[OSCE] General Paeds Flashcards
(125 cards)
1
Q
What are the features of ADHD?
A
IHI
Inattention - short attention span with difficulty concentrating in class
Hyperactivity - unable to sit still for long periods, fidgeting
Impulsiveness - unable to wait in turn and little sense of danger
2
Q
What is the criteria for ADHD?
A
Symptoms persisting >6months, Occuring in more than one environment (home, school, shopping), and affects childs normal functioning
3
Q
What are the risks that affected children with ADHD have?
A
Prone to unprovoked temper tantrums
Reckless behaviour
Learning difficulties
4
Q
What are the classical features of cerebral palsy?
A
Abnormal posture (slouched while sitting) Unsteady gait (scissoring, toe walking) Facial gestures (involuntary movements) Movements appearing clumsy
5
Q
What are the features of cystic fibrosis?
A
CF PANCREAS
Cough (chronic)
Failure to thrive
Pancreatic insufficiency Appetite decreased Nasal polyps Clubbing Recurrent chest infections Electrolyte elevation in sweat, salty skin Atresia of vas deferens (infertility) Sputum (staph, pseudo)
6
Q
What are the common causative pathogens of Bronchiolitis?
A
RSV
7
Q
What are the symptoms of croup?
A
Mnemonic of croup symptoms - Three S’s
Stridor
Subglottic swelling
Seal-bark cough
8
Q
What are the common causative pathogens of croup?
A
Parainfluenza
9
Q
What are the features of acute severe asthma?
A
Child too breathless to speak or feed . RR >40 (1-5yrs) or >30 (>5yrs) HR >140 (1-5yrs) or >125 (>5yrs) PEFR 33-50% of best predicted value
10
Q
What are the features of life-threatening asthma?
A
Agitation (hypoxia) Reduced consciousness (hypercapnia) Fatigue or exhaustion Silent chest, cyanosis, poor respiratory effort PEFR <33% of best predicted value
11
Q
What are the features of epiglottitis (a life-threatening condition) that differentiate it from croup?
A
Rapid onset (hours) vs Slow (days) Absent/weak cough vs Seal-Bark Drooling vs Able to swallow Unable to eat (pain) vs Able to eat Weak whispering voice vs Hoarse voice Soft continuous stridor vs Harsh INSpiratory stridor
12
Q
In what situation may you not perform an ENT examination and why?
A
In suspected Upper Airway Obstruction due to increased distress and breathlessness. In epiglottitis this can lead to Acute Sudden Airway Obstruction
13
Q
What is the most common causative organisms of epiglottitis?
A
H.Influenza (therefore epiglottitis tends to be very uncommon due to vaccinations early on)
14
Q
What position may a child with epiglottitis assume as a way of relieving some of the symptoms?
A
Leaning forward
Neck extended
15
Q
Which causes of upper airway obstruction onset very suddenly and require emergency management/intubation?
A
Epiglottitis
Bacterial Trachitis
Foreign Body Aspiration
16
Q
Which causes of upper airway obstruction results in drooling on attempts to swallow?
A
Epiglottitis
Bacterial Trachitis
17
Q
Name an anatomical cause of upper airway obstruction that presents from birth?
A
Laryngomalacia
18
Q
What is the triad of features found in anaphylaxis?
A
Hypotension (pallor)
Bronchoconstriction (wheezy)
Airway compromise (lip swollen)
19
Q
What type of gait may you see in cerebellar diseases?
A
Wide base / ataxic gate
20
Q
What type of gait may you see in cerebral palsy?
A
Hemiplegic CP - Hemiplegic gait
Spastic CP - spastic diplegic gait
21
Q
What are the precipitating factors for an acute asthma attack?
A
The DIPLOMAT’s son had asthma
Drugs (NSAIDs, Beta Blockers, Aspirin) Infection (URTI, LRTI) Pollutants (smoking, gas) Laughter (emotion) Oesophageal reflux (nocturnal asthma) Mites Activity and exercise Temperature (cold)
22
Q
What is the prognosis for children with asthma?
A
1/3 grow out of it
1/3 improve during teens but returns at adults
1/3 continue to have it whole life
23
Q
What is the definition of cerebral palsy?
How may you say this to a patient?
A
Disorder of TONE, POSTURE and MOVEMENT caused by a NON-PROGRESSIVE lesion in the brain
Cerebral palsy is the name for a group of lifelong conditions that affect movement and co-ordination, caused by a problem with the brain that occurs before, during or soon after birth.
24
Q
How, and at what age, may pyloric stenosis typically present?
What are the complications?
A
2-7 weeks
Projectile vomiting, no bile
Extremely large volumes
Hungry after vomiting
No diarrhoea
Complications
- Constipation (starvation stools)
- Dehydration
- Failure to thrive
25
How would you investigate and manage pyloric stenosis?
ABCDE
Ensure Obs stable. Take U&Es, LFTs, FBC
Do a PEWS score.
Test-feed, observe LUQ peristalsis during feed
Examine olive-shaped mass in epigastrum
USS to confirm
Manage:
Rehydrate with IV fluids
Pyloromyotomy
26
What are the typical features of GORD?
Recurrent regurgitation related to feeds
Relieved by sitting up
Distressed after feeds - feeding / behavioural difficulties
Apnoea
27
Name two risk factors for GORD?
Premature delivery
| Cerebral Palsy
28
Investigation and management for GORD?
Investigation
- ABCDE, ensure alert
- History and examination should point towards GORD and be sufficient
Management
- Rehydrate
- Reassurance
- Avoid overfeeding (common cause)
- Drugs: Infant gaviscon (Na/Mg alginate)
29
What age does intussucception typically present?
What are the typical signs and symptoms in both early and late intussucception?
Typically 5-10 months (m:f = 3:1)
Episodic cockily abdominal pain (every 10-20min)
Drawing knees to chest
Insolable cry
Early
- Vomiting which rapidly becomes bile-stained
Late
- Mucus and Blood PR
- Red currant jelly
30
How would you investigate and manage a patient with intussucception?
Investigation
- abdominal exam may reveal sausage shaped mass
- USS
- Ensure to take bloods, FBC, U&E, LFTs, Crossmatch
Management
- Air enema if diagnosed early
- Surgery otherwise
31
What age may coeliac present?
What are the typical signs and symptoms?
~4-6 months, around when they begin weaning
```
Pallor
Steatorrhoea
Vomiting
Abdominal distension
Failure to thrive
```
32
How may you investigate coeliac disease?
What is the management?
IgA tTg, anti-gliadin, endomysial antibodies
Villous atrophy on small bowel biopsy
Lifelong gluten-free diet
33
What are the typical signs and symptoms of meningitis?
```
Vomiting - not taking foods
Fever, irritable, lethargic
Non-blanching purpuric rash
Cold extremities (sepsis)
Signs of raised ICP (bulging fontanelle)
```
34
What is the management of bacterial and viral meningitis?
Bacterial - Abx (benzylpenecillin IM first, then Cefotaxime IV)
Viral - Antipyretics and analgaesia in viral
Dont forget, always IV fluids in every situation where fluid has been lost!
35
What investigations would you do in suspected meningitis?
```
Neuro exam
Look for rash
CT head if suspected raised ICP
LP
Blood cultures
Blood glucose (DEFG!)
```
36
What are the typical features in the history of a child with gastroenteritis?
Diarrhoea and vomiting
Fever, irritable and unwell
(similar to meningitis at this point)
History of recent TRAVEL
There will be someone else in the family or school with similar symptoms!
37
What is the recommended imaging modality to investigate UTI?
USS
Can view with good specificity, detect scars
38
What investigations would you do in a child presenting with vomiting, giving reasons for each.
Bedside
- Physical exam
- Neuro exam (meningitis; rash, neck stiffness etc)
- LP (meningitis)
- USS (pyloric stenosis, bowel obst, intussuception)
- Stool sample
Bloods
- U&E (dehydration)
- Antiendomysial/Antigliadin autoantibodies (coeliac)
- Cultures (meningitis)
- Glucose (DKA)
Ix
- CT / MRI of abdomen
- CT head (raised ICP / SoL)
39
What symptoms would point towards CF in paediatrics?
Recurrent Chest Infections! (productive cough)
Diarrhoea
Failure to thrive
Nasal Polyps
Delayed puberty
40
What are the organic and non-organic aetiologies for a child with a failure to thrive?
Organic PIMM
- Prenatal
- Intake issues
- Malabsorption
- Metabolic
Non-Organic CI
- Constitutional delay
- Inadequate feeds
hint: Organically the problem has to be either the mothers (prenatal), or a problem with them i.e. eating (intake), absorbing (malabsorption) or using whats absorbed (metabolic). Non-organically it has to either be fate (constitutional delay) or bad luck (no being fed).
41
what are the prenatal causes of failure to thrive?
```
Premature
Maternal nutrition
Congenital infection
IUGR
Toxins (alcohol, smoking)
```
42
what are the causes of intake issues that results in a failure to thrive?
Can't suck or swallow (NMD such as cerebral palsy)
Cleft palate
GORD / vomiting after feeds
43
what are the causes of malabsorption resulting in a failure to thrive?
CF (with URTI, productive cough)
Coeliac (diarrhoea)
IBD
Cow's Milk Protein Intolerance
44
what are the metabolic causes of a failure to thrive?
either poor metabolism or increased demand
Poor metabolism
- Hypothyroid
- Diabetes
Increased demand
- Asthma
- Heart failure / renal failure
45
what are some causes of inadequate feeding that results in a failure to thrive?
```
Neglect / Lack of knowledge
Underfed or infrequently fed
Distracted during meals
Poor technique
Bottles not made up properly
Problems in home environment
```
46
What investigations would you perform in a child presenting with a failure to thrive?
Bedside
- Plot height and weight on growth chart
- Full system examinations (murmurs, wheeze, bowels)
- MSU for diabetes, infection, renal problems (culture)
- Stool culture for ova / parasites / cysts
- Faecal fat for malabsorption
- Sweat test
Bloods
- FBC, U&E, TFT, LFT, Glucose, CRP
- Antiendomysial & Antigliadin autoantibodies
47
What are the steps involved in sepsis 6?
3 in, 3 out
in
1. IV fluids
2. BS Abx
3. Oxygen
out
1. Cultures
2. ABGs (lactate)
3. Urine output (catheter)
48
What type of seizures are febrile convulsions?
What age range do they tend to affect? How long do they usually last?
Tonic +/- clonic, symmetrical, generalised seizure
Affects those between 6 months - 6 years, lasting <6 minutes
49
What sign/symptom/detail should alert you to an alternative diagnosis of febrile convulsions?
Signs of CNS infection / meningism / neck stiffness
Focal neurological deficit
Previous history of epilepsy
>15 minutes or >1 attack in 24h
50
How may you Rx a child having a febrile convulsion?
How would you advise the parent about a child having febrile convulsions?
Recovery position
If >5m IV lorazepam / buccal midazolam / PR diazepam
Tepid sponging if hot
Paracetamol syrup
Parents
- Allay fear (child is not dying during a fit)
- Does not usually mean ^risk of epilepsy
- If recurrances, teach buccal / PR benzodiazepines
- -Consider prophylactic PR diazepam during fevers
51
What investigations would you consider in any patient convulsing regardless of aetiology?
Bedside
- Neuro examination (kernig's & brudzinski's)
- Look for rashes
- Inspect frontonelle
- LP & blood cultures if suspected meningitis
- ECG (arrhythmias)
Bloods
- FBC
- U&E
- LFT
- Glucose (hypoglycaemia)
(EEG, best done during seizure)
52
What are the features of a reflex anoxic seizure?
How long does it last?
What type of seizure is seen?
Describe in a before/during/after fashion
Before
- Paroxysmal
- Triggered by pain / fear / anxiety
During
- <1 minute
- Pale, limp, LoC brief
- Involuntary tonic +/- clonic movement of limbs
After
- Incontinence
- Groggy
53
What is a differentiating feature between reflex anoxic seizure and epilepsy?
Tongue-biting is NOT a feature of Reflex Anoxic Attacks
also...
Much shorter, triggered by vagal stimulation
54
How may you educate a parent about reflex anoxic attacks, its danger and its prognosis?
Try avoid the word seizure
Emphasize benign nature and that child usually grows out of it (but may occur in later life, and in older siblings)
55
What is a breath-hold attack?
Similar to reflex anoxic attack
Precipitated by emotion (anger, frustration, trauma)
Crying episode, breath withheld, pallor and cyanosis may develop
LoC may occur, recovery is usually very quick!
56
What are some risk factors and precipitants for epilepsy?
RF: Birth asphyxia, cerebral palsy, trauma
Precipitants: TV, lack of sleep
57
What is the difference between simple and complex seizures?
Simple - No LoC
| Complex - impaired Level of Conciousness
58
How may partial and generalised epileptic seizures differ in presentation?
Partial; depend on the area of cerebrum affected
- Deja Vu
- Paraesthesia down one limb
- -lasts up to a few minutes
Generalised; whole cerebrum
- Absence (last up to 2-3 seconds)
- tonic-clonic (last up to 2-3 min)
59
What medication is reserved for partial and generalised epileptic seizures?
Partial - Sodium Valproate
Generalised - Carbamazepine
hint: Sodium-Valproate is 2 part name for a drug.
60
At what age should hand preference be acquired and what may a preference before this indicate?
Should NOT be acquired until 1-2 years old
Before this implies pathology present e.g. cerebral palsy or other
61
How many words minimum should a child of 2 years old be able to speak?
6 words minimum
Normally 20-50
62
What additional features would be present for cerebral palsy to be the aetiology of motor development delay?
Learning difficulty
| Epilepsy
63
What are the causes of cerebral palsy?
Antenatal / perinatal / post-natal
Causes are usually in the antenatal period
antenatal
- APH with hypoxia
- TORCH
- Alcohol
- X-Rays
perinatal
- Birth hypoxia
- Fetal distress
- Hypoglycaemia
- Hyperbilirubinaemia
post-natal
- head trauma / IVH
- Meningoencephalitis
- Hypoxia
64
What inheritance patter does DMD follow?
X-Linked recessive
Affects boys only
65
What features are seen in DMD?
Delayed achievement of motor milestones
Waddling gait
Global delay possible
Gower's sign - child climbs up legs with hands to stand up
66
What are some metabolic causes of delayed motor development?
What features would point you towards either diagnosis?
Ricket's
- Low Vitamin D
- Inadequate sunlight exposure
- Calcium deficiency
- Bony deformities (bow legs)
- Family history
Hypoglycaemia
- Tiredness
- Lethargy
67
What is a common cause of hearing difficulty in childhood?
What are the other symptoms of this?
Otitis media
```
Otalgia
Irritability
Decreased hearing
Vomiting or fever
Ongoing viral respiratory infection
```
68
What are some causes of speech and language development?
New Hearing Aids Cured Larry's Deafness
```
Normal variation
Hearing difficulties (otitis media)
Autistic
Cleft palate
Learning difficulties
Deprivation and neglect
```
69
What are some features of autism?
Impaired reciprocal social interaction and communication
Repetitive behaviour
Playing in isolation
Delayed / lack of speech development with no other forms of communication such as miming or gesturing used in its place
70
What other features would make you suspect CF in a child presenting with a cough?
Recurrent chest infections?
Productive cough
Wheeze
Failure to thrive
Mecomium ileus (neonate)
Diarrhoea and steatorrhoea due to malabsorption
71
What inheritance pattern does CF transfer by?
Autosomal Recessive
72
What extra features / precipitating in a cough history would suggest to you asthma as the diagnosis?
Diurnal variation
Wheeze
Family history / personal history of atopy
Precipitated by cold weather, exercise, pets, cigarette smoke
Responds well to bronchodilators
73
What signs would indicate a severe bronchiolitis infection?
Fewer wet nappies
Poor feeding
Grunting sounds
74
What is the step ladder approach to asthma in children?
Avoid triggers or allergens
Inhalers: SABA > ICS > LABA > Leukotrine antagonist
75
What are the typical features of pertussis?
Initially sore throat, dry cough, coryzal symptoms
Intense bouts of coughing 1-2 minutes
Cough - Whoop - Cough - Whoop
Red or blue in the face
Vomiting after bouts
76
What investigation should be performed in a patient suspected of pertussis?
Perinasal swab
77
Investigation for bronchiolitis
Nasopharyngeal mucus secretion analysis
78
Investigation for asthma
PEFR if child capable (usually >7)
| Reversible airway obstruction
79
What are the typical signs and symptoms of epiglottitis?
```
Drooling
Dysphagia
Dysphonia
Dyspnoea (rapidly increasing!)
Soft stridor
Severe sore throat
Feverish and very unwell
```
80
What investigation is performed for patients suspected of epiglottitis?
How is a patient with epiglottitis managed?
Fibre-optic laryngoscopy in theatre
Involve senior paediatrician and anaesthetist
Start broad spectrum Abx e.g. cefotaxime
Likely will need intubation
81
What are the symptoms of ADHD?
IHI
Inattention - short attention span with difficulty concentrating in class
Hyperactivity - unable to sit still for long periods, fidgeting
Impulsiveness - unable to wait in turn and little sense of danger
82
What is the criteria for symptoms in ADHD?
What age range does it usually affect?
Symptoms must be present for >6 months across atleast 2 different environments (home and school)
Usually affects children aged between 3-7
83
What are some risk factors for autistic spectrum disorder?
Gestational age <35 weeks
Family history
Chromosomal disorders
Cerebral palsy
84
What investigations should be performed in any child with behavioural problems?
Physical exam to rule out medical causes
Hearing assessment to rule out hearing problems
Speech and language assessemt if developmentally delayed
MDT observing child in different settings
85
What is the management of ADHD?
Behavioural modification
Family therapy
Parent education
Methylphenidate can be used in moderate-severe cases
86
What is the management of autism?
Behavioural modification
SALT
OT
TEACHH (treatment and education of autistic and communication-related handicapped children)
87
What is the classical tetrad of HSP?
Hint: PAAG
PAAG
```
Purple pupura (non-blanching intradermalbleeding)
Abdo pain (cockily intussusception)
Arthritis/arthralgia (joint pain)
Glomerulonephritis (haematuria)
```
*commonly preceeded by an URTI, also bruising present
May also see blood in stool, haematuria, scrotal swelling
No history of fever
88
Where on the body may bruisings be evident in HSP?
Where on the body may rashes / pupura be predomintantly seen?
Bruising on extensor surfaces of lower limbs and buttock
Palpable Purpuric rash predominantly or exclusively on areas below the wasit
89
What features would point towards a diagnosis of luekemia?
Pancytopaenic symptoms (pallor, infection, bleeding, bruising)
Mucosal Bleeding
Lymphadenopathy
Hepatosplenomegaly
Fatigue
Anorexia
Bone pain
90
What other bleeding / bruising disorder may present similar to HSP, also with a preceeding URTI?
ITP
91
What are the symptoms / signs of ITP?
Acute bruising
Pupura and pitechiea
Recent URTI or GI enteritis
[Arthralgia and abdo pain are uncommon in ITP, platelets are low in ITP but normal in HSP]
92
What investigations should you perform in suspected HSP?
```
Dipstix for blood and protein
BP (renal impairment)
U&E kidney function
Group A strep infection
Platelet count (if low then >>> ITP)
Stool sample (FOB vs Infection)
```
93
What is the treatment for HSP?
Self limitting, no treatment usually required appart from analgaesia for joint pain.
Most recover in <2 months
Steroids may help resolve abdo/joint pain + reduce kidney damage
If complications (gut/renal involvement), supportive therapy may be necessary)
94
How may you conselle a mother on treating nappy rash?
Using water and cotton wool instead of baby wipes (which may contain alcohol or other irritating products)
Using barrier creams such as zinc oxide
Exposure to the air (leave nappy off)
Candida responds to antifungal creams. Groin and mouth may both need treatment.
95
What are the triadic features of autism?
Social - Plays alone, fails to make eye contact, doesnt come for comfort when hurt or upset
Communication - never babbled or spoken intelligble words
Ritualisitic - Has marked routines which produce violent temper tantrums if disrupted
96
What features would suggest CHD?
```
Murmur at birth
Sweating
Poor feeding
Cyanosis
2 days old (PDA closes within hours/days of age suggesting duct-dependent lesion)
```
97
What investigations would you perform in suspected CHD?
ECG
Echo
CXR - cardiomegaly, oligaemic/plethoric lung fields, signs of LTRI
Blood gas - oxygen, lactate, acidosis
98
What may you administer IV to maintain PDA patency?
IV Prostoglandin E2
99
What are the contraindications for giving an LP?
Signs of cerebral herniation
Focal neurological signs
Cardiorepiratory compromise
100
How may you counselle and safety net a mother worried about her child who has a typical tummy bug / gastroentiritis?
Self limiting
Will resolve in around 2 weeks
Keep hydrated with fluids and dyarolyte sachet
Watch for signs of dehydration such as
- Sunken eyes and glazed look
- Mottled skin
- Strong-smelling urine
- Dry mouth
101
What does the MMR vaccine protect against and what is a serious complication of these infections?
Measles, Mumps and Rubella
Meningitis, encephalitis, deafness
102
What age of the child is the MMR vaccine given?
1st dose - After 1st birthday (1 year old)
2nd dose - Before starting school (3 years old)
Optional dose - high risk / measles outbreak (6-9 month)
103
How long should a lady avoid getting pregnant for after having an MMR vaccine?
What is a serious complication of a Rubella infection on pregnancy?
Can a woman have the MMR if she is already pregnant?
Wait 1 month before getting pregnant
Rubella carries risk of serious birth defects and miscarriage
If already pregnant, can NOT have the MMR. Must avoid exposure to infections. Contact Dr if exposed.
104
What are the side effects of the MMR?
Can I have a single M / M / R vaccine rather than the combined MMR?
3in1 therefore will have different side effects onsetting at different times.
Weakened version of the live vaccine means very mild symptoms experienced.
A week after injection, very mild form of measles (rash, temperature, LoA, malaise) lasting 2-3 days.
3-4 weeks after injection, rarely may develop very mild form of mumps (swelling of glands, cheek, neck, under jaw) lasting 1-2 days.
105
How may a muscular dystrophy present and what investigation would you order to investigate further?
Delay in walking until 18 months of age
- toe walking
- calf hypertrophy
- hip muscle weakness
Investigate: ↑↑↑CK, genetic testing, muscle biopsy (no dystrophin)
106
What is the management for DMD?
Mobility assistance - exercise, physio, physical aids
Support groups - practical and emotional impacts
Surgery - correcting deformities such as scoliosis
Medication - steroids to improve muscle strength, ACEi and B-Blockers for heart problems
107
What vaccinations are given in the first 6 months of life?
2 months - 6in1 + Rota + Pneumococcal + MenB
3 months - 6in1 + Rota
4 months - 6in1 + Pneumococcal + MenB
6in1: Diptheria, Tetanus, Polio, H.Influenzae, Hep B, Pertussis
108
What type of condition is HSP?
Immune mediated vasculitis associated with IgA deposition
Complexes deposited in skin, gut, glomeruli triggering localised inflammatory response and necrosis of small blood vessles
109
What is the most common infectious trigger for HSP?
URTI with a group of bacteria called Group A Strep
110
What are some complications of HSP?
Most people have no complications, however in some who do develop them, you may find
1. Kidney involvement - nephritis (inflammation)
2. Bleeding in gut - Intussusception
3. Orchitis - inflammation of testicles causing pain, swelling and redness of scrotum
111
What are the risk factors for SIDS?
```
Prone position at last sleep
Bed sharing
Formula fed
Premature
Low birth weight
Exposure to cigarette smoke
Maternal cigarette smoking, alcohol and drug use
```
112
What are the reccommendations for reducing risk of SIDS?
```
Sleep on back, alone in basket in same room, without blanket, foot to feet
No cigarette smoke exposure
Breastfeed
Firm flat mattress
Room temperature of 16-20 Degree C
```
113
What causes SIDS?
Unknown but thought to have a problem in the way they respond to stresses and how they regulate their heart rate, breathing and temperature
114
What are some physical features of down's syndrome?
1. Floppiness (hypotonia)
2. Eyes slanting upwards and outwards
3. Small mouth with tongue sticking out
4. Flat back of head
5. Low birth weight and birth length
6. Single palmar crease
115
What developmental delays and co-morbid conditions are common in down's syndrome?
Learning disability. Delay in achieving milestones. Will take longer than normal. Varies across population and from child to child.
```
1/10 will also have autism or ADHD
Heart (septal defect), bowel problems
Hearing and visual difficulties
Greater risk of infection (pneumonia)
Hypothyroidism
```
116
What tests are offered if there is suspicious findings on nuchal scanning?
CVS at 11-14 weeks - small sample of placenta tested
Amniocentesis at 16-20 weeks - sample of amniotic fluid tested
117
What support is available for children with downs syndrome?
Good access to healthcare - range of specialities and doctors
Support for development - SALT, Physio, home teaching
Support groups - Downs Syndrome Association, other familities with children with down's
118
How can a parent help their child with Down's Syndrome?
Using play - show them how to play with toys, to encourage them to reach, grasp and move
Naming and talking about things the child is looking at or interested in
Providing opportunities to mix with other children
Encouraging independance early as possible with things like feeding, dressing, making bed, brushing teeth, going toilet
Playing games to teach new words (SALT or home tutor can give ideas)
Remember to have fun, not all activities have to be purposeful or meaningful, any activity is beneficial
119
What regular health check-ups will a child with down's syndrome require?
Hearing and vision tests
Height and weight
Blood tests for thyroid problems
Checking for signs of heart problems
Regular appointments with paediatrician
120
What finding is present on CXR of a child with ToF?
Boot-shaped heart
121
What are the 4 defects found in ToF
1. pulmonary artery stenosis
2. RVH
3. VSD (R>L shunt due to RVH)
4. Aorta overides septal defect
122
What is the most common cause of CYANOTIC CHD?
ToF
123
What are the features of ToF in a baby?
Cyanosis of lips and fingers
Feeding difficulties
Failure to thrive
124
What are the triadic features of Fetal Alcohol Syndrome?
1. Growth restriction
2. Facial abnormalities
3. CNS dysfunction and learning disabilities
also cardiac defects > VSD (holosystolic murmur)
125
What are the triadic features of Fetal Alcohol Syndrome?
1. Brain - CNS dysfunc + learning disability
2. Body - growth retardation and restriction
3. Face - facial abnormalities
