injury increases metabolic demands

exacerbated by hypothermia

162
Q

what is meant by the first peak of deaths after trauma

A

¬ Die instantaneously or at the scene

¬ Usually due to un-survivable major vessel & brain injury

163
Q

what is meant by the second peak of deaths after trauma

A

¬ Die from significant ABCD problems unless adequately resuscitated
λ “Platinum ten minutes” – life threatening trauma and not trapped > hospital
λ “Golden hour” – adequate resuscitation, belongs to the patient

164
Q

what is meant by the third peak of deaths after trauma

A

¬ Delayed deaths despite resuscitation, surgery & intensive care
λ Multi-organ failure
λ Sepsis

165
Q

what is different about resuscitation after major trauma

A

catastrophic haemorrhage control – tourniquets, haemostatic dressings, direct pressure, elevation

166
Q

how do you manage a major trauma

A

cABCDE: catastrophic haemorrhage control – tourniquets, haemostatic dressings, direct pressure, elevation
Airway with C-spine – remember O2! -
Breathing with Ventilation
Circulation with Haemorrhage Control
Disability – neuro assessment, preserve spinal cord
Exposure/Environment
Don’t Ever Forget Glucose!

167
Q

what is meant by the 1st and 2nd degree survey after a trauma

A

1st - identify and deal with immediate threats to life

2nd - full body analysis

168
Q

why is it difficult to recognise drug interactions in children

A

children struggle to report side effects

169
Q

why is it difficult to prescribe for children

A

lack of accurate dosage data, appropriate formulations

effects on growth and development may be unknown

170
Q

what are off label medicines in paediatrics

A

licensed for human use but not for use in children below a certain age such as 16 or18 years.

171
Q

why are neonates more sensitive to drugs that adults

A

organ system immaturity

greater variation

172
Q

do infants have more or less albumin than adults

A

less

increased free drug

173
Q

do infants have reduced or increased hepatic metabolism

A

reduced

174
Q

do infants have reduced or increased renal elimination

A

reduced

175
Q

what effect do fever, acidosis and dehydration have on sensitivity to drugs

A

increased sensitivity

176
Q

what is the difficulty in prescribing drugs to adolescents

A

Sexual development produces major changes in in body size and composition which affect drug metabolism
hormone secretion

177
Q

what makes adolescents difficult to prescribe for

A

less compliant

take alcohol, drugs , smoke

178
Q

what SSRI should not be used in children

A

paroxetine

associated with a 4x increase in suicide

179
Q

why do anti-epileptic drugs need to be a high dose in younger children than adults

A

hepatic metabolism rapid

half life shorter

180
Q

what policy is used to report side effects in children

A

yellow card policy

181
Q

when are adult levels or gastric acid and gastric emptying levels reached

A

3 years

careful in oral drugs

182
Q

are topical drugs metabolism enhanced or dampened in children

A

enhanced

183
Q

when are rectal medicines used in children

A

vomiting or unwilling to take oral medication

avoids first pass metabolism

184
Q

what makes the distribution of drugs different in infants

A

have high extracellular fluid volume of 45%.
Total body water is high 75-92%.
high fat content 12%

185
Q

why is there greater unbound/ active drug in neonates

A

plasma protein binding reduced

186
Q

why are infants really sensitive to CNS toxicity

A

undeveloped blood-brain barrier

187
Q

why is consideration of renal function important in neonates

A

decreased excretion

for most drugs t1/2 prolonged

188
Q

why is hepatic metabolism of drugs slow in neonates

A

immaturity of enzymes

Oxidation and glucuronidation are reduced

189
Q

what is a good way to know the weight of a child < 1 year

A

(0.5 x Age in months) + 4

190
Q

what is the average birth weight

A

3.5kg

191
Q

what is a good way to know the weight of a child 1-5

A

(2 x age) + 8

Paediatrics (3 decks)

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