Developmental

Question 1

How much should babies receiving formula feed have a day ?

Answer 1

150ml / kg split between feeds every 2-3 hrs initiall

Question 2

What is acceptable weight loss in a new baby ?

Answer 2

• Breast fed babies to loose up to 10%
• Formula fed babies to loose up to 5%

By day 5 of life, they should be back at their birth weight by day 10

Question 3

What is plotted on a growth chart ?

Answer 3

Childs weight, height and head circumference against normal distribution for their age and gender

Question 4

What is defined as faltering growth

Answer 4

A fall in weight across :

• > One or more centile spaces if their birthweight was below the 9th centile
• > Two or more centile spaces if their birthweight was between the 9th and 91st centile
• > Three or more centile spaces if their birthweight was above the 91st centile

Question 5

Give 4 causes of inadequate nutritional intake that can lead to faltering growth

Answer 5

Maternal malabsorption if breastfeeding
Iron deficiency anaemia
Family or parental problems
Neglect
Availability of food (i.e. poverty)

Question 6

Give 4 causes of difficulty feeding that can lead to faltering growth

Answer 6

Poor suck, for example due to cerebral palsy
Cleft lip or palate
Genetic conditions with an abnormal facial structure
Pyloric stenosis

Question 7

Give 5 causes of malabsorption that can lead to faltering growth

Answer 7

Cystic fibrosis
Coeliac disease
Cows milk intolerance
Chronic diarrhoea
Inflammatory bowel disease

Question 8

Give 4 causes of increased energy requirements that can lead to faltering growth

Answer 8

• Hyperthyroidism
• Chronic disease, for example congenital heart disease and cystic fibrosis
• Malignancy
• Chronic infections, for example HIV or immunodeficiency

Question 9

Give 2 causes of inability to process nutrients properly that can lead to faltering growth

Answer 9

Inborn errors of metabolism
Type 1 diabetes

Question 10

how can a child’s predicted height be calculated ?

Answer 10

• Boys: (mother height + fathers height + 14cm) / 2
• Girls: (mothers height + father height – 14cm) / 2

Question 11

Give 7 causes of short stature

Answer 11

• Familial short stature
• Constitutional delay in growth and development
• Malnutrition
• Chronic diseases, such as coeliac disease, inflammatory bowel disease or congenital heart disease
• Endocrine disorders, such as hypothyroidism
• Genetic conditions, such as Down syndrome
• Skeletal dysplasias, such as achondroplasia

Question 12

What is constitutional delay in growth and puberty and what is a key feature ?

Answer 12

-> Variation on normal development
-> Short stature in childhood but normal height in adulthood
- > Feature : Delayed bone age compared with reference for age and sex on xray

Question 13

5 causes of delay specific to gross motor

Answer 13

Cerebral palsy
Ataxia
Myopathy
Spina bifida
Visual impairment

Question 14

5 causes of delay specific to fine motor

Answer 14

Dyspraxia
Cerebral palsy
Muscular dystrophy
Visual impairment
Congenital ataxia (rare)

Question 15

3 causes of delay specific to personal and social domain

Answer 15

Emotional and social neglect
Parenting issues
Autism

Question 16

6 causes of delay specific to speech and language domain

Answer 16

• Specific social circumstances, : exposure to multiple languages or siblings that do all the talking
• Hearing impairment
• Learning disability
• Neglect
• Autism
• Cerebral palsy

Question 17

How is the severity of a learning disability determined ?

Answer 17

Based on IQ :

55 – 70: Mild
40 – 55: Moderate
25 – 40: Severe
Under 25: Profound

Question 18

Normal age of puberty

Answer 18

• Girls : 8-15
• Boys : 9-15

Question 19

Stages of puberty girls

Answer 19

Breast buds
Pubic hair
Menstrual periods

Question 20

Stages of puberty boys

Answer 20

Testicular enlargement
Penis enlargement
Darkening of scrotum
Pubic hair
Deepening voice

Question 21

What staging is used to determine pubertal stage based on examination findings ?

Answer 21

Tanner staging

Question 22

what are the 6 types of abuse

Answer 22

Physical
Emotional
Sexual
Neglect
Financial
Identity

Question 23

What criteria needs to be met when prescribing contraception to a female <16 without parental input

Answer 23

Frazer guidelines

1. They are mature and intelligent enough to understand the treatment
2. They can’t be persuaded to discuss it with their parents or let the health professional discuss it
3. They are likely to have intercourse regardless of treatment
4. Their physical or mental health is likely to suffer without treatment
5. Treatment is in their best interest

Question 24

what is Gillick competence ?

Answer 24

• Judgement about whether the understanding and intelligence of the child is sufficient to consent to treatment