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Health and Society Year 4 > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

Define preterm birth

A

Less than 37 weeks

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2
Q

Epidemiology of preterm birth

A

8/100 babies

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3
Q

5 risk factors for preterm birth

A

Hx preterm labour, Smoking, Age, PROM, TVUS

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4
Q

6 signs of preterm birth

A

regular contractions, period pain, show, water breaking, back-ache, cervical dilation

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5
Q

4 investigations for preterm birth

A

VE, blood test, urine test, CTG

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6
Q

6 consequences of preterm birth

A

jaundice, hypoglycaemia, RDS, ventricular haemorrhages, cerebral palsy, NEC

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7
Q

4 ways to manage a preterm birth

A

Tocolytics (atociban, nifedipine)
Abx if suspected chorioamnionitis
Steroids if 24-35w
Cerclage (cervical suture before 24w if <25mm on US or hx of >/=3 preterm cervical dilation

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8
Q

Define low birth weight

A

Less than 2.5kg

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9
Q

Epidemiology of low birth weight

A

7%

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10
Q

10 RF for preterm birth

A
  • prematurity and IUGR are most common causes

- substance abuse (smoking), malnutrition, black, diabetes, hypertension, infection, pre-eclampsia

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11
Q

Monitoring for low birth weight

A

monitored on US at antenatal screening – can do it more regularly if suspected

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12
Q

7 immediate and 4 late consequences of low birth weight

A

Immediate: RDS, intraventricular haemorrhage, PDA, NEC, ROP, jaundice, infection
Later: DM, HTN, cerebral palsy, metabolic syndrome.

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13
Q

2 ways to management low birth weight

A

Tackle risk factors and prevent prematurity

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14
Q

Define Sudden Unexpected Death in Infancy (SUDI)

A

Unexpected and initially unexplained death

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15
Q

What does a SUDI require?

A

Post-mortem and police enquiry

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16
Q

Epidemiology of SUID

A

Most common cause of death in first year of life

>200 babies die/year

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17
Q

5 causes of SUID

A

50% no cause is found

Infection, Genetic/metabolic; Accidental injury; Non-accidental injury (10%)

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18
Q

What happens to siblings following SUID

A

Sibling screen for sepsis/inborn errors of metabolism

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19
Q

5 RF and 3 PF for SUID

A

RF: Sleeping in prone position, smoking, premature, bed sharing, hyperthermia
PF: breast feeding, room sharing, use of pacifiers

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20
Q

6 ways to prevent SUID

A
  • do put baby sleeps on back
  • do keep babies head uncovered
  • do breastfeed baby if possible
  • don’t smoke in the same room
  • don’t sleep in the same bed
  • don’t let your baby get too hot (room temp 16-20)
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21
Q

Epidemiology of asthma in children

A

1/11 children have asthma
Increased in prevalence in 2d half of 20th century, now plateauing
We have highest rates in Europe
13% of carers give up work

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22
Q

3 costs of asthma to the NHS

A

consultations, hospital admissions and meds

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23
Q

Childhood vaccinations at 8 weeks

A

6 in 1: Diphtheria, Tetanus, Pertussis, Polio, Hib and Hep B
Men B
Rotavirus

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24
Q

Childhood vaccinations at 12 weeks

A

6 in 1
Pneumococcal
Rotavirus

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25
Childhood vaccinations at 16 weeks
6 in 1 | Men B
26
Childhood vaccinations at 1 year
Hib Men C + B MMR Pneumococcal
27
Childhood vaccinations throughout childhood for elegible groups
Influenza annually
28
Childhood vaccinations at 3 years 4 months
Diphtheria, tetanus, pertussis and polio | MMR
29
Childhood vaccinations at 12-13 years
HPV
30
Childhood vaccinations at 14 years
Tetanus, Diphtheria and Polio | MEN ACWY
31
Vaccinations in the elderly
65 years: Pneumococcal then influenza annually | 70-79: Shingles
32
Vaccinations in pregnant women
Influenza | Pertussis
33
Who gets the TB vaccine?
Infants in areas with a high TB incidence or who live with a parent/grandparent born in a high incidence country
34
Change in schedule to children born to hepatitis B infected mothers
At birth, 4 weeks and 12 months
35
Most common accident in babies and pre-school age
At home e.g. falling down the stairs/trapping fingers in doors
36
Most common accident in school age
Outside the home e.g. RTA
37
Most common accident in older children
Risk taking behaviour
38
Most common age and gender for accidents
6-9 year | Male
39
How many children die every year?
5000
40
What percentage of accidents are caused by cut injuries/lacerations
56%
41
What are the percentages for the highest causes of deaths?
24% malignancy | 14% injuries/poisons
42
Order of external causes of deaths
1st RTA 2nd suffocation 3rd drowning 4th smoke/fire, poisons
43
Biggest cause of death in 10-18 year old
75% RTA
44
Most common cause of death in pre-term
Prematurity (age, smoking, socio-economic status)
45
Most common cause of death at term
Congenital
46
% of poisoning that occurs in under 5's
50%
47
3 primary prevention mechanisms for childhood accidents
- modification of product: vehicle child design - alter environment: speed limits - educating children: public health service
48
1 secondary prevention mechanism to prevent childhood accidents
Rehabilitation for burns | secondary prevention is after the accident has occured
49
What age suffer 45% of burns and scalds? | How?
Children under 5 | In the kitchen (hot water, irons, ovens)
50
3 methods to reduce the risk of burns
- consider sunburn (sunscreen, hat, out of sun) - get smoke alarms, don’t smoke near bed/sofa - keep hot objects out of their reach
51
6 specific causes of childhood accidents and methods to prevent them
Choking: hold them when feeding, cut food into small bits, sit with child Suffocation: no loose bedding, dispose of plastic bags safely Falls: careful carrying baby, strap a child in high chair Poisoning: CO alarms, medicines out of reach Drowning: never leave baby in bath alone Road accidents: correctly fitting rear seat every journey
52
3 consequences of poor early health in children
Start life in poor health > LD + poor mental health, poor diet Adolescents > leave school early, physically inactive Adulthood: mortality risk, physical/mental health, social stigma
53
How many children die every week from cruelty
1 child
54
4 RF for child deaths
Poverty Social isolation Disability Chronic disease
55
What is the toxic trio?
Domestic violence and abuse Parental mental health Parental substance abuse
56
What act safeguards children | What is its main motto
Children's Act (1989 > 2004) | Every child matters
57
3 common causes of bruising in children
Coagulation disorders (haemophilia, VWD, liver disease, thrombocytopaenia (ITP, ALL,), HDN
58
Common site for bruising in children
Bony prominences
59
5 worrying signs of bruises in children
Excessive multiple bruises of different ages Bruise patterns which indicate slapping, gripped tightly, belts Face, ears, neck, buttocks, trunks, proximal part of lower limbs Well demarcated/ burn injuries Spiral/ metaphysis fractures
60
4 worrying signs for abuse in the Hx
no explanation, presented late, listen to the child, changing hx
61
How can you distinguish between a fabricated/induced illness
discrepancy between hx and presentation, range of symptoms, multiple presentations, exaggerating mild disease
62
7 signs of sexual abuse in children
- recurrent GU symptoms (enuresis, constipation, soiling) - abdo pain - self harm - alcohol/drug misuse - pregnancy - emotional/behavioural problems - sexualized behavior
63
Define neglect
Persistent failure to meet child’s basic physical and psychological needs Poor interactions, poor growth, poor dental health, cleanliness, missed appointments
64
Define emotional abuse
Persistent emotional maltreatment such as to cause severe and persistent adverse effects on a child or young persons emotional development.
65
What must you do if you suspect neglect?
- recognize > document > report to senior > designated safeguarding specialist - local authority social services by law have to investigate (NSPCCC, police) - information can be concerned without consent if public interest/ law - give child advice about where they can go for advice and support
66
Statutory responsibility when it comes to children
- must act on any concerns and be open minded - learn different cultural/ religious background; make sure your own culture doesn’t distract you. - listen to children - keep clear records
67
4 critical conditions which might end in paediatric end of life care
1 Life threatening condition for which curative treatment may be feasible but can fail e.g. malignancy 2 Conditions where premature death is inevitable, long intensive treatment e.g. CF 3 Progressive conditions without curative options where treatment is palliative and may be go over many years e.g. Batten’s disease 4 Irreversible but non-progressive conditions causing severe disability leading to susceptibility to health complications and likelihood of premature death e.g. severe brain injury
68
Define the doctrine of double effect
risk of hastening death is accepted when intention of using the drug it to control symptoms when death in inevitable
69
3 things to consider in childhood palliative care
Pain N+V Anxiety
70
What does time off school affect in adolescents?
exams, social isolation, mental health, dependence on parents, impact employment
71
4 things that might make a child miss their medications
- poor thinking i.e. forgetful - feel bulletproof – don’t think about long-term - rejection of medical professional/ parental advice - bad side effects
72
Define transition
purposeful, planned process that addresses psychological, education needs of adolescent with physical/mental condition as they move from child centered to adult centered health care systems good transition improves outcomes, attendance
73
Talking with VS Talking to children
talking with is inclusive, encourages responsibility for themselves, discussion, respect

Health and Society Year 4 (9 decks)

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