Paediatrics Flashcards
(121 cards)
1
Q
Define small / preterm baby
A
Preterm is defined as babies born alive before 37 weeks of pregnancy are completed. There are sub-categories of preterm birth, based on gestational age: extremely preterm (less than 28 weeks) very preterm (28 to 32 weeks)
The definition of SGA varies; it is most commonly defined as birth weight less than the 3rd percentile, 10th percentile, or -2 standard deviations compared with the mean birth length or body weight
2
Q
Explain the aetiology / risk factors for a small / preterm baby
A
- Cone biopsy/LLETZ procedure - late miscarriage risk or premature birth; increased risk if excision more than 10mm
- Intrahepatic cholestasis of pregnancy - liver disorder during pregnancy, build-up of bile acids and other substances in the liver which leak into the bloodstream; common after 28wks; 10% dx have a preterm baby and increased risk of meconium; if bile acids too high then
- Pre-eclampsia - HTN and proteinuria; causes IUGR and prematurity, mainly due to tx which is to deliver baby asap if pre-eclampsia is very severe
- IUGR - 3% of pregnancies; growth of baby slows or stops during pregnancy; main causes: multiple pregnancy, failure of placenta, APS, infection, congenital anomaly, maternal PMHx, warfarin, low pregnancy weight, smoking/drugs/alcohol during pregnancy; close monitoring, regular scan and uterine artery doppler test
- Diabetes type 1 or 2 - keep glucose levels to normal levels, diet and exercise is important
- Lifestyle - alcohol (esp first 3 months) and cocaine/heroin increases risk of prematurity and growth/brian development; smoking increases 2x risk of stillbirth/prem, occurs with PROM, IUGR and cot death; maternal age (in teens and above 35) and weight (BMI<19.8 and >30) increases risk of prem; low income/physical work (and standing/shift work) is linked to preterm birth; domestic and physical violence/stress also increases risk
- Anti-phospholipid syndrome - Autoimmune against phospholipids; linked with recurrent miscarriage, IUGR, preterm and pre-eclampsia
- Multiple pregnancy - increased risk; normal gestation for twins 37wks, triplets 34wks and quads 32wks; increased risk of miscarriage, pre-eclampsia, PPH, placentla abruption, hyperemisis gravidarum, IUGR, GDM, TTTS
- Uterine abnormality - shape (bicornuate womb, unicornuate - increased risk of ectopic and late miscarriage also; didelphic only slight; septate has increased 1st trimester miscarriage; arcuate increased 2nd trimester miscrriage NOT preterm
- Cervical incompetence - cervix shortens and dilates in the 2nd trimester/early thrid trimester without any other syx, leading to PPROM or intrauterine infection causing preterm birth
- PPROM - premature prelabour rupture of membranes before 37wks; can lead to preterm but also to infection of mother and baby
- Placental abruption - placenta starts to come away from the inside of the womb wall before the baby has delivered (due tp impact or PE/IUGR
- Placenta praevia - linked to spontaenous preterm delivery and PPROM
- Gestational diabetes - increased risk of stillbirth, macrosomia, birth tauma, shoulder dystocia, hyperinsulinaemia/hypoglycaemia after birth
- Intrauterine infection - can cause PPROM
3
Q
Summarise the epidemiology of a small / preterm baby
A
Every year, an estimated 15 million babies are born preterm (before 37 completed weeks of gestation), and this number is rising.
Preterm birth complications are the leading cause of death among children under 5 years of age, responsible for approximately 1 million deaths in 2015 (1).
Three-quarters of these deaths could be prevented with current, cost-effective interventions.
Across 184 countries, the rate of preterm birth ranges from 5% to 18% of babies born.
Highest numbers in India, China, Nigeria, Indonesia and US
4
Q
Recognise the presenting symptoms of a small / preterm baby
A
x
5
Q
Recognise the signs of a small / preterm baby on physical examination
A
x
6
Q
Identify appropriate investigations for a small / preterm baby and interpret the results
A
x
7
Q
Generate a management plan for a small / preterm baby
A
x
8
Q
Identify the possible complications of a small / preterm baby and its management
A
x
9
Q
Summarise the prognosis for a small / preterm baby
A
x
10
Q
Define meconium aspiration
A
The passage of meconium becomes increasingly common the greater the infant’s gestational age, particularly when postterm. Infants who also become acidotic may inhale thick meconium and develop meconium aspiration syndrome.
