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Paediatrics > 1: Endocrine - Growth Faltering (FTT) > Flashcards

1: Endocrine - Growth Faltering (FTT) Flashcards

1
Q

What is failure to thrive now known as

A

Growth faltering

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2
Q

What is FTT

A

Failure to grow at expected rate

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3
Q

What is weight-faltering

A

Crossing down-centiles for weight

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4
Q

What is growth-faltering

A

Crossing down centiles for weight or height (length)

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5
Q

When is weight a batter indicator for growth

A

Weight is a better indicator in infants and small children

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6
Q

When is height a better indicator for growth

A

Height is a better indictor for children

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7
Q

What is the main cause of FTT

A

Insufficient food-intake

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8
Q

How can causes of FTT be divided

A
  1. Organic

2. Non-organic

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9
Q

What are the 4 categories of ‘organic’ FTT

A
  1. Impaired intake
  2. Malabsorption
  3. Increased energy requirement
  4. Inability to use nutrients
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10
Q

What are 4 causes of impaired intake

A
  1. Impaired suck - cleft palate
  2. Oromotor dysfunction
  3. Chronic illness causing anorexia
  4. Vomiting - GORD
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11
Q

What can cause impaired suck

A

Cleft palate

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12
Q

What can cause oromotor dysfunction

A

Cerebral palsy

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13
Q

What are 3 causes of increased energy expenditure

A
  • Malignancy
  • HF
  • Cystic Fibrosis
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14
Q

What are two causes of malabsorption

A
  • Coeliac disease

- Cystic fibrosis

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15
Q

What are 2 causes of failure to utilise nutrients

A
  • Chromosomal disorders
  • Congenital anomalies (eg. hypoT)
  • Congenital infections
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16
Q

How can non-organic causes of FTT be divided

A

Inadequate intake

Psychosocial

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17
Q

What are causes of decreased food availability

A
  • Poor breast feeding technique

- Poor timing of bottle-feeds

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18
Q

What are psychosocial causes of FTT

A

Poor bonding
Maternal depression
Abuse and Neglect

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19
Q

Explain weight change in neonates post-delivery

A

Following delivery, it is common for neonates to loose weight, which usually stops by day 3-4. Neonates then gain their birth-weight by 3W

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20
Q

When is it abnormal neonatal weight loss

A

> 10%

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21
Q

If infant looses more than 10% of their brith weight, what should be done

A
  • Feeding History
  • Observe breast-feeding
  • Clinical exam
  • May require other investigations
22
Q

Define growth-faltering in infants/children

A
  1. Crossing down 3 centiles for weight in more than the 91st centile
  2. Crossing down 2 centiles for weight, if 9-91st centile
  3. Crossing down 1 centile for weight, if less than 9th centile
23
Q

What determines growth in-utero

A

Placenta

24
Q

What determines infantile growth

A

Nutrition

TH

25
Q

What determines childhood growth

A

GH
Thyroid
Genetics

26
Q

What determines adolescent growth

A

Androgens

GH

27
Q

How often should growth be measured in 0-1 years

A

5-recordings

28
Q

How often should growth be measured in 1-2 years

A

3-recordings

29
Q

How often should growth be measured in >2 years

A

Annually

30
Q

How is weight and height plotted

A

On growth chart

31
Q

When is child’s head circumference plotted

A

Until 2-years

32
Q

When is child’s length plotted until and what takes over afterwards

A

2-year. Then use height

33
Q

Explain how pre-terms are plotted on growth chart

A

Plot in pre-term section until 42W of age. When 42W plot on chart for correctional gestational age.

Correctional gestational age: plot weight for child’s actual age and then draw back to how many weeks child was pre-term

Continue this until 2-years

34
Q

In investigating growth-faltering what is first-thing to do

A

Plot values on growth chart

35
Q

What should be calculated for growth concerns

A

Mid-parental height

36
Q

Explain how mid-parental height is calculated for a girl

A

[(Dad’s height - 14) + (Mum’s height + 8.5)]/2

37
Q

Explain how mid-parental height is calculated for a boy

A

[(Mums height + 14) + (Dad’s height + 10)]/2

38
Q

What type of history is taken in FTT

A
  • Detailed Feeding history including weaning
39
Q

What bedside tests should be ordered for FTT

A

Urinalysis

Urine MC+S

40
Q

Why is MC and S ordered

A

Renal dysfunction

41
Q

What blood-test is ordered for most cases of FTT

A

anti-TTG (coeliac screen)

42
Q

What do other investigations depend on

A

History

43
Q

What should be kept for all patients

A

Food diary

44
Q

When should a child be referred to paediatrics for FTT

A
  • Suspect NAI
  • Failure to respond to primary care interventions
  • Unexplained short-stature
  • Rapid weight loss
45
Q

What does management of FTT generally depend on

A

Cause

46
Q

How are neonates with FTT generally managed

A

Formula supplements

47
Q

How is child with FTT managed

A

Oral nutritional supplements

48
Q

If FTT in 1m, how often should they be weighed

A

Daily

49
Q

If FTT in 1-6m, how often should they be weighed

A

1W

50
Q

If FTT in 6-12m, how often should they be weighed

A

2W

51
Q

If FTT in >1 year, how often should they be weighed

A

Monthly

Paediatrics (61 decks)

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