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12.08.29 Assorted notes from the first 2 days

Terminology
  • Term
    • 37-42 weeks
    • Weeks are measured from LMP
  • Preterm
    • <37 weeks
  • Low Birth Weight (LBW)
    • <2.5 kg
    • VLBW <1.5kg
    • ELBW <1kg
  • Small for Gestational Age (SGA)
    • BW <10th centile
  • Neonate
    • First 28 days

Pedigree symbols




IUGR

  • Asymmetrical
    • More common
    • Maternal factors
      • Malnutrition
      • Smoking
      • Pre-eclampsia toxaemia
    • Placental dysfunction
  • Symmetrical
    • Fetal factors
      • Genetic
      • Syndromes
      • Malformations


Neonatal heal-prick test

  • PKU
  • Hypothyroidism
  • Sickle cell
  • MCADD
  • Cystic fibrosis

Puberty - Process
  • Adrenarche
    • Increase of adrenal androgen production
    • Approximately age 7
  • Gonadarche
    • Testicular/ovarian enlargement
    • Approximately age 8
  • Thelarche
    • Approximately age 11 in females
  • Pubarche
    • Appearance of pubic hair
    • Approximately age 12
  • Menarche
    • Approximately age 12.5 in females
  • Spermarche
    • Approximately 11-15 years in males

Precocious puberty

  • Central
    • Gonadotrophin-dependant
    • Normal consonance
  • Peripheral
    • Suppressed LH/FSH
    • Advanced bone age


Congenital Adrenal Hyperplasia


Description of child psychological problems
  • DSM
    • Vulnerability factors
    • Precipitating factors
    • Maintaining factors
    • Protective factors
  • ICD10
    • Acute diagnosis
    • Specific developmental disorder
    • Intellectual level
    • Associated medical conditions
    • Adverse events of psychosocial conditions (z codes)
    • Global Social Function

Diagnosis of autism
  • Poor language + non-verbal communication
  • Difficulties in social interaction
  • Restricted, unimaginative, ritualistic play/activities

Nine temperament characteristics of Thomas and Chess


Random notes

  • Haemorrhagic disease of the newborn (HDN)
    • Extremely serious
    • Everyone gets prophylactic Vit K after birth, just in case
  • Retinopathy of prematurity
    • Caused by ROS damage
    • Prevent by limiting O2 (carefully!)
  • Pituitary dysfunction in sickle cell anaemia
    • Frequent blood transfusions => iron overload
    • Treated with chelating agents
    • Complexes deposited in pituitary
  • ODD => Conduct disorder => Antisocial personality disorder
  • ABC analysis of behaviour
    • Antecedents
    • Behavioural traits
    • Consequences
  • ADHD drugs
    • Controlled: Methylphenidate (Ritalin), Dexamphetamine
    • Non-controlled/non-stimulant: Atomoxetine
  • Loss of menstruation is a required feature for diagnosis of anorexia nervosa
  • Fat children
    • Steroids (e.g. Cushings) => Short + fat
    • Food (obesity) => Tall + fat
  • "Faltering growth" not "Failure to thrive"
  • Prader Willi => Can't stop eating
  • Girl < 3rd centile => Check for Turner's
  • Small size at birth
    • Weight deficiency => Short-term problem (e.g. recent malnutrition)
    • Height deficiency => Longer-term, more serious problem
  • Average male-female height difference
    • 14 cm
    • Use to calculate parent's average height, to calculate expected height
      • Or just use average of parent's centiles
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