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Paediatrics > A Child's Journey: Growth, Development and Health > Flashcards

A Child's Journey: Growth, Development and Health Flashcards

1
Q

Neonate is…

A

<4w

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2
Q

Infant is …

A

12m/1yr

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3
Q

Toddler is…

A

~1-2yr - usually on feet - toddle on feet

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4
Q

5 Key Developmental Fields

A 
Gross motor
Fine motor
Socail and self help
Speech and language
Hearing and vision
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5
Q

How we get about is called

A

Gross motor

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6
Q

What we do with our hands

A

Fine motor

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7
Q

Whats a milestone?

A

Achievement of key development skills

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8
Q

E.g.s of Milestones

A

Social smile, sitting, walking, first words

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9
Q

What to do if not achieved milestones by limit age (2 SDs from mean)?

A

Refer

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10
Q

milestones; correct for prematurity?

A

Yes until 2yrs

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11
Q

Influencing Factors on development

A 
Genetics (Family, race, gender)
Environment
Positive early childhood experience
Developing brain vulnerable to insults
Antenatal
Post natal
Abuse and neglect
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12
Q

Antenatal adverse environmental factors for development

A

infections

toxins

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13
Q

Postnatal adverse environmental factors for development

A

Infection (Meningitis, encephalitis)
Toxins (solvents mercury, lead)
Trauma (Head injuries)
Malnutrition (iron, folate, vit D)
Metabolic (Hypoglycaemia, hyper + hyponatraemia)
Maltreatment/ under stimulation/ domestic violence
Maternal mental health issues

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14
Q

What are the specific groups of kids that should be developmentally assessed

A

premature, syndromes, events

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15
Q

Milestones : e.g. walking

early walkers…

A

9-10 months

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16
Q

Milestones : e.g. walking

median age walkers…

A

12months

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17
Q

refer if not walking by

A

18 months

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18
Q

Problem if not smiling by

A

8wks

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19
Q

RED FLAGS

…. of Development skills

A

loss

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20
Q

RED FLAGS

Parental/ professional concern re….

A

vision

hearing loss

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21
Q

RED FLAGS

tone…

A

Low - floppy

increased muscle tone

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22
Q

RED FLAGS

no speech by

A

18 months

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23
Q

RED FLAGS

type of walking

A

toe walking

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24
Q

OFC stands for

A

Occipitofrontal circumference

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25
Q

RED FLAGS

OFC >

A

99.6th centile

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26
Q

RED FLAGS

OFC

A

0.4th centile

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27
Q

Expected Skills at 6 months

A

Sits steadily without support (by 8-9 months)

Transfers toy from one hand to the other.

Responds to name (turns and looks).

Reaches for familiar people.

Feeds self biscuits or similar food.

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28
Q

Expected Skills at 12 months

A

Walks without help. (By 18 months)

Stacks 2 or more blocks.

Uses “Mama” or “Dada” specifically for parents, or similar.

Shows shared attention/ pointing to things of interest.

Feeds self with spoon.

29
Q

Expected Skills at 2 yrs

A

Climbs on play equipment

Scribbles with circular motion.

Has a vocabulary of at around 30-50 words.

“Helps” with simple household tasks.

Opens door by turning knob.

30
Q

Expected skills at 3yrs

A

Rides on a tricycle, using pedals.

Draws or copies a complete circle.

Asks questions beginning with “Why? When? How?”

Gives directions to other children.

Toilet trained (but may need help with wiping etc.).

31
Q

How do they communicate?

A

(Speech and Language)

32
Q

What can they do for themselves?

A

Social and Self Help)

33
Q

Main components of Child health programme (Scotland)

A

Health promotion

Developmental screening (including hearing)

Immunisation

34
Q

Childs progress is reordered in the…

A

Red Book

35
Q

Child health Programme involves:

A 
New-born exam and blood spot screening*
New-born hearing screening (by Day 28)
Health Visitor First Visit
6-8w Review (Max 12w)
27-30 month Review (Max 32m)
Orthoptist vision screening (4-5y)
36
Q

6-8w Review (GP and HV) involves…

A

Identification data (Name, address, GP)
Feeding (breast/ bottle/ both)
Parental concerns (appearance, hearing; eyes, sleeping, movement, illness, crying, weight)
Development
Measurements (Weight, OFC, Length)
Examination (heart, hips, testes, genitalia, femoral pulses and eyes (red reflex))
Sleeping position (supine, prone, side)

37
Q

27-30m Review (HV)

A

Identification data (name, address, GP)
Development
Physical measurements (height and weight)
Diagnoses / other issues

38
Q

Do you correct age for immunisations in prematures?

A

No

39
Q

Growth Monitoring

3 key parameters

A

Weight (grams and Kgs)
Length (cm) or height (if >2y)
Head circumference (OFC) (cm)

40
Q

birth weight
length
OFC

A

3.3kg
50cm
35cm

41
Q

4 months weight

length

A

6.6kg

60cm

42
Q

12 months weight
length
OFC

A

10kg
75cm
45cm

43
Q

3y weight

lenght

A

15kg

95cm

44
Q

A ‘Centile’ is…

A

% divisions of the reference population sampled

45
Q

50th Centile means

A 
“If you take the average 100 healthy children 50 are above this point and 50 are below”
“About half the kids in class are smaller…”
46
Q

0.4th centile means

A

“If you take the average 1000 healthy children 4 are below this point 996 are above”

47
Q

0.4th centile means

A

“If you take the average 1000 healthy children 4 are below this point 996 are above”

48
Q

Failure to thrive (FTT) also known as

A

Weight Faltering

49
Q

FTT is when a child grows too … in …. and usually in … at the expected rate for his or her age

A

slowly in form and usually in function at the expected rate for his or her age

50
Q

In FTT there is a significantly low rate of

A

weight gain

-crossing centile spaces

51
Q

FTT is not a diagnosis but a…

A

description of a pattern

52
Q

FTT means the SUPPLY of Energy and/or nutrients is

A

< DEMAND

for Energy and nutrients

53
Q

Causes of FTT in early life

Deficient intake can be either

A

maternal or infant

54
Q

Maternal causes for deficient intake in FTT

A

Poor lactation
Incorrectly prepared feeds
Unusual milk or other feeds
Inadequate care

55
Q

Infant causes for deficient intake in FTT

A

Prematurity
Small for dates
Oro palatal abnormalities (e.g. cleft palate)
Neuromuscular disease (e.g. cerebral palsy)
Genetic disorders

56
Q

Increased metabolic demands causes for FTT

A 
Congenital lung disease
Heart disease
Liver disease
Renal disease
Infection
Anaemia
Inborn errors of metabolism
Cystic fibrosis
Thyroid disease
Crohn’s/ IBD
Malignancy
57
Q

Excessive nutrient loss causes of FTT

A 
Gastro oesophageal reflux
Pyloric stenosis
Gastroenteritis (post-infectious phase)
Malabsorption
Food allergy
Persistent diarrhoea
Coeliac disease
Pancreatic insuffiency
Short bowel syndrome
58
Q

4 broad causes of FTT

A

Deficient intake
Increased Metabolic demands
Excessive nutrient loss
Non medical causes

59
Q

Non medical causes of FTT

A

Poverty/ socio-economic status
Dysfunctional family interactions (especially maternal depression or drug use)
Difficult parent-child interactions
Lack of parental support (eg, no friends, no extended family)
Lack of preparation for parenting/ education
Child neglect
Emotional deprivation
Poor feeding or feeding skills disorder

60
Q

History in FTT

A

Presenting symptoms
Dietary assessment
Birth/family/social

61
Q

Physical exam FTT

A

Dysmorphic features
Anthropometry
Systems, Development

62
Q

After physical exam in FTT what do you do?

A

Trial of feeding in Hospital

63
Q

What is involved in a Trial of feeding in Hospital in FTT?

A

Observe feeding, mothers handling
Dietician / SALT assessment
Developmental assessment

64
Q

What is a SALT?

A

speech and language therapist

65
Q

FTT If child has good feeding intake in hospital assess…

A

Weight gain

66
Q

FTT If child has good feeding intake in hospital and does gain weight condition is …

A

Non organic

67
Q

FTT If child has good feeding intake in hospital and does NOT gain weight condition is …

A

Organic

investigate accordingly

68
Q

FTT If child has poor feeding intake in hospital causes are…

A

Organic cause
Feeding disorder
Non-Organic or mIxed

Paediatrics (15 decks)

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