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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.

• 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.