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s4 - Repro, Develop, Ageing, Pharm > DEVELOP - GROWTH > Flashcards

DEVELOP - GROWTH Flashcards

1
Q

What is psychomotor development?

A

The progressive attainment of skills that involve both mental and muscular activity

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2
Q

In brain development, neurlation begins at week 3-4 gestation, prosencephalic development at 2-3months then what up to birth? What is the 1 that begins post natally?

A
  • neuronal proliferation then migration then neuronal organisation continues into life
  • myelination begins after birth
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3
Q

What does the outer marginal layer, the middle layer and the inner layer of the neural tube form?

A
  • outer –> white matter
  • middle –> grey matter
  • inner –> lining of the ventricles
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4
Q

At 4th week you have the prosencephalon, mesencephalon and rhombocephalon. What does the prosencephalon then divide into (at 5th week) and the rhombocephalon into?

A
  • the telencephalon and diencephalon (from prosen.)

- the metencephalon and myelencephalon (from rhomb.)

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5
Q

What is Anencephaly a result of?

A

-faliure of anterior neural tube to fuse so prosencephalon is in contact with amniotic fluid and degenerates. Skull is open.

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6
Q

What is Holoprosencephaly?

A
  • prosencephalon doesnt split, remains as one so you dont get 2 hemispheres
  • impaired face and brain function e.g. 1 eye, no nose
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7
Q

When do synapses in the brain reach maximum density?

A

6-12months after birth

NB: as myelination progresses, nervous system functions improve

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8
Q

What spheres need to be fullfilled for a child to get optimal developmentand reach their potentials?

A

-psychological, physical and emotional

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9
Q

give 3 one-word descriptions of “development”

A
  • innate
  • incremental
  • progressive
  • responsive to stimuli
  • interdependent
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10
Q

What are the 4 major spheres for milestones of development used by paediatricians to try to help achieve full potential by early management of obstacles..?

A
  • Gross Motor
  • Fine Motor (hand skills, vision)
  • Communication (speech and hearing)
  • Social/Emotional
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11
Q 
Gross Motor.
Newborn: reflex head turn
6months..
12 months..
18 months...
2-4yrs...
NB: development is in a head to toe direction
A

6months.. sit alone 30secs
12 months.. walk independently
18 months… run around
2-4yrs… walk up stairs

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12
Q 
Fine Motor.
3-4months - looks at hands 
6months...
9months...
14months...
3yrs .. can copy circle
4.5..can draw a square
6..can draw a triangle
A

6months. ..transfers objects between hands
9months. ..uses pincer grip
14months. ..use pencil/build block tower

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13
Q 
Speech/Hearing.
Newborns..startled by noises
6wks...
6months..
8months...
12months...
16months - points to body parts
2yrs - 50word vocab
2.5yrs - knows peoples 1st and last names
A

6wks. ..recognises mother’s voice
6months. . can babble
8months. .. can use muma/dada unspecifically
12months. .. mum/dad correctly

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14
Q 
Social/Emotional.
Newborns - can regard peoples faces
6wks...
6months..
7months..
10months..wave goodbye/play peekaboo
18months - uses a spoon
2yrs..
3yrs..
A

6wks. ..smile
6months. .discriminate smile to enjoyed things
7months. . stranger danger anxiety

2yrs. .parallel play
3yrs. .play interactively with others

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15
Q

Name 3 primitive reflexes. When should they disappear by?

A

-Moro reflex (arms)
-rooting (suck)
-grasp
-stepping (when held vertically)
By 6months

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16
Q

What is Developmental Delay? 2 Types are..

A

Faliure to aquire a particular developmental skill at an age when 95% of peers have. Can be global or specific.

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17
Q

What is Global Developmental Delay?

NB: causes include genetics, asphyxia at birth, infection or trauma

A

delay in more than 2 areas of development due to a widespread problem of brain structure

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18
Q

What is Specific Developmental Delay?

A

in one area of development due to a more targeted abnormality e.g. speech delay, V. field defect, myopathy/neuropathy, deafness

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19
Q

Name a cause for concern of Developmental Delay by 8wks…
3months ..no eye contact
5months.. no reaching for objects on a play mat
3 causes of concern by 18months….

A
  • baby is not smiling by 8wks

- baby is not walking unaided, not saying words with meaning or not making 2-3word sentences by 18months

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20
Q

The Diagnostic approach for Developmental Delay begins with Screening. What HCP may be involved?

A
  • Dr/specialist midwife checks newborn
  • GP checks at 6months
  • heathcare visitors 6-9months, 18 months and 3yrs
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21
Q

The diagnostic approach for Developmental Delay after abnormal screening is Evaluation of development in clinic. What are they scorred according to? What is the next step?

A

Griffith’s Developmental Score
Next step is looking for causes e.g. chromosomal, brain defects, hearing issue, visual abnormality. thyroid..
So refer appropriately

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22
Q

In Developmental Delay we must try to correct the cause where possible e.g. hearing aid, thyroxine..why is correction important?

A

To promote development as skills are interdependent so a deficit will impact other spheres if not corrected early

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23
Q

Name 5 risk factors for Developmental Delay:

A
  • linear growth restriction/poor maternal nutrition
  • inadequate cognitive stimulation
  • iron deficient
  • lead exposure
  • violence at home
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24
Q

Suggest 2 uses for monitoring growth:

A
  • assess overall health/nutrition of child
  • diagnose diseases that present as poor growth
  • monitor disease and response to treatment
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25
Q

If a baby is born preterm (before 37wks) you plot on the far left and continue to plot on preterm section until…?

A

42weeks (EDD+2weeks) then plot on infancy section using gestational correction

26
Q

What is the main growth influence perinatally? And after 1st year?

A

Perinatally: Nutrition (placental function, diet)
Later: genetics

27
Q

What term is used to describe children whose weight is crossing down the centiles? When to investigate?

A

Faltering Growth

Investigate if crosses down 2+

28
Q

What does short stature in a child refer to

A

Not meeting their height potential

29
Q

Underweight is a child with a BMI less thean the 2nd centile for age and sex. What is overweight and obese?

A

Overweight: child’s BMI >91st centile for age and sex
Obese: BMI over 98th centile

30
Q

Other that diet, what may condition may cause overweight/obesity in a child?

A

Hypothyroidism

31
Q

Alveoli within CT stroma is the secretatory unit of mammary gland. What epithelia is alveolus made of? How is milk ejected from here?

A
  • mammary cuboidal/low columnar epithelial cells

- ejected by myoepithelial cells around alveolus

32
Q

What is “lactogenesis I” that begins in pregnancy? 2 hormones?

A

-placental lactogen and prolactin promote breast and glandular tissue development

33
Q

During “lactogenesis I” that begins in pregnancy what 2 hormones supress milk production? Anything else?

A
  • progesterone and oestrogen

- duct cells release autocrine inhib. factors

34
Q

What causes “lactogenesis II” that begins post-partum? 2 hormones and what behaviour?

A

Abrupt fall in progesterone and oestrogen

Suckling stimulus releases PrL and oxytocin

35
Q

What are the roles of Prolactin and Oxytocin in breastfeeding?

A
  • prolactin drives milk synthesis

- oxytocin drive milk ejection

36
Q

What is the “let down reflex”?

A
  • triggered by suckling, mother/baby closeness
  • causes myoepithelial contraction
  • reflex can become conditioned
37
Q

What are the drugs “bromocriptine” and “cabergoline” effects on lactation? When are they used?

A
  • decrease PrL/increase DA so suppress lactation

- use if still-birth

38
Q

What are the drugs “domperidone” and “metoclopramide” effects on lactation? When are they used?

A
  • increase PrL/decrease DA

- in premature deliveries

39
Q

How does breast milk vary? Composition changes within and between feeds…how to ions vs lactose % change?

A
  • Na, K, Cl levels decrease over time

- lactose increases over time p.partum

40
Q

Name 4 main benefits of breastfeeding?

A
  • nutritional
  • GI
  • immunity
  • mother
  • societal
41
Q

What fatty acids do human breast milk contain which are important for brain and retinal development?

A

-LCPUFA (long chain poly-unsat, fatty acids)

42
Q

What effect does breast milk have on GI function?

A
  • improves gastric emptying

- prevents NEC and pneumatosis intestinalis

43
Q

Name 3 components of breastmilk and their importance in immunity:

A
  • sIgA (esp. in preterms)
  • Complement C1 to C9, C3 esp high which opsonises bacteria
  • Lactoferin inhibits bacteria growth by binding Fe
  • Cytokines-allow milk to protect, not injure gut epith.
  • Lysozyme-cleave peptidoglycans of bact. walls
44
Q

What is the enteromammary axis about?

A
  • you produce sIgA specific to the bacteria in your baby’s environment
  • so skin-skin contact is recommended to colonise the mothers flora
45
Q

Name 3 long term benefits of breastfeeding:

A
  • less type I and II diabetes
  • less obesity, better growth, better cholesterol :
  • prevents/delays AD, cows milk allergy and wheezing
  • better cognitive outcome
  • less risk of child myelo/lympho-blastic leukemia
46
Q

Name 2 maternal benefits of breastfeeding:

A

-releases oxytocin, uterus contracts, less p.p. haem
-reduced breast and ovarian cancer
-uses loads of calories–> pre-preg. weight
-

47
Q

Breastfeeding could save 800,000+ lives/yr globally and 20,000/yr from what pathology? As well as save healthcare $$$

A

-breast cancer

48
Q

CHIN = pneumonic for effective breast feeding, what do you need?

A
  • Hold baby Close
  • Head should be free to move back
  • Body should be In line
  • Nose to Nipple
49
Q

What are the 2 patterns of suckling and their function?

A
  • non-nutritive: rapid bursts to stimulate milk supply to be ejective
  • nutritive: follows, slower, interspersed with audible swallowing
50
Q

GIve 3 risks of ineffective breastfeeding for the mother/baby:

A
  • sore nipples and engorgement
  • ineffective milk removal -> mastitis and less milk produced
  • poor weight gain, jaudice, hypernatraemia in baby
51
Q

What is the best formula milk? (First Steps Nutrition Trust Website is best info source)

A

NONE, £ is completely irrelevant.

They all require the same necessary ingredients

52
Q

1st trimester-rapid growth/differentiation
2nd trimester-cellular hypertrophy
3rd trimester-?

A

Maturation of organs, weight/sub cut fat gain

53
Q

Give 2 extrinsic and 2 intrinsic factors on pre-natal growth:

A
  • placenta, B.flow, nutrition, maternal anatomy

- genes, hormones

54
Q

What does the ICP model of post natal growth stand for?

A

Infancy, Childhood, Puberty

55
Q

In infancy there is deceleration of growth rate, and the main influence on growth is genes/environment, what about in childhood?

A

-hormone influence (GH, TH) takes over nutrition

56
Q

What is “Catch up Growth” - give an e.g of condition it may follow

A

Height Velocity above normal limit for age at least 1yr after transient period of growth inhibition e.g. IUGR/hypothyroidism

57
Q

The genes KAL and FGF8 control the migration of which neurones to the hypothalamus along the olfactory tract?

A

-the GnRH neurones from the olfactory placode

58
Q

How does bone growth come to an end?

A

-epiphyses and diaphyses fuse to obliterate the epiphyseal plate

59
Q

Name 2 consequences of how/when bone growth cessates?

A
  • after puberty is complete, no growth is possible

- obese children, enter puberty earlier so will be shorter adults

60
Q

What does Baker’s hypothesis predict about Catch up Growth’s effect on the system? Stresses the system..

A

-babies born small who have a massive C.U.Growth, are more susceptible to T2DM, DT & CHD

s4 - Repro, Develop, Ageing, Pharm (14 decks)

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