Failure to thrive/short stature

Question 1

How many centile lines are there on a growth chart?

Answer 1

9

Question 2

What are the centile lines on the growth charts?

Answer 2

0.4th / 2nd / 9th / 25th / 50th / 75th / 91st / 98th / 99.6th

Question 3

Where should children born between 32 weeks and 36+6 weeks gestation be plotted, and for how long?

Answer 3

In the preterm section on the left

Growth should be plotted there until 2 weeks after the EDD

Question 4

On the main chart, how long should a gestational correction be done for if the child is born before 32 weeks?

Answer 4

2 years

Question 5

On the main chart, how long should gestational correction be done for if the child is born 32-36+6 weeks?

Answer 5

1 year

Question 6

When is a child considered to be ‘on the centile’?

Answer 6

When they plot within 1/4 space of the line

Question 7

When is a child considered to be ‘between centiles’?

Answer 7

When they plot outside 1/4 space of the line

Question 8

How is the mid-parental height of a girl calculated?

Answer 8

(Father’s height + mother’s height - 12.5)/2

Question 9

How is the mid-parental height of a boy calculated?

Answer 9

(Father’s height + mother’s height + 12.5)/2

Question 10

How is predicted adult height calculated?

Answer 10

Using specific part of chart, plot child’s last centile, then +/-6cm and read of predicted adult range. 80% of children will grow to fall between this range.

Question 11

How is the mid-parental centile comparator calculated?

Answer 11

Using specific part of the chart, plot Mother and Father’s height, draw and line between them. +/- 2 centiles from mid-point. 90% of children will fall between these centile lines.

Question 12

How should head circumference measurements be taken?

Answer 12

3 times, and take an average

Question 13

By what age should an IUGR child catch-up in growth?

Answer 13

4y/o

Question 14

What is a short 5th metacarpal a sign of?

Answer 14

Pseudohypoparathyroidism

Question 15

What is a baby’s milk requirement?

Answer 15

150ml-200ml/kg/day

Question 16

How many ml in 1oz?

Answer 16

230ml

Question 17

When should weening start?

Answer 17

6 months

Question 18

How can causes of failure to thrive be categorised?

Answer 18

1. Inadequate caloric intake
2. Inadequate caloric absorption
3. Excessive caloric expenditure

Question 19

What are the causes of inadequate caloric intake in a toddler/infant?

Answer 19

1. Breast feeding problem
2. Incorrectly made up formula
3. GORD
4. Care-giver depression
5. Lack of food availability
6. Cleft lip/palate

Question 20

What are the causes of inadequate caloric absorption in a toddler/infant?

Answer 20

1. Food allergy
2. Malabsorption
3. Pyloric stenosis
4. GI atresia/malformation
5. Inborn error of metabolism

Question 21

What are the causes of excessive caloric expenditure in a toddler/infant?

Answer 21

1. Thyroid disease
2. Chronic infection/immunodeficiency
3. Chronic pulmonary disease
4. Congenital heart disease
5. Malignancy

Question 22

What are the causes of inadequate caloric intake in a child/adolescent?

Answer 22

1. Mood disorder
2. Eating disorder
3. GORD
4. IBS

Question 23

What are the causes of inadequate caloric absorption in a child/adolescent?

Answer 23

1. Food allergy
2. Coeliac disease
3. Malabsorption
4. IBD
5. Inborn error of metabolism

Question 24

What are the causes of excessive caloric expenditure in a child/adolescent?

Answer 24

1. Thyroid disease
2. Chronic infection/immunodeficiency
3. Chronic pulmonary disease
4. Congenital heart disease
5. Malignancy

Question 25

What are the differentials for short stature?

Answer 25

1. Familial 2. Constitutional 3. IUGR 4. Nutritional 5. Chromosomal 6. Chronic disease 7. Social deprivation/neglect/child abuse