Child Health Revision

Front 1

Average onset of puberty:

- Girls

- Boys

Back 1

- 11 years

- 11.5 years

Front 2

What are the gonadotrophins?

Back 2

FSH and LH

Front 3

Precocious puberty in

- girls

- boys

Back 3

- before 8

- before 9

Front 4

Delayed puberty in

- girls

- boys

Back 4

- after 13

- after 14

Front 5

Order of female puberty

Back 5

1) Thelarche - breast budding

2) Adrenache - hair and body odour

3) Mecharche - periods

Front 6

How long after thelarche does menarche usually start?

Back 6

2 years (range 1-5)

Front 7

Peak height velocity age

- girls

- boys

Back 7

Girls = 12 years

Boys = 14 years

Boys PHV is greater than girls

Front 8

If child unable to walk by 18 months check

Back 8

CK (for muscular dystrophy)

Front 9

Gower's Maneuver think

Back 9

Muscular dystrophy

Front 10

Cerebral palsy

- Hemiplegia

- Paraplegia

- Quadraplegia

Back 10

- One side (leg and arm)

- Both legs

- Both legs and arms

Front 11

Breastfeeding mothers should take

Back 11

Vitamin D supplements of 10 micrograms per day

Front 12

Nutrients commonly under RNI in children?

Nutrients commonly over RNI in children?

Back 12

Vitamin D, sometimes Iron

Vitamin C, Vitamin A, Sodium, Protein, Calcium

Front 13

Physical activity guidelines for children capable of walking

Back 13

180 minutes throughout the day

Front 14

Physical activity guidelines for children 5-18

Back 14

At least 60 minutes a day of moderate to intense physical activity

3 days a week - vigorous intensity activites

Front 15

Exclusive breastfeeding is recommended for

Back 15

First 6 months of babies life

Front 16

What is not recommended for formula milk feeding?

Back 16

Changing from Whey to Casein not recommended (whey recommended for first year)

Changing brand

Front 17

No advantage of _________ over standard infant formula so NOT recommended

Back 17

Follow on milk

Front 18

Do not start introducing solid food before?

Recommended time to start introducing solid foods?

Back 18

4 months

6 months

Breastfeeding should remain main source of milk

Front 19

Full fat cows milk can be introduced:

in cooking from....

a drink from......

Back 19

cooking - 6 to 9 months

as a drink - from 12 months

Front 20

Benefits of breastfeeding

Back 20

Immunological factors

Anti-infective agents

Growth factors

Modulators of intestinal growth

Increased IQ

Decreased respiratory infections and diarrhoea

Reduction in atopic disease

Lower obesity risk for baby in later life

Front 21

Benefit for mother of breastfeeding

Back 21

Reduced risk of breast cancer

Front 22

Children should be introduced to drinking from cups at

Back 22

about six months of age

Front 23

Associations with obesity in later life

Back 23

Early weaning

Maternal obesity

Rapid weight gain in first 2 years

Front 24

3 stages of growth and what leads them

Back 24

1) Infant - nutrient lead

2) Child - growth hormone lead

3) Pubertal - sex steroid lead

Front 25

What does the "N"th centile mean?

Back 25

N% of children will fall below the Nth centile

Front 26

Things to remember for head circumference

Back 26

- Take three measurements and use average

- Measure at widest part of head

Front 27

At what age do you begin measuring using a stadiometer or T-piece

Back 27

2 years

Front 28

Babies born between _____________ are considered "term"

Back 28

37 and 42 weeks

Front 29

Most children should not weigh less than their birth weight at 2 weeks. Weight loss of over ___% at 2 weeks requires investigation

Back 29

10%

Front 30

BMI above ______ centile suggests child is overweight

BMI above _______ centile suggests child is obese

Back 30

91st

98th

Front 31

4/5th of children will be within _____ cm of their adult predicted height

Back 31

6

Front 32

Fluid requirements in a child?

Back 32

20mls/kg of 0.9% saline

Front 33

Normal CSF should have

Back 33

No red blood cells

< 5 WBC/ml

<2g protein/dl

Glucose 2/3rds of serum glucose

Front 34

Iliac crests spinal level

Back 34

L4

Front 35

Any suspicion of menigitis give

Back 35

IV ceftriaxone

Front 36

Above what age are you considered capable of making all your own medical decisions?

Back 36

16 years and over

Front 37

When might someone under 16 be able to make their own decisions regarding their care?

Back 37

If a practitioner deems them capable of understanding the nature and possible consequences of the treatment

Front 38

Date where Parental responsibility changes?

Explain PR before and from this date

Back 38

4 May 2006

(4/5/6)

Before - Father has parental responsibility if married to mother. If not he needs to a PR order

From this date - both parents have PR if they are named on birth certificate

Front 39

Live attenuated vaccines?

Back 39

Measles, Mumps and Rubella (MMR)

Polymyelitis

Front 40

Inactivated organisms vaccines?

Back 40

Pertussis

Typhoid

Front 41

Components of organism vaccines?

Back 41

Influenza, pneumococcal, diptheria, tetanus (toxoid)

Front 42

Features of diptheria

Back 42

Sore throat, low grade fever

White membrane on tonsils/pharynx/nasal cavity

Front 43

What can haemophilus influenzae B cause?

Back 43

Meningitis

Epiglottitis

Front 44

What serogroup is most deadly in meningococcol disease?

Back 44

B

Front 45

Define:

Elimination

Eradication

Extinction

Back 45

- Reduction of disease incidence to zero in a defined area, intervention still needed

- Reduction of disease incidence to zero worldwide, no more intervention needed e.g. smallpox

- Agent no longer survives in nature or in a laboratory - no examples

Front 46

What screening will a child receive?

Back 46

- Neonatal hearing screening

- Health Visitor visit

- 6-8 week screening (health visitor and GP)

- 27/30 month review

- Vision screening (4-5 years)

Front 47

Most common organism causing uncomplicated UTI in a child?

Back 47

E.Coli

Front 48

What is the mean number of respiratory infections in a child under 2 per year?

Back 48

3-6

Front 49

How does the anatomy of the throat differ in the throat in children?

Back 49

Floppy epiglottis

High anterior larynx

Front 50

Treatment for:

Bronchiolitis

Croup

Back 50

Bronchiolitis - supportive

Croup - steroids

Front 51

MSK symptoms and eyelid discolouration

Back 51

Dermatomyositis

Front 52

Causes of "hepatic" jaundice

Back 52

Viral hepatitis

Epstein Barr Virus

Wilson's Disease

Exposure to Halothane

Front 53

What is achondroplasia?

Back 53

Dwarfism - short limbs and normal sized trunk

Front 54

Alport syndrome?

Back 54

Deafness and renal failure

Front 55

Henoch -Schonlein purpura?

Back 55

Pupura (usually lower extremeties), arthritis, and abdominal pain = classic triad

Front 56

Idiopathic thrombocytopaenia purpura

Back 56

Previously healthy child, history of viral illness, generalised asymmetric purpuric rash, bleeding can occur from mucous membranes and nosebleeds common

Front 57

4 Ainsworth attachment classifications

Back 57

Secure - goes to carer when stressed and this resolves stress

Insecure avoidant - tries to resolve stress without carer

Insecure ambivalent - involves carer to resolve stress but shows uncertainty and ambivalence in how this is achieved

Insecure disorganised - chaotic or unpredictable actions that show the child has no basis for response)

Front 58

Common age for:

Pyloric Stenosis

Intususspection

Back 58

7 weeks

7 months

Front 59

What age are fractures treated as adult fractures

Back 59

12- 14 years (remodelling potential decreases)

Front 60

Fractures where have the potential to disrupt?

Back 60

Physis (growth plate)

Front 61

Erbs palsy - affected nerves, posture, outcome

Back 61

C5-C6

Waiters tip posture - unopposed subscapularis leading to internal rotation

Good outcome with physio

Front 62

Klumpke's palsy - affected nerve and posture

Back 62

Rare

C8-T1

Paralysis of intrinsic hand muscles and fingers