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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
What do you expect a baby to be doing by 13-18 months?
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
What do you expect from a baby by 2 years?
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
What do you expect from a baby by 3 years?
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
What do you expect from a baby by 4 years?
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
What do you expect from a baby by 5 years?
Skips Draw triangle Know colours, age, address Name friends, comforts in distress
30
When assessing delay, what do you have to think about?
Global delay or isolated milestone? Abnormal or just a variