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Child Health > Growth and Development > Flashcards

Growth and Development Flashcards

1
Q

What is a normal birth weight?

A

3.5kg (7lbs)

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2
Q

What is a normal weight at 1yr?

A

10kg

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3
Q

When is the first micturition normally?

A

<24 hours

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4
Q

When should meconium have passed by?

A

<48 hours

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5
Q

How much milk should a baby be having?

A

150ml/kg/day

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6
Q

When is weaning advised?

A

6 months

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7
Q

What calorie intake is suggested for babies?

A

<1yo - 110/kg/day

>1yo - 1000 + (100xage)

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8
Q

How do you calculate maintenance fluids for a baby?

A

First 10 kg - 100ml/kg/day
Next 10 kg - 50ml/kg/day
After - 20ml/kg/day

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9
Q

When do you expect children to be urinary continent in the day?

A

2-3 years

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10
Q

When do you expect children to be urinary continent in the night?

A

3-4 years

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11
Q

When do you expect children to stop soiling by?

A

By 4 years

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12
Q

How much would you expect neonates to sleep?

A

16 hours a day

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13
Q

What RR and HR would you expect for a <1yo?

A

RR - 30-40

HR - 110-160

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14
Q

What RR and HR would you expect for a 1-2yo?

A

RR - 25-35

HR - 100-150

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15
Q

What RR and HR would you expect for a 2-5yo?

A

RR - 20-30

HR - 95-140

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16
Q

What RR and HR would you expect for a 5-12yo?

A

RR - 15-20

HR - 80-120

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17
Q

What RR and HR would you expect for a >12yo?

A

RR - 12-16

HR - 60-100

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18
Q

What categories can developmental milestones be divided into?

A

Gross Motor
Fine motor and vision
Speech and language
Social

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19
Q

What do you expect a baby to do at birth?

A

Startle

Quiets to voice

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20
Q

What do you expect a baby to be doing by 6-8 weeks?

A

Head held up briefly
Fix and follow - 90 degrees
Vocalise
6 week social smile

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21
Q

What do you expect a baby to be doing by 3 months?

A

Hold up head & lose palmar grasp reflex
Reach to grasp, hold rattle, fix and follow for 180 degrees
Turn to sound
Laugh

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22
Q

What do you expect a baby to be doing by 4-5 months?

A

Reach for toys
Play, hands together
Squeal
Excited by food

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23
Q

What do you expect a baby to be doing by 6-9 months?

A

Sit without support, crawl
Transfer objects between hands, palmar grasp
Babble, turn to voice
Stranger awareness

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24
Q

What do you expect a baby to be doing by 10-12 months?

A

Cruise furniture
Immature pincer grip
Double syllable babble
Wave bye bye, peak a boo

25
Q

What do you expect a baby to be doing by 13-18 months?

A

Walk unaided
Pincer grip, to and fro scribble, build a 3 block tower
Point to body part
Drink from cup, ask for food, indicate wants

26
Q

What do you expect from a baby by 2 years?

A

Running and jumping, kick ball
Scribble, build tower of 6-7 blocks
Speak 2 word sentences, name 2 body parts
Difficulty sharing, feed self with spoon

27
Q

What do you expect from a baby by 3 years?

A

Ride tricycle, go up and down stairs, hop
Build tower of 9-10 bricks, draw circle
Say name, age, sex, count to 10, name 5 body parts
Mostly toilet trained, undress self, interactive play

28
Q

What do you expect from a baby by 4 years?

A

Stand on 1 leg
Copy square/cross, build 10 block tower
Tell story, use past tense, count to 20
Dress with help, parallel play with other children

29
Q

What do you expect from a baby by 5 years?

A

Skips
Draw triangle
Know colours, age, address
Name friends, comforts in distress

30
Q

When assessing delay, what do you have to think about?

A

Global delay or isolated milestone?
Abnormal or just a variant of normal?
Neurological signs?

31
Q

What are the possible causes for delayed walking?

A

Cerebral palsy
Muscular dystrophy
Global delay as part of syndrome
Neurology related (maternal drinking, head injury, malnutrition)

32
Q

How would you assess delayed walking?

