At what age is handedness ususally established?
- Handedness is usually established by 3 years of age.
- Developing handedness before 18 months indicates weakness or hypotonia on the less dominant side which may be an early sign of CP.
What is the mechanism of action in phototherapy?
- Structural isomerisation to lumirubin (non-reversible) which is more polar and soluble than bilirubin and therefore readily excreted in to bile and urine without conjugation.
- Photoisomerisation to a less toxic bilirubin isomer (reversible) which is also more soluble and able to be excreted in bile.
- Photo-oxidisation to polar molecules which are excreted primarily in the urine is a very slow process.
What is the average weekly weight gain from birth to 3m?
- 200g (30g/day).
- Drops to 20g/day at 3 months.
- Infants up to 3m of age require 115kcal/kg/day to grow.
How do you calculate corrected Na?
- Corrected Na = Measured Na + (0.3x [measured gluc - 5.5])
Hos do you calculate a GCS?
- > 2y.
- EMV.
- Eyes: Spontaneous (4), to voice (3), to pain (2), no response (1).
- Motor: Obeys commands (6), localises to pain (5), flexion withdrawal (4), abnormal flexion (3), extension (2), no response (1).
- Voice: Orientated (5), confused (4), inappropriate (3), incomprehensible (2), no response (1)
What are risk factors for abusive head trauma?
- Unmarried single mothers associated with greatest risk.
- Young maternal age also associated.
- Short interpregnancy interval.
- Decreased gestational age.
What factors are not found to increase the risk of abusive head trauma?
- Maternal drug and alcohol use.
- Medical or psychiatric history.
- Smoking.
- Socioeconomic status.
What is a macule?
- Circumscribed flat area, recognisable by colour variation from surrounding skin <1cm.
What is a patch?
- Large macule >1cm.
What is a papule?
- A circumscribed elevation <1cm.
What is a plaque?
- A well circumscribed, elevated, superficial, solid lesion >1cm.
What is a nodule?
- A circumscribed solid elevation >1cm.
How do you estimate the correct sized ETT tube?
- Under 8 use uncuffed.
- (Age + 16)/4
What is pellagra?
- Vitamin B3 (niacin) deficiency.
- Diarrhoea, dermatits, dementia and dilated cardiomyopathy.
What is acrodermatitis enteropathica?
- Zn deficiency.
- Perioral and perianal rash.
What is the most important factor influencing prognosis in ASD after intellect?
- Functional speech.
- Level of verbal communication and IQ before 5y are the strongest predictors of outcome.
What predictors at 3-5y are associated with more severe ASD at 8-10y?
- At 3-5y, more severe preoccupations with parts of objects, sensory interests and stereotyped motor movements predict less developed cognitive and adaptive skills, and greater ASD symptom severity at 8-10y.
- What percetage of cases of hearing loss are syndromic?
- 30%.
What are the most common syndromic causes of hearing loss?
- Usher and Pendred syndrome.
What are features of Pendred syndrome?
- Most common AR form of sensorineural hearing loss.
- Also present with thyroid abnormalities.
What are features of Waadenburg syndrome?
- Sensorineural hearing loss and and pigmentation abnormalities.
- WS type 1 has the added feature of dystopia canthorum,
- WS3 has skeletam abnormalities of the upper lims and WS 4 is associated with Hirschsprungs.
What gene mutation is associated with atopic dermatitis and alopecia areata?
- FLG (profilaggrin).