What clinical signs are associated with a patent ductus arterious and why do they occur?
• Hyperactive precordial impulse - due to increased blood return to the left side of the heart, it becomes both dilated and hypertrophied.
• Breathlessness - There is also increased pressure in the left atrium this causes back pressure into the pulmonary capillaries causing oedema.
Why is there a bounding pulse in a PDA?
The flow is both diastolic and systolic, so during diastole their is run off into the pulmonary circulation resulting in easily felt pulses.
What kind of murmur is present in a PDA?
It is a harsh and continuous murmur heard best on the left sternal border.
What is the treatment options for a PDA?
Coil occlusion - via a cardiac catheter.
Surgery-
• Lateral thoracotomy
• Metal clip
There are three possible outcomes from a single point mutation in mRNA, what are they?
1) Silent mutation - Changed codon, codes for the same amino acid.
2) Missense mutation - Changed codon changes the amino acid.
3) Nonsense mutation - The changed codon does not code for any amino acid so is a termination codon.
What are the two main types of small children?
Acute and Chronic
• Acute - Wasted, normal height but reduced weight for age and height.
• Chronic - Stunted, short for age, normal weight for height but low for age.
What is marasmus?
Nutrition deficiency characterised by:
• Thin, flaccid skin, 'little old man appearance'.
• Reduced fat and muscle.
• Alert and irritable.
What is Kwashiorkor?
Characteristic symptoms of nutrition deficiency:
• Oedema
• Flaky-paint dermatitis
• Dry, thin, pigmented hair
• Hepatomegaly
• Apathy, misery, lethargy
What is colostrum and what is its composition?
• The initial breast milk (0-2 days).
• High protein (Whey 80%, Casein 20%).
• Very little fat.
• Anti-infective agents.
• Growth factors.
What is the content of mature breast milk?
• Casein 40%, Whey 60%
• More fat
• Lactose
When should weaing be commenced?
4-6 months until age 1.
