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semester 2 year 2 week 9-16 > paediatrics > Flashcards

paediatrics Flashcards

(73 cards)

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1
Q

what is difference in kids?

A

size, drug dose, fluid
larger head to body ratio
larger body: surface area( fluid)

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2
Q

difference in airway in children?

A

large occiput, short neck, big tongue, small mouth

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3
Q

difference in breathing in children?

A

higher RR(40-60)
Smaller immature airways
compliant chest wall
diaphragmatic breathing

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4
Q

difference in circulation in children?

A

RV=LV at brith until
pulmonary vascular resistance fall at 6 mo
circulating blood volume by body weight ( small losses significant)
high HR

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5
Q

normal HR in newborns

A

110-160bpm

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6
Q

skin difference in children

A

thin epidermis

increase absorption

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7
Q

MSK difference

A

bone not yet ossified( growth centre), growth plate not fuse yet,

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8
Q

fracture in kids

A

greenstick, Satter Harris ( around growth plates)

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9
Q

immune system in kids

A 
less mature system
immature BBB(more intracranial infection esp new born required LP)
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10
Q

Infectious disease in newborns

A

Group B strep, E.coli

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11
Q

metabolic system in kids

A

high BMR( higher requirement and expenditure)

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12
Q

4 domain in developmental in children

A
  1. motor
  2. speech language
  3. social
  4. cognition
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13
Q

4 things to ask in history in kids

A
  1. oral intake
  2. output
  3. sleep
  4. activity level
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14
Q

sleep time in kids?

A

longer than adults

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15
Q

3 aspects of history to ask

A
  1. ob and birth history
  2. developmental history
  3. immunisation history
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16
Q

adolescent history?

A 
HEADS Screen
home
education 
activity 
drug
sexuality, suicide. mood, safety
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17
Q

causes in irritability in children?

A

dehydration , sleep deprivation, hunger, pain or discomfort, behaviours, CNS infection, fever

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18
Q

pain rating scale

A
  1. Wong becker FACE pain rating scale
  2. numerical ratings cale
  3. FLACC scale( face, legs, activity, cry, consolability)
  4. neonatal pain ax tool
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19
Q

general observation

A

alert, active, playful, dysmorphisms, growth vital signs

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20
Q

how to measure growth

A

weigh, height and head circumference

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21
Q

wide pulse pressure in kids means

A

PDA or aorta regurgitation

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22
Q

narrow pulse pressure

A

aortic stenosis

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23
Q

signs of respiratory distress in children

A

intercostal, subcostal recession, tracheal tug and nasal flaring

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24
Q

gross motor function develop timeline

A 
rolling (by 9mo)
scrawling( by 12mo)
sitting
standing (18mo)
walking(2yo)
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25
language development timeline
``` babbling(6 mo) two part babble( 9mo) 1-3 words(1yo) 2 words together(2yo) understand 2 steps commands(2.5yo) understand sentence(3yo) understand complex sentence (5yo) ```
26
time range to look at in milestone
- 3rd and 97th percentile (beyond : worry about but still can be normal)
27
reach for objects in fine motor occur when
3-4mo
28
banging objects together, casting and pointing to objects
6-12mo
29
pincer grip in fine motor when
9-12mo
30
hand dominance occurs when
2 yo (should not occur before 12mo)
31
what can children do at 2 yo
walking, putting 2 words together, hand dominance, 2 steps commands, interaction with other children
32
2 parts of langue milstones
expressive and receptive
33
language milestone development
attention and listening skill--> social interaction and play skills--> understanding language--> expressive language-- speech pronunciation and fluency skill
34
following commands in receptive language skill happen when
one step commands 1yo | two steps command 2yo
35
when will the children star to be understood by strangers
4 yo
36
social developmental red flag
smile by 6-8 mo
37
turn playing develops when
3yo
38
weight, height and head circumference at birth
weight: loss 5-10% in first few days(7-10d return to normal) height: 50cm head circumference: 35cm
39
risk factors to normal development
* Prematurity * Low birth weight * Birth injury * Chronic illness * Vision and/or hearing impairment * Low parental education * Parental mental illness * Social isolation * Poverty * Lack of access to services
40
Developmental screening tests
Denver
41
Parent questionnaires
– PEDS, ASQ
42
Leading cause of death in children 0-14 years of age
injury Boys > Girls (1.5 time) Indigenous > Non-indigenous
43
common cause of injury in 0-14
<1: breathing, assault | 1-14: transport and accidental drowning
44
causes of injury in Infants <12 months
* Drowning (75% bathtubs) | * Thermal injuries
45
causes of injury Children 1-4yrs
* Drowning (60% swimming pools) * Thermal injuries * Unintentional poisoning * Falls (from playground equipment)
46
causes of injury Children Children 5-9yrs
• Falls
47
causes of injury Children 10-14yrs
* Unintentional transport injury * Intentional self harm * Assault * Falls
48
cause of injury in adolescents
• Intentional self harm
49
ED presentation in children
<1: bronchiolitis 1-9: gastro 10-18: abdo pain
50
Developmental delay?
Develop fall outside 2 SD below expected range to achieve developmental milestone Normal development with right succession with delayed compared to age
51
Global impairment
Delay or impairment in 2 or more area
52
Specific delay
Delay in one area only
53
Atypical development
Cerebral palsy, ADHD, trajectory very different
54
Primitive reflexes need to be lost before development
Loss by 6-8 wks Stepping reflex startle reflex
55
screening development in birth to 8 yo
PEDS
56
biological factors in development affecting Developmental myelination
``` Genetics Monogenic disorder Epigenetics Exposure to toxin Modification of genomic transcription, Trauma. Nutrition ```
57
psychosocial factors in development
temperament, availability of parent, parenting style, bullying, self-esteem
58
triad of ADHD
hyperactivity impulsivity poor concentration
59
presentation of autism
1. social communication ( no reciprocal , non-verbal communication, relationship) 2. repetitive restricted pattern of behaviours ( sameness, adherence, highly restricted, rigid) 3. hyper or hypo-activity to sensory stimulus M>F, 2-4yo
60
Ix for autism
ADOS, ADI-R
61
recognition of the serious ill children
Skin: mottle, cyanotic, petechiae, pallor Activity: assistance, ambulating, responsive Ventilation: retraction, head bobbing, robbing, nasal flaring, slow rate, fast rate, stridor, wheezing Eye contract: glassy starte, fail to engage Abuse: unexplained bruising or injuries/ inappropriate parent Cry: high pitched, cephalic, irritable, Heat: high fever(>41), hypothemia( <30) Immune system: sick cell, AIDS, corticosteroids Level of consciousness(irritable, lethargic, pain , consoling, unresponsive) Dehydration( hollow eyes, cap refill, god and, voiding, D+V, bilious persistence,dry mucous membrane)
62
toxic appearance
``` poor interaction with parent eye contact poor person cyanosis irritable not constable ```
63
suspects sepsis
cyanosis, rapid breathing, poor perfusion, petechial rash, parental concern, clinician instincts, T>40
64
color in NICE guideline
pale, mottle/ ashen, blue
65
activity in NICE
no response, appears ill, no wake, weak, high pitched or continuous cry
66
resp in NICE
grunting, tachycardia, RR>60, chest indrawing
67
circulation/dehydration in NICE
reduced skin turgor
68
other red flag in nICE
Age<3. temp>38, non-bleaching rash, balding fontanelle, neck stiffness, status epileptics, focal near signs, focal seizures
69
things to consider in a sick chid
abuse, aortic stenosis, TGA, pulmonary atresia, malrotation, lactate, ketone,
70
CEWT scores
identify ill children in hospital oxygen, resp rate HR, BP
71
Common cause of cardiac arrest in children
fluid loss fluid maldistribution resp distress resp depression
72
resp effort
stridor: upper airway pathology wheeze: low airway pathology grunt: airspace pathology or pneumonia
73
AVPU score
alert response to voice response to pain unresponsive

semester 2 year 2 week 9-16 (11 decks)

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