A 
When did the parents walk?
Significant FH
Has carer been encouraging walking
Assess tone and muscle control
Babinski reflex
33
Q

What are some primary causes of speech delay?

A

Receptive language disorder

Expressive language disorder

34
Q

What are some secondary causes of speech delay?

A 
Structural defects - cleft lip, tongue tie
Deafness
Autism
Selective mutism
Learning disability
Familial
35
Q

How is speech delay assessed?

A

Hearing test
Can they understand and not speak or not understand?
Assess non-verbal

36
Q

What is prenatal growth dependent on?

A

Maternal size and nutrition
Intrauterine environment
Insulin, insulin like growth factor and human placental lactogen

37
Q

What is infantile growth dependent on?

38
Q

What is childhood growth dependent on?

A

Growth hormone

General health

39
Q

What is pubertal growth dependent on?

A

Sex steroids - oestrogen and testosterone

Growth hormone

40
Q

What is failure to thrive?

A

Descriptive term for child drowning less than expected during first 3 years of life

In America - child cross 2 major gentiles on growth chart or fall below 3rd centile

41
Q

Is it worrying if a child falls through the height centile in the first 2 years of life?

A

Depend on how child is:

If healthy and happy, no need for concern, likely genetic
Consider parental height

42
Q

What is the normal pattern of weight change for a newborn?

A

Lose 10% of weight in first few days but regain within 2 weeks

43
Q

What are most cases of failure to thrive due to?

A

Undernutrition - 95%

44
Q

What are some other causes for failure to thrive?

A

Excess food loss
Inadequate absorption
Increased energy requirements

45
Q

What could cause a child to have inadequate intake?

A

Feeding disorders - reflux, Hx of NG tubes

Structural issues - oesophageal stricture, atresia, TOF

46
Q

What are some causes for excess food loss?

A

Severe vomiting - GORD, pyloric stenosis, raised ICP, malrotation

Diarrhoea - Coeliac, cow milk protein allergy, short gut syndrome

Urine - diabetes

47
Q

What can cause malabsorption?

A 
Coeliac
IBD - UC/Crohns
Cystic fibrosis
Cow milk allergy
Short gut syndrome
Parasite
48
Q

How do you correct for premature babies?

A

Use a corrected age: Time since birth - degree of prematurity

12 week old baby born at 32 weeks = 12-8 = treated as 4 weeks old

49
Q

When should premature babies reach a normal head circumference?

50
Q

When should premature babies reach a normal weight?

51
Q

When should premature babies reach a normal height?

52
Q

What areas are important to explore in the history and examination of a child who is failing to thrive?

A

Feed - what and how much
Nappies - wet and dirty? what is the stool like?
Illness/infection
Maternal interaction with child
Signs of down’s or turner’s
Cyanosed?Jaundice?Tachypnoeic?Muscle tone? Dehydrated?

53
Q

What strategies should be used before investigating failure to thrive?

A

Behavioural management:

3 meals and 2 snacks a day
Limit milk to 500ml and limit juice and squash
Increase variety of foods
Praise child when food eaten, ignore if not
Limit meal time to 30 mins

54
Q

When should children be reviewed by the GP for Failure To Thrive?

A

Below 2nd centile for height

55
Q

When should children be reviewed by a paediatrician for FTT?

A

Below 0.4th centile for height
OR
Drop 2 centiles

56
Q

Who else should be involved in the management of Failure To Thrive?

A

Dietician
Psychology
Social services

57
Q

What investigations can be done for Failure To Thrive?

A

Bloods
Immunoglobulins - coeliac screen
Sweat test, IEM screen, karyotype, oesophageal pH
Image - barium swallow, CXR, OGD, Small intestine biopsy, Abdo USS, Echo

58
Q

What prenatal aspects can cause Failure To Thrive?

A

IUGR
Chromosome abnormalities
Toxin exposure
Premature

59
Q

What can increase metabolic demand and such lead to Failure To Thrive?

A

Hyperthyroidism
Chronic heart or lung failure
Malignancy

Child Health (30 decks)

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