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Flashcards in Others Deck (11):
1

What is the most common cause of death in children aged 1 month to 1 year?

Sudden infant death syndrome (SIDS)
- "Cot death"

2

What are some preventive measures/advice to give to parents to avoid SIDS?

- Supine sleeping position
- Avoid co-bedding
- Avoid smoking in the house
- Avoid over-heating
- Feet-to-foot position while sleeping
- Blanket not covering head

3

What is the peak age for SIDS?

2-4 months

4

What is the peak age of accidental poisoning in children?

30 months

5

How do one manage a child with suspected poisoning?

1. Identify the agent.
2. Identify the toxicity of the named agent.
3. Decide if removal of the poison is indicated by
>> Activated charcoal: most effective
>> Gastric lavage: rarely used in children
>> Induced vomiting with ipecac
>> Little evidence this works if presentation is at more than 1 hour of ingestion
4. Investigations
>> BG for alcohol
>> Blood levels for:
- Alcohol
- Paracetamol
- Salicylates
- Iron
- Digoxin
>> Toxicology screening
5. Clinical management
>> Admission
>> Specific antedotes
6. Assess social circumstances

6

What are the features of non-accident injuries/physical child abuse?

Fractures
- In a non-mobile child
- Rib fractures
- Spiral fractures
- Multiple fractures of different ages

Bruising
- The shape of a hand or any object
- Around the wrists suggesting ligatures
- Around the neck suggesting strangulation
- On the buttock of a child > Look out for retinal hemorrhages and intracranial/subdural hemorrhages

7

What are the advantages of breast-feeding?

For the infant
- Ideal nutrition for infants in the first 4–6 months of life
- Reduces the risk of gastrointestinal infection, and, in preterm infants, of necrotising enterocolitis
- Enhances mother–child relationship
- Reduces risk of insulin-dependent diabetes, hypertension and obesity in later life

For the mother
- Promotes close attachment between mother and baby
- Increases the time interval between children
- Possible reduction in premenopausal breast cancer

8

What is the most common nutritional disorder affecting children and adolescents?

Obesity

9

How do we define obesity in children?

>91th centile: overweight
>98th centile: obesity
>3.5SD: very severe obesity
>4SD: extreme obesity

10

What are the causes of obesity in children?

Exogenous
- Over-eating

Endogenous
- Hypothyroidism
- Cushing's syndrome
- Syndromal causes: Prader Willi syndrome (look for hypotonia, hypogonadism and dysmorphic facies with almond-shaped eyes and fair complexion)
- Leptin deficiency (> Over-eating children with obesity are typically also taller due to over-nutrition.
>> Short obese patients should be investigated for endogenous causes.

11

What are the complications of obesity?

Orthopedic
- Slipped capital femoral epiphysis
- Tibia vara
- Feet abnormalities

Metabolic conditions
- Type II DM
- Hypertension
- Abnormal lipid profile

Other medical conditions
- Idiopathic intracranial hypertension
- Polycystic ovarian syndrome
- Gallbladder disease

Psychosocial
- Low self-esteem
- Depression