Growth Flashcards
how long is the embyronic phase
8 weeks
how long is the fetal period
9weeks till birth
how long is the neonatal period
from birth to 28 days of life
whats the infancy period
from 29 days of life to 1st year of life
which stage of development is the period of fastest growth
infancy
how much weight do children lose in the first few days after birth
5-10%
when do children return to their birth weight
7-10 days of age
when do children double their birth weight
4-5 months
when do children triple their birth weight
1 year
whats a daily weight gain for children for the first 3-4 months
20-30g
whats a daily weight gain for children for the rest of the first year
15-20g
what are the normal growth rates in children
birth to 1 yr- 18-25 cm
1-2 yrs- 10-13 cm
2yr to puberty- 5-6cm
pubertal growth spurt in girls- 6-11
pubertal growth spurt in boys- 7-13
what are important growth monitoring parameters
weight
height/length ( dont use an upright measurement for children< 2yrs)
head circumference
what are the MBI categories
underweight- <5th percentile
normal- 5th percentile-85th percentile
risk for overweight- 85th percentile- <95th percentile
overweight- >95th percentile
what measurement is used to determine physical growth
weight for age
what measurement reflects immediate nutrional status
weight for age
why should infants be weighed monthly
because growth during this period is extremely rapid
what does linear growth reflect
musculoskeletal growth
what non nutritional factors govern linear growth
endocrinologic- GH, TH, steroids
nonendocrine- chronic illness, genetic disorders, undernutrition
when does parental genetic effect on growth manifest in a child
between 2-5 years so if there is no genetic reduced height for age (indicates stunting) it indicates chronic illness, long standing malnutrition or hormonal deficiency
what does head circumference reflect
brain growth
what are causes of microcephaly
familial- present from birth with normal development
autosomal recessive condition with developmental delay
congenital infection e.g. CMV
acquired e.g. perinatal hypoxia, hypoglycemia or meningitis (often accompanied by cerebral palsy and seizures)
what are causes of macrocephaly
-hydrocephalus
-macrosomia
-familial macrocephaly
-raised ICP
-chronic subdural hematoma
-cerebral tumor
-neurofibromatosis (is an autosomal dominant genetic disorder of the NS where tumors grow on nerves)
-cerebral gigantism (sotos syndrome- a rare genetic condition where children grow faster than other children their age, showing characteristics of-tall stature, large head with distinct facial features)
-CNS storage disorders e.g. mucopolysaccharidosis (hurler syndrome-is an inherited lysosomal storage disorder)
whats a growth spurt
increase in growth velocity e.g. adolescents
whats a growth delay/ growth lag
decrease in the rate/ velocity of normal expected growth e.g. malnutrition
whats is catch up growth
its an increase in growth rate to return to normal size e.g. preterm
whats catch down growth
its when weight falls down a lower genetically determined growth centile e.g. infants of diabetic mothers
what are the causes of failure to thrive
-inadequate intake due to food insecurity, developmental delay, emesis from pyloric stenosis
-malabsorption or loss e.g food protein allergy
-increased metabolic demand e.g. malignancy, chronic disease
-renal causes
-cardiac causes
-respiratory causes
-constitutional causes
whats the diagnosis for inadequate intake in FTT
-neglect
-failure of breastfeeding
-cleft palate
whats the investigation for inadequate intake in FTT
observation
what is the diagnosis for vomiting in FTT
-gastroesophageal reflux
-pyloric stenosis
whats the investigation for vomiting in FTT
-observation
-upper GI barium study
-abdominal ultrasound
whats the diagnosis for malabsorption in FTT
-cystic fibrosis
-celiac disease`
-milk intolerance
what are the investigations for malabsorption in FTT
cystic fibrosis- sweat test, which measures the amount of chloride in sweat and in cystic fibrosis there is 2 to 5 5 times more chloride
celiac disease- celiac antibodies and upper small bowel biopsy
milk intolerance- stool sugar chromatography and trial of alternative milk
what is the diagnosis for renal causes of FTT
UTI
how do you investigate renal causes of FTT
urine culture
what is the diagnosis for cardiac causes in FTT
congenital heart disease
what is an investigation for cardiac causes of FTT
echocardiogram
what is the diagnosis for respiratory causes in FTT
infection
what are investigations for respiratory causes in FTT
nasopharyngeal aspirate and chest x-ray
what is the diagnosis for constitutional causes in FTT
-chromosomal disorders
-congenital syndromes
-inborn errors of metabolism
-perinatal infections
what is short stature
height <2 -2.5 standard deviations below the mean for age
what is a differential diagnosis for short stature
-normal (constitutional/familial)
-due to medical problems like chronic illness; emotional and physiological effects(psychosocial dwarfism); LBW, small for gestational age; chromosomal abnormalities, syndromes, infections, maternal alcohol
-FTT
what are investigations for short stature
-bone age radiography
-CBC, ESR, chemistry profile and UA (chronic illness)
-free T4 and TSH levels (hypothyroidism)
-karyotype (turner syndrome)
-insulin like growth factor (IGF)-1- GH deficiency
