Failure To Thrive

Question 1

What are causes of failure to thrive?

Answer 1

1. Non organic causes: inadequate patenting, poor nutrition
2. Failure of intake: nipple disorders, cleft palpate, dyspnoea secondary to congenital heart disease
3. Abnormal losses: vomiting (eg pyloric stenosis), stools (eg steatorrhoea), urine (eg kidney disease)
4. Failure of utilisation: metabolic disorders eg PKU, endocrine disorders eg diabetes
5. Increased demand eg hyperthyroidism, chronic infection eg CF

Question 2

What screening tests should be performed for failure to thrive?

Answer 2

FBC, EUC, lft, tft, urine m/c/s + u/a

Check heel prick results

Question 3

What tests should be considered for short stature?

Answer 3

If the growth velocity is less than 25th centile for bone age consider
TMT
FBC, ESR (crohns disease)
Coeliac disease
Chromosomes in girls to exclude turner xo
Growth hormone studies
Kidney function
Bone age xray left wrist and hand

Question 4

What are some causes for tall stature?

Answer 4

Familial
Precocious puberty
Growth hormone excess
Hyperthyroidism 
Syndromic: Marfan, kleinfelter, xyy males, homocystinuria

Question 5

What is an average weight gain for a baby?

Answer 5

150-200g/ week
Doubling of birth weight by 4-5 months
Tripling of birthweight by 12 months

Question 6

What are the 4 types of abuse?

Answer 6

Physical, neglect, emotional, sexual