FTT Flashcards
Defn of FTT
any 1 of following
- growth below 3-5th %ile
- less than 6 mo old that does not gain weight for 2-3mos
- growth crosses more than 2 major growth%iles in a short time
Suspect FTT, next steps?
- assess developmental status
- observe a feeding (intolerance or bonding issues/abuse)
- food diary for caloric intake + counseling
Treatment for non-organic FTT in infant 1yo
1: 100kcal/kg/day
MC etiologies of inadequate weight gain due to not enough calories coming in
feeding disorders, neuro disorders (CP), TE fistula
etiologies of FTT due to altered growth potential
prenatal insult, chrom abnormalities, endo disorder
etiologies of FTT due to caloric wasting
emesis, biliary atresia, celiacs, IBD, infections, toxins, renal losses (RTA, DM)
etiologies of FTT due to increased calorie needs
hyperthyroid, congenital heart disease, chronic infection, chronic resp dz, RTA
Cause of FTT in infant with developmental delay + cataract surgery after birth + seizures + pupura at birth
congenital CMV (small at birth due to IUGR)
CT findings in CMV vs toxoplasmosis
CMV calcified lesion in periventricular pattern
Toxo throughout the cortex
2 yo below 50%ile for wt, HC, ht with nml development + only wants to eat mac n cheese–FTT?
NO, nml development
RTA types
1–prox tubule defect causing impaired bicarb REABS
2–distal tubule defect causing impaired H+ secretion (bicarb not abs then)
4–impaired ammoniagenesis (distal defect)
How to diagnose RTA
low bicarb on CMP/BMP with alkalotic urine (pH8) w/ otherwise unremarkable UA
short ammonium chloride test = failure to acidify urine following oral acid load
How does RTA lead to FTT
??
Treatment for RTA
oral supplementation with bicarb
presentation of RTA
-FTT
-anion gap metabolic acidosis (inc bicarb excretion)
hypoK
-kidney stones –> hematuria (due to alkalotic urine)
-Nephrocalcinosis (depotsition of Ca in kidney)–> rickets (dec vit D) –> bone demineralization
