108 Normal Child and 121 Growth faltering

Question 1

What respiratory adaptation happens at birth?

Answer 1

• fluid resorbed by type 1 pneumocytes
• through stimulation from catecholamines and prostaglandins

Question 2

What causes the ductus arteriosus to constrict during the 1st few minutes of life?

Answer 2

• O₂ in the blood from ventilation

Question 3

What is the effect of the first breath after birth on pulmonary vascular resistance?

Answer 3

Reduces it

Question 4

What does the increase in pulmonary venous return and increase in atrial pressure cause in infants just after birth?

Answer 4

• closure of foramen ovale
• septum primum presses against septum secondum

Question 5

What are the symptoms of respiratory distress in the newborn?

(6 listed)

Answer 5

• tachypnoea
• tachycardia
• chest wall recession
• nasal flaring
• expiratory grunting
• cyanosis

Question 6

Where in the newborn is brown fat found?

Answer 6

• lower posterior neck
• supraclavicular region

Question 7

What is brown fat rich in and what is the significance of this?

Answer 7

• triglycerides
• FFA oxidation by mitochondria –> heat

Question 8

What 3 things can result from babies getting cold?

Answer 8

• hypogycaemia
• respiratory distress
• surfactant deactivation

Question 9

Where is glycogen found in neonates?

(unlike any other time of life)

Answer 9

Heart

Question 10

What are the 3 metabolic adaptations of a baby at birth?

Answer 10

• decrease in plasma concentration of insulin
• increase in catecholamines
• increase in pancreatic glucagon release

Question 11

What is acrocyanosis?

Answer 11

Dusky blue appearance of peripheries

Question 12

Why is vitamin K given at birth?

Answer 12

• helps with clotting
• some babies are born with Vit K deficiency
• danger of bleeding

Question 13

What does the low activity of glucuroninsultransferase cause in the first few days of life?

Answer 13

Physiological jaundice

Question 14

What is the normal HR of a newborn?

Answer 14

110-150 bpm

Question 15

What is the normal BP of a newborn?

Answer 15

⁶⁵/₄₀mmHg

Question 16

What is the average hea circumference of a newborn?

Answer 16

35cm

Question 17

What is the average weight of a newborn?

Answer 17

3.5kg

Question 18

Which 2 hormones are essential for growth?

Answer 18

• GH
• TH

Question 19

Which hormones are stimulated by the ovaries and testes?

Answer 19

• FSH
• LH

Question 20

What percentage of growth happens in the foetal phase?

Answer 20

30%

Question 21

What percentage of growth happens in the infantile phase?

Answer 21

15%

Question 22

What percentage of growth happens in the childhood phase?

Answer 22

40%

Question 23

What percentage of growth happens in the pubertal phase?

Answer 23

15%

Question 24

Which 2 things are important for the foetal stage of growth?

Answer 24

• maternal nutrition
• placenta

Question 25

Which 2 hormones are important in childhood?

Answer 25

* GH * TH

Question 26

When are androgens secreted?

Answer 26

* 6-8 years * promote axillary and pubic hair growth

Question 27

When and where is there an increase in the release of GTRH?

Answer 27

Nocturnally secreted from the hypothalamus- gonadarche

Question 28

* Which hormones are released from the pituitary upon secretion of GTRH from the hypothalamus? * Which hormones are stimulated from the ovaries/testes following this?

Answer 28

* FSH and LH from the pituitary --\> increased development of the ovaries/testes * increased secretion of oestriol/testosterone from ovaries/testes

Question 29

Why do girls stop growing before boys?

Answer 29

Oestrogen is the main cause of termintation of growth

Question 30

Which gene is defective in achondroplasia?

Answer 30

FGFR-3\

Question 31

Which hormone is increased in hypothyroidism?

Answer 31

TSH

Question 32

What is the consequence of GH insufficiency in childhood?

Answer 32

Faltering growth and short stature due to lack of proliferation of the chondrocytes at the epiphyseal plates

Question 33

Name 4 conditions which cause tall stature (4 listed)

Answer 33

* hyperthyroidism * precocious puberty * Marfans * Kliinefelters

Question 34

What is marasmus?

Answer 34

Stunted growth caused by chronic malnutrition

Question 35

What is kwashiorkor?

Answer 35

Starvation and oedema due to low albumin and hepatomegaly

Question 36

Which protein is in abundence in colostrum? * whey * casein

Answer 36

Whey (80%)

Question 37

Which protein in milk can become allergenic?

Answer 37

Casein

Question 38

What are the proportions of whey and casein in mature milk? (in %)

Answer 38

60% whey 40% casein

Question 39

What is the main carbohydrate in mature milk?

Answer 39

lactose

Question 40

What should the weight gain of an infant be (per week) in the first 3 months post partum?

Answer 40

200g per week

Question 41

What should the weight gain be per week in an infant of 4-6 months?

Answer 41

150g/week

Question 42

How much milk should an infant 0-4 months have daily?

Answer 42

150-200ml/kg

Question 43

How much milk should an infant 4-6months have daily?

Answer 43

140ml/kg