Meconium is passed before birth by 8–20% of babies. It is rarely passed by preterm infants, and occurs increasingly the greater the gestational age, affecting 20–25% of deliveries by 42 weeks. It may be passed in response to fetal hypoxia. At birth these infants may inhale thick meconium
11
Q
Explain the aetiology / risk factors of meconium aspiration
A
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12
Q
Summarise the epidemiology of meconium aspiration
A
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13
Q
Recognise the presenting symptoms of meconium aspiration
A
x
14
Q
Recognise the signs of meconium aspiration on physical examination
A
x
15
Q
Identify appropriate investigations for meconium aspiration and interpret the results
A
x
16
Q
Generate a management plan for meconium aspiration
A
x
17
Q
Identify the possible complications of meconium aspiration and its management
A
x
18
Q
Summarise the prognosis for patients with meconium aspiration
A
x
19
Q
Explain the aetiology / risk factors of Meckel’s diverticulum
A
x
20
Q
Summarise the epidemiology of Meckel’s diverticulum
A
x
21
Q
Recognise the presenting symptoms of Meckel’s diverticulum
A
x
22
Q
Recognise the signs of Meckel’s diverticulum on physical examination
A
x
23
Q
Identify appropriate investigations for Meckel’s diverticulum and interpret the results
A
x
24
Q
Generate a management plan for Meckel’s diverticulum
A
x
25
Identify the possible complications of Meckel’s diverticulum and its management
xj
26
Summarise the prognosis for patients with Meckel’s diverticulum
x
27
Explain the aetiology / risk factors of inherited metabolic disorders (incl. G6PD deficiency)
x
28
Summarise the epidemiology of inherited metabolic disorders (incl. G6PD deficiency)
x
29
Recognise the presenting symptoms of inherited metabolic disorders (incl. G6PD deficiency)
x
30
Recognise the signs of inherited metabolic disorders (incl. G6PD deficiency) on physical examination
x
31
Identify appropriate investigations for inherited metabolic disorders (incl. G6PD deficiency) and interpret the results
x
32
Generate a management plan for inherited metabolic disorders (incl. G6PD deficiency)
x
33
Identify the possible complications of inherited metabolic disorders (incl. G6PD deficiency) and its management
x
34
Summarise the prognosis for patients with inherited metabolic disorders (incl. G6PD deficiency)
x
35
Explain the aetiology / risk factors of Hirschsprung disease
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36
Summarise the epidemiology of Hirschsprung disease
x
37
Recognise the presenting symptoms of Hirschsprung disease
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38
Recognise the signs of Hirschsprung disease on physical examination
x
39
Identify appropriate investigations for Hirschsprung disease and interpret the results
x
40
Generate a management plan for Hirschsprung disease
x
41
Identify the possible complications of Hirschsprung disease and its management
x
42
Summarise the prognosis for patients with Hirschsprung disease
x
43
Explain the aetiology / risk factors of necrotising enterocolitis (NEC)
x
44
Summarise the epidemiology of necrotising enterocolitis (NEC)
x
45
Recognise the presenting symptoms of necrotising enterocolitis (NEC)
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46
Recognise the signs of necrotising enterocolitis (NEC) on physical examination
x
47
Identify appropriate investigations for necrotising enterocolitis (NEC) and interpret the results
x
48
Generate a management plan for necrotising enterocolitis (NEC)
x
49
Identify the possible complications of necrotising enterocolitis (NEC) and its management
x
50
Summarise the prognosis for patients with necrotising enterocolitis (NEC)
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51
Explain the aetiology / risk factors of developmental dysplasia of the hip
x
52
Summarise the epidemiology of developmental dysplasia of the hip
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53
Recognise the presenting symptoms of developmental dysplasia of the hip
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54
Recognise the signs of developmental dysplasia of the hip on physical examination
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55
Identify appropriate investigations for developmental dysplasia of the hip and interpret the results
x
56
Generate a management plan for developmental dysplasia of the hip
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57
Identify the possible complications of developmental dysplasia of the hip and its management
x
58
Summarise the prognosis for patients with developmental dysplasia of the hip
x
59
Explain the aetiology / risk factors of congenital malformations (incl. cleft lip/palate, diaphragmatic hernia, tracheoesophageal fistula, oesophageal/biliary/small bowel atresia, urinary tract anomalies, anorectal malformations, cryptorchidism)
x
60
Summarise the epidemiology of congenital malformations (incl. cleft lip/palate, diaphragmatic hernia, tracheoesophageal fistula, oesophageal/biliary/small bowel atresia, urinary tract anomalies, anorectal malformations, cryptorchidism)
x
61
Recognise the presenting symptoms of congenital malformations (incl. cleft lip/palate, diaphragmatic hernia, tracheoesophageal fistula, oesophageal/biliary/small bowel atresia, urinary tract anomalies, anorectal malformations, cryptorchidism)
x
62
Recognise the signs of congenital malformations (incl. cleft lip/palate, diaphragmatic hernia, tracheoesophageal fistula, oesophageal/biliary/small bowel atresia, urinary tract anomalies, anorectal malformations, cryptorchidism) on physical examination
x
63
Identify appropriate investigations for congenital malformations (incl. cleft lip/palate, diaphragmatic hernia, tracheoesophageal fistula, oesophageal/biliary/small bowel atresia, urinary tract anomalies, anorectal malformations, cryptorchidism) and interpret the results
x
64
Generate a management plan for congenital malformations (incl. cleft lip/palate, diaphragmatic hernia, tracheoesophageal fistula, oesophageal/biliary/small bowel atresia, urinary tract anomalies, anorectal malformations, cryptorchidism)
x
65
Identify the possible complications of congenital malformations (incl. cleft lip/palate, diaphragmatic hernia, tracheoesophageal fistula, oesophageal/biliary/small bowel atresia, urinary tract anomalies, anorectal malformations, cryptorchidism) and its management
x
66
Summarise the prognosis for patients with congenital malformations (incl. cleft lip/palate, diaphragmatic hernia, tracheoesophageal fistula, oesophageal/biliary/small bowel atresia, urinary tract anomalies, anorectal malformations, cryptorchidism)
x
67
Explain the aetiology / risk factors of congenital, perinatal & neonatal infection (incl. TORCH)
x
68
Summarise the epidemiology of congenital, perinatal & neonatal infection (incl. TORCH)
x
69
Recognise the presenting symptoms of congenital, perinatal & neonatal infection (incl. TORCH)
x
70
Recognise the signs of congenital, perinatal & neonatal infection (incl. TORCH) on physical examination
x
71
Identify appropriate investigations for congenital, perinatal & neonatal infection (incl. TORCH) and interpret the results
x
72
Generate a management plan for congenital, perinatal & neonatal infection (incl. TORCH)
x
73
Identify the possible complications of congenital, perinatal & neonatal infection (incl. TORCH) and its management
x
74
Summarise the prognosis for patients with congenital, perinatal & neonatal infection (incl. TORCH)
x
75
Explain the aetiology / risk factors of respiratory disease in a neonate (incl. chronic lung disease (CLD) of prematurity, respiratory distress syndrome (RDS), perisistent pulmonary hypertension (PPH), transient tachypnoea of the newborn)
x
76
Summarise the epidemiology of respiratory disease in a neonate (incl. chronic lung disease (CLD) of prematurity, respiratory distress syndrome (RDS), perisistent pulmonary hypertension (PPH), transient tachypnoea of the newborn)
x
77
Recognise the presenting symptoms of respiratory disease in a neonate (incl. chronic lung disease (CLD) of prematurity, respiratory distress syndrome (RDS), perisistent pulmonary hypertension (PPH), transient tachypnoea of the newborn)
x
78
Recognise the signs of respiratory disease in a neonate (incl. chronic lung disease (CLD) of prematurity, respiratory distress syndrome (RDS), perisistent pulmonary hypertension (PPH), transient tachypnoea of the newborn) on physical examination
x
79
Identify appropriate investigations for respiratory disease in a neonate (incl. chronic lung disease (CLD) of prematurity, respiratory distress syndrome (RDS), perisistent pulmonary hypertension (PPH), transient tachypnoea of the newborn) and interpret the results
x
80
Generate a management plan for respiratory disease in a neonate (incl. chronic lung disease (CLD) of prematurity, respiratory distress syndrome (RDS), perisistent pulmonary hypertension (PPH), transient tachypnoea of the newborn)
x
81
Identify the possible complications of respiratory disease in a neonate (incl. chronic lung disease (CLD) of prematurity, respiratory distress syndrome (RDS), perisistent pulmonary hypertension (PPH), transient tachypnoea of the newborn) and its management
x
82
Summarise the prognosis for neonates with respiratory disease (incl. chronic lung disease (CLD) of prematurity, respiratory distress syndrome (RDS), perisistent pulmonary hypertension (PPH), transient tachypnoea of the newborn)
x
83
Explain the aetiology / risk factors of cerebral palsy and hypoxic-ischaemic encephalopathy
x
84
Summarise the epidemiology of cerebral palsy and hypoxic-ischaemic encephalopathy
x
85
Recognise the presenting symptoms of cerebral palsy and hypoxic-ischaemic encephalopathy
x
86
Recognise the signs of cerebral palsy and hypoxic-ischaemic encephalopathy on physical examination
x
87
Identify appropriate investigations for cerebral palsy and hypoxic-ischaemic encephalopathy and interpret the results
x
88
Generate a management plan for cerebral palsy and hypoxic-ischaemic encephalopathy (incl. statutory/non-statutory organisations and the role of the paediatrician in providing specialist advice to the education authority)
x
89
Identify the possible complications of cerebral palsy and hypoxic-ischaemic encephalopathy and its management
x
90
Summarise the prognosis for patients with cerebral palsy and hypoxic-ischaemic encephalopathy (incl. educational consequences)
x
91
Explain the aetiology / risk factors of chromosomal syndromes (incl. trisomy 13 (Patau), 18 (Edwards), 21 (Down), Noonan, Prader-Willi, Turner, Klinefelter)
x
92
Summarise the epidemiology of chromosomal syndromes (incl. trisomy 13 (Patau), 18 (Edwards), 21 (Down), Noonan, Prader-Willi, Turner, Klinefelter)
x
93
Recognise the presenting symptoms of chromosomal syndromes (incl. trisomy 13 (Patau), 18 (Edwards), 21 (Down), Noonan, Prader-Willi, Turner, Klinefelter)
x
94
Recognise the signs of chromosomal syndromes (incl. trisomy 13 (Patau), 18 (Edwards), 21 (Down), Noonan, Prader-Willi, Turner, Klinefelter) on physical examination
x
95
Identify appropriate investigations for chromosomal syndromes (incl. trisomy 13 (Patau), 18 (Edwards), 21 (Down), Noonan, Prader-Willi, Turner, Klinefelter) and interpret the results
x
96
Generate a management plan for chromosomal syndromes (incl. trisomy 13 (Patau), 18 (Edwards), 21 (Down), Noonan, Prader-Willi, Turner, Klinefelter)
x
97
Identify the possible complications of chromosomal syndromes (incl. trisomy 13 (Patau), 18 (Edwards), 21 (Down), Noonan, Prader-Willi, Turner, Klinefelter) and its management
x
98
Summarise the prognosis for patients with chromosomal syndromes (incl. trisomy 13 (Patau), 18 (Edwards), 21 (Down), Noonan, Prader-Willi, Turner, Klinefelter)
x
99
Explain the aetiology / risk factors of neonatal jaundice (incl. breast milk jaundice)
x
100
Summarise the epidemiology of neonatal jaundice (incl. breast milk jaundice)
x
101
Recognise the presenting symptoms of neonatal jaundice (incl. breast milk jaundice)
x
102
Recognise the signs of neonatal jaundice (incl. breast milk jaundice) on physical examination
x
103
Identify appropriate investigations for neonatal jaundice (incl. breast milk jaundice) and interpret the results
x
104
Generate a management plan for neonatal jaundice (incl. breast milk jaundice)
x
105
Identify the possible complications of neonatal jaundice (incl. breast milk jaundice) and its management
x
106
Summarise the prognosis for patients with neonatal jaundice (incl. breast milk jaundice)
x
107
Define necrotising enterocolitis (NEC)
x
108
Define congenital, perinatal & neonatal infection (incl. TORCH)
x
109
Define Hirschsprung disease
x
110
Define Meckel's diverticulum
x
111
Define inherited metabolic disorders (incl. G6PD deficiency)
x
112
Define respiratory disease in a neonate (incl. chronic lung disease (CLD) of prematurity, respiratory distress syndrome (RDS), perisistent pulmonary hypertension (PPH), transient tachypnoea of the newborn)
x
113
Define chromosomal syndromes (incl. trisomy 13 (Patau), 18 (Edwards), 21 (Down), Noonan, Prader-Willi, Turner, Klinefelter)
x
114
Define developmental dysplasia of the hip
x
115
Define septicaemia in the neonate/child
x
116
Define congenital malformations (incl. cleft lip/palate, diaphragmatic hernia, tracheoesophageal fistula, oesophageal/biliary/small bowel atresia, urinary tract anomalies, anorectal malformations, cryptorchidism)
x
117
Define congenital heart disease (incl. ASD, AVSD, CoA, PDA, PS, ToF, ToGA, VSD)
x
118
Define congenital adrenal hyperplasia
x
119
Define neonatal jaundice (incl. breast milk jaundice)
x
120
Recall the investigation and management of dysmorphism/congenital abnormality
x
121
Classify and differentiate the causes of dysmorphism/congenital abnormality
x
