Growth and Development Flashcards
Females
(a) Puberty onset—years
(b) Precocious puberty years
(c) Delayed puberty years
(d) First physical sign—
(e) Peak height velocity—
(f) Menarche—years
(g) Fertility— years
Females
(a) Puberty onset—9 to 10 years
(b) Precocious puberty 8 years
(c) Delayed puberty 13 years
(d) First physical sign—breast buds
(e) Peak height velocity—12.4 years
(f) Menarche—12.5years
(g) Fertility—15 years
Males
(a) Puberty onset— years
(b) Precocious puberty years
(c) Delayed puberty years
d) First physical sign—
e) Peak height velocity—years
f) Spermarche—years
(g) Fertility—years
Males
(a) Puberty onset—11 to 12 years
(b) Precocious puberty 9 years
(c) Delayed puberty 14 years
d) First physical sign—testicular growth
e) Peak height velocity—14.4 years
f) Spermarche—13 to 14 years
(g) Fertility—15 years
Stages of genital maturity in male takes approximately \_\_years to move from stage 2 to5 (tanner Staging)
4 years
FEMALES (Tanner staging)
(1) Stage 1:
(2) Stage 2:
(3) Stage 3:
(4) Stage 4:
(5) Stage 5:
Female
(Tanner staging)
(1) Stage 1: Preadolescent breast with nipple elevation, no pubic hair
(2) Stage 2: Breast buds with areolar enlargement, sparse pale fine pubic hair
(3) Stage 3: Breast enlargement without separate contour with nipple, darker more curled increased amount of pubic hair
(4) Stage 4: Projection of areola and nipple as secondary mound to breast, hair is adult in character, but doesn’t cover entire pubic area
(5) Stage 5: Adult breast with areola receding and nipple projecting from
breast, adult distribution in quantity and pattern
Stages of pubic hair development in males and females (Tanner staging) (1) Stage 1: (2) Stage 2: (3) Stage 3: Stage 4: Stage 5
Stages of pubic hair development in males
and females (Tanner staging)
(1) Stage 1: Preadolescent without pubic hair
(2) Stage 2: Sparse, pale, fine pubic hair
(3) Stage 3: Darker, more curled, increased amount of pubic hair
Stage 4: Hair is adult in character but doesn’t cover entire pubic area
(5) Stage 5: Adult distribution in quantity, quality, and pattern
Male genital maturity with hair Stage 1: Stage 2: Stage 3: Stage 4: Stage 5:
Stage 1: Preadolescent testes, scrotum, and penis, no pubic hair
Stage 2: Enlargement of scrotum and testes; scrotum reddens and roughens , sparse pale fine pubic hair
Stage 3: Penis enlarges primarily in length, Darker, more curled, increased amount of pubic hair
Stage 4: Penis enlarges in breadth and development of glans, Hair is adult in character but doesn’t cover entire pubic area
Stage 5: Adult size and shape, hair distribution adult quality

Gynecomastia is usually found in which of the following?
a 14 year old male who is at Tanner stage 3
What is thelarche and when does it happen?
Tanner Stage
What age
Thelarche is the earliest breast development and it is at onset of Tanner Stage 2, earliest age is 7 years old
What is pubarche and when does it happen?
Tanner Stage
What age
Earliest pubic hair development in Tanner Stage 2.
8 year old to 13 years old.
Tanner Stage ?
Projection of areola and nipple as secondary mound to breast,
4
Tanner Stage ?
hair is adult in character, but doesn’t cover entire pubic area
4
Tanner Stage?
Penis enlarges in breadth and development of glans,
4
Tanner Stage
Darker, more curled, increased amount of pubic hair
3
Tanner Stage
Breast buds with areolar enlargement
2
Prepubertal growth occurs at Tanner Stage ____ in girls
Prepubertal growth occurs at Tanner Stage ____ in boys
Prepubertal growth occurs at Tanner Stage 2-3 in girls
Prepubertal growth occurs at Tanner Stage 3-4 in boys
The correct order of maturation in males is:
- Facial, axillary, then pubic hair
- axillary, pubic, facial hair
- pubic, axillary, and then facial hair
- They all appear within 6 months of each other
- pubic, axillary, and then facial hair
Starts low and then moves up
The earliest secondary sexual characteristic in girls is
- Development of pubic hair
- the onset of breast development (thelarche)
- Linear growth
- Menarche
- the onset of breast development (thelarche)
The earliest stage of male maturation is
- the development of pubic hair
- Linear growth
- Testicular volume
- Lengthening of the penis
- Testicular volume
Normal vision in child is expected by
- 4 years of age
- 5 years of age
- 6 years of age
- 7 years of age
6 years of age
In most children, the primary teeth have completely erupted by:
- 12 months
- 14 months
- 20 months
- 24 months
24 months
In most children, the first teeth have erupted by:
- 4 months
- 6 months
- 8 months
- 10 months
6 months
When should a child be completely intelligible in terms of articulation?
- 3 years
- 4 years
- 5 years
- 6 years
by 4 years
First permanent dentition in child is expected by
- 5-6 years of age
- 6-8 years of age
- 8-9 years of age
- 9-10 years of age
6-8 years
When is fluoride supplementation begun?
at 6 months
The best way to examine the oral cavity of a small child is
- with the child standing looking at the ceiling
- to lie the child on his back on an exam table
- to have the caregiver hold the child in her lap
- by asking the child to open his mouth
- to lie the child on his back on an exam table
What is the normal heart rate of a child at birth
120 -1 60 bpm with marked sinus arrhythmia
What is the normal heart rate of a child at 3 years of age
80 -120 beats per minute
What is the normal heart rate of a child at 6 years of age
70-110 beats per minute
When should routine BP screening begin for children?
- 3 years
- 4 years
- 5 years
- 6 years
3 years old
True or False
Physiologic jaundice usually is found in the first 24 hours
False
True or False
Pathologic jaundice usually is found in the first 24 hours
True
Anterior Fontanel closes by
18 months
Posterior Fontanel closes by
2-3 months
At which age of the following ages in an infants life is parental anticipatory guidance about teething most helpful?
a. 1 to 2 months
b. 2 to 4 months
c. 4 to 6 months
d. 8 to 10 months
4 to 6 months (thats when they start eating the solids)
At which age of the following ages in a young child’s life is parental anticipatory guidance about TEMPER TANTRUM most helpful?
a. 12 to 14 months
b. 10 to 12 months
c. 14 to 16 months
d. 8 to 10 months
10 to 12 months (before they start walking, and knowing things)
At which age of the following ages in a young child’s life is parental anticipatory guidance about FALLS most helpful?
a. birth
b. 2 weeks
c. 2 months
d. 4 months
a. birth
At which age of the following ages in a young child’s life is parental anticipatory guidance about sleep most helpful?
a. birth
b. 2 weeks
c. 2 months
d. 4 months
BIRTH
At which age of the following ages in a young child’s life is parental anticipatory guidance about TIME OUT most helpful?
a. 12 to 14 months
b. 18 to 24months
c. 24 to 30 months
d. 30 to 36 months
b. 18 to 24months
At which age of the following ages in a young child’s life is parental anticipatory guidance about TOILET TRAINING readiness most helpful?
a. 12 months
b. 15 months
c. 18 months
d. 24 months
18 months
The following chromosomal syndrome is a common etiology of social and verbal developmental delays in boys:
a. Tay-Sachs disease
b. Cystic fibrosis
c. Fragile X
d. Trisomy 18
c. Fragile X
One physical sign of Fragile X syndrome in males include
a. large eyes
b. large forehead
c. small head
d. recessive jaw
Large forehead, ears, prominent jaw, tendency to avoid eye contact, large habits, hyperactivity, developmental disability common.
Females; Less common with fewer prominent findings, usually with less severe developmental issues.
Kleinfelter syndrome is most commonly marked by:
a. language impairment in males
b. fine motor delay in males
c. hip and breast enlargement in women
d. ADD in males
a. language impairment in males
Kleinfelter syndrome and risk for having a child with this condition can be accurately identified by (choose all that apply):
a. urine test
b. literacy assessment
c. amniocentesis
d. blood testing for carrier state.
c. amniocentesis
d. blood testing for carrier state.
Fragile X and risk for having a child with this condition can be accurately identified by (choose all that apply):
a. urine test
b. literacy assessment
c. amniocentesis
d. blood testing for carrier state.
c. amniocentesis
d. blood testing for carrier state.
An 11 year old well child presents with no documented primary tetanus immunization series. Which of the following represents the immunization needed?
a. 3 doses of DTaP vaccine 2 months apart
b. tetanus immune globulin now and 2 doses of tetanus diphtheria (td) 1 month apart
c. one dose of Tdap followed by 2 doses of Td in 1 and 6 months
d. Td (tetanus, diphtheria) as a single dose.
c. one dose of Tdap followed by 2 doses of Td in 1 and 6 months
Older children going through a “catch up” immunization schedule should receive one Tdap and 2 td doses at the appropriate interval.
(7-18 years old)
Usual tx for a child with hep A includes:
a. interferon alpha
b. ribarivin
c. acyclovir
d. supportive care.
d. supportive care.
At which age is a child at greatest risk for Pertussis?
a. 10 years old.
Common signs and symptoms of pertussis in a 3 year old child include all of the following except:
a. uncontrollable cough
b. vomiting
c. fatigue
d. diffuse rash
diffuse rash
The most helpful tests to support the diagnosis of pertussis include which of the following? more than one can apply:
a. chest x ray
b. nasopharyngeal culture
c. blood culture
d. polymerase chain reaction (PCR) testing
b. nasopharyngeal culture (gold standard)
d. PCR testing
The preferred treatment option for a 6 year old boy with pertussis is :
a. amoxicillin
b. ceftriaxone
c. Azithromycin
d. Levofloxacin
Macrolide
Azithromycin.
What is Pertussis?
whooping cough, a highly contagious respiratory disease. The infection is characterized by a paraoxysmal cough (a series of severe, vigorous coughs during a single expiration) that offend makes it difficult to breathe. Following a cough fit, the child often needs to take deep breaths resulting in the high pitched whooping sound. Pertussis most often affects infants and young children and can be fatal, particularly in infants less than 1 year old.
The preferred treatment option for a 2 month old boy with pertussis is :
a. clarithromycin
b. Erythromycin
c. Azithromycin
d. Levofloxacin
Azithromycin, the other two macrolide are not recommended especially if the infant is
The preferred treatment option for a 2 month old who is sensitive to Azithromycin is :
a. amoxicillin
b. TMP-SMX
c. clarithromycin
d. Levofloxacin
TMP-SMX
