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Paediatrics > Child's journey - growth, development, and health > Flashcards

Child's journey - growth, development, and health Flashcards

1
Q

What are the recognised phases of childhood?

A 
Neonate (<4w)
Infant (<12m)
Toddler (around 1-2y)
Preschool (around 2-5y)
School age
Teenager/adolescent
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2
Q

What are the 5 key development fields?

A 
Gross motor - general  movements
Fine motor - Precise movements eg pincer grip
Speech and language
Hearing and vision
Social and self help
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3
Q

What are the main childhood objectives?

A 
To grow
To develop and achieve their potential
To attain optimal health
To develop independence
To be safe
To be cared for
To be involved
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4
Q

What are milestones?

A

Key skills

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5
Q

What are examples of milestones?

A

Smiling - around 2 months, issue if not by 4 months
Sitting - around 6 months, issue if not by 10 months
First steps - around 12 months, issue if not by 18 months
First words - around 12 months but if not by 2 years then concerns

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6
Q

What should happen to a child who is premature regarding developmental milestones?

A

Their prematurity should be taken off their age

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7
Q

What is the limit age of normal for milestones?

A

2 standard deviations from the mean

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8
Q

Why is development important?

A

Learning functional skills for later life
Hone skills in a safe environment
Allow our brain’s genetic potential to be fully realised
Equip us with tools needed to function as older children and adults
Many are completely automatic

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9
Q

What are influencing factors for 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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10
Q

What are antenatal adverse environmental factors?

A

Infections - CMV, rubella, toxoplasmosis

Toxins - alcohol, smoking, anti-epileptics, etc

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11
Q

What are post natal adverse environmetal factors?

A 
Infection - meningitis, encephalitis
Toxins - solvent mercury, lead
Trauma - head injury
Malnutrition (iron, folate, vit D)
Metabolic - hypoglycaemia
Maltreatment/neglect
Maternal mental health issues
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12
Q

Why do we assess development?

A 
Reassurance and show progress
Early diagnosis and intervention
Discuss positive stimulation/parenting strategies
Provision of information
Imrpoving outcomes - pre-school years
Genetic counselling
Coexistent health issues
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13
Q

What children are especially assessed for development?

A

Premature
Syndromes
Adverse events

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14
Q

Who assesses development?

A

Parents and wider family
Health visitors, nursery, teachers
GPs, A&E, FYs, STs, students
Paediatricians and community paediatricians

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15
Q

What is used to assess development?

A

Healthy child programme (HCP) UK

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16
Q

What toys can we use to assess development?

A

Blocks - picking up, transferring to each hand, stacking
Crayons - drawing, fine motor skills
Ball - gross motor skills
Tea cup and tea set - imaginary play and social and language skills
Books - language

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17
Q

Whats important to consider about the progress of each developmental field?

A

One may be more prominently deficient than others - global vs specific delay

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18
Q

What are developmental red flags?

A 
Loss of developmental skills
Parental/professional concern
Hearing loss
Persistent low muscle tone
No speech by 18 months, especially if no other communication
Asymmetry of movement
Not walking by 18 months
19
Q

Who performs child health screening?

A

GP
Health visitor
Midwife

20
Q

What are the main components of child health screening?

A

Health promotion
Developmental screening (including hearing)
Immunisation

21
Q

What is tested for in the blood spot screening?

A 
PKU
Hypothyroid
CF
Sickle cell
MCADD
22
Q

When do children have their health checked?

A 
New-born exam and blood spot screening
New-born hearing screening (day 28)
Health visitor first visit
6-8w review
27-30m review
Orthoptist vision screening (4-5y)
23
Q

What is assessed at the 6-8w review?

A

Identification data
Feeding
Parental concerns (appearance, hearing, eyes, sleeping, etc)
Development
Measurements (weight, length)
Examination (heart, hips, testes, genitalia, femoral pulses, eyes)
Sleeping position

24
Q

What is done at the 27-30m review?

A

Identification data
Development
Physical measurements (height and weight)
Diagnoses

25
Q

Should you give vaccines if a child is immunocompromised?

A

No

26
Q

Is egg allergy contraindicated for MMR?

A

No

27
Q

What do we monitor in growth?

A

Weight (grams)
Length or height if over 2y (cm)
Head circumference (OFC) (cm)

28
Q

What can be derived from growth measurements?

A 
Weight for age
Length/height for age
BMI
Weight for length
Rate of weight gain (only in infants)
29
Q

What is the weight, length, and head circumference of a newborn?

A

Weight - 3.3kg
Length - 50cm
OFC 35cm

30
Q

What is the weight, length, and head circumference of a 12 month old?

A

Weight - 10kg
Length - 75cm
OFC - 45cm

31
Q

What is failure to thrive?

A

Child growing too slowly in form and usually in function at the expected rate for his or her age
Significantly low grade of weight gain

32
Q

What are maternal causes of deficient intake leading to failure to thrive?

A

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

33
Q

What are infant causes of deficient intake leading to failure to thrive?

A 
Prematurity
Small for dates
Oro palatal abnormalities ie cleft palate
Neuromuscular disease
Genetic disorders
34
Q

What increased metabolic demands lead to failure to thrive?

A 
Congenital lung disease
Hypothyroidism
Liver disease
Heart diease
Renal disease
Infection
Anaemia
Cystic fibrosis
IBD
Malignancy
35
Q

What are causes of excessive nutrient loss leading to failure to thrive?

A

Gastro oesophageal reflux
Pyloric stenosis
Gastroenteritis
Malabsorption

36
Q

What are causes of malabsorption in the child?

A 
Food allergy
Persistent diarrhoea
Coeliac disease
Pancreatic insufficiency
Short bowel syndrome
37
Q

What are non medical causes of failure to thrive?

A 
Poverty/socio-economic status
Dysfunctional family interactions
Difficult parent-child interactions
Lack of parental support
Lack of preparation for parenting
Emotional deprivation
Poor feeding or feeding skills disorder
Difficult baby
38
Q

What should you ask about in history about failure to thrive?

A

Presenting symptoms
Dietary assessment
Birth/family/social

39
Q

What should be assessed on physical examination in failure to thrive?

A

Dysmorphic features
Anthropometry
Systems, development

40
Q

What is anthropometry?

A

Measurement of body proportions

41
Q

What is done during trial feeding in failure to thrive?

A

Observe feeding and mothers handling
Dietician/SALT assessment
Developmental assessment

42
Q

What can cause poor food intake in hospital in trial feeding?

A

Organic cause
Feeding disorder
Non-organic or mixed

43
Q

What can cause no weight gain in trial of feeding despite good food intake?

A

Organic - investigate accordingly

Paediatrics (25 decks)

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