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MBBS3-Pediatrics > Growth > Flashcards

Growth Flashcards

1
Q

how long is the embyronic phase

A

8 weeks

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2
Q

how long is the fetal period

A

9weeks till birth

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3
Q

how long is the neonatal period

A

from birth to 28 days of life

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4
Q

whats the infancy period

A

from 29 days of life to 1st year of life

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5
Q

which stage of development is the period of fastest growth

A

infancy

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6
Q

how much weight do children lose in the first few days after birth

A

5-10%

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7
Q

when do children return to their birth weight

A

7-10 days of age

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8
Q

when do children double their birth weight

A

4-5 months

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9
Q

when do children triple their birth weight

A

1 year

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10
Q

whats a daily weight gain for children for the first 3-4 months

A

20-30g

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11
Q

whats a daily weight gain for children for the rest of the first year

A

15-20g

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12
Q

what are the normal growth rates in children

A

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

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13
Q

what are important growth monitoring parameters

A

weight
height/length ( dont use an upright measurement for children< 2yrs)
head circumference

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14
Q

what are the MBI categories

A

underweight- <5th percentile
normal- 5th percentile-85th percentile
risk for overweight- 85th percentile- <95th percentile
overweight- >95th percentile

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15
Q

what measurement is used to determine physical growth

A

weight for age

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16
Q

what measurement reflects immediate nutrional status

A

weight for age

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17
Q

why should infants be weighed monthly

A

because growth during this period is extremely rapid

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18
Q

what does linear growth reflect

A

musculoskeletal growth

19
Q

what non nutritional factors govern linear growth

A

endocrinologic- GH, TH, steroids
nonendocrine- chronic illness, genetic disorders, undernutrition

20
Q

when does parental genetic effect on growth manifest in a child

A

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

21
Q

what does head circumference reflect

A

brain growth

22
Q

what are causes of microcephaly

A

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)

23
Q

what are causes of macrocephaly

A

-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)

24
Q

whats a growth spurt

A

increase in growth velocity e.g. adolescents

25
Q

whats a growth delay/ growth lag

A

decrease in the rate/ velocity of normal expected growth e.g. malnutrition

26
Q

whats is catch up growth

A

its an increase in growth rate to return to normal size e.g. preterm

27
Q

whats catch down growth

A

its when weight falls down a lower genetically determined growth centile e.g. infants of diabetic mothers

28
Q

what are the causes of failure to thrive

A

-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

29
Q

whats the diagnosis for inadequate intake in FTT

A

-neglect
-failure of breastfeeding
-cleft palate

30
Q

whats the investigation for inadequate intake in FTT

A

observation

31
Q

what is the diagnosis for vomiting in FTT

A

-gastroesophageal reflux
-pyloric stenosis

32
Q

whats the investigation for vomiting in FTT

A

-observation
-upper GI barium study
-abdominal ultrasound

33
Q

whats the diagnosis for malabsorption in FTT

A

-cystic fibrosis
-celiac disease`
-milk intolerance

34
Q

what are the investigations for malabsorption in FTT

A

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

35
Q

what is the diagnosis for renal causes of FTT

A

UTI

36
Q

how do you investigate renal causes of FTT

A

urine culture

37
Q

what is the diagnosis for cardiac causes in FTT

A

congenital heart disease

38
Q

what is an investigation for cardiac causes of FTT

A

echocardiogram

39
Q

what is the diagnosis for respiratory causes in FTT

A

infection

40
Q

what are investigations for respiratory causes in FTT

A

nasopharyngeal aspirate and chest x-ray

41
Q

what is the diagnosis for constitutional causes in FTT

A

-chromosomal disorders
-congenital syndromes
-inborn errors of metabolism
-perinatal infections

42
Q

what is short stature

A

height <2 -2.5 standard deviations below the mean for age

43
Q

what is a differential diagnosis for short stature

A

-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

44
Q

what are investigations for short stature

A

-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

MBBS3-Pediatrics (2 decks)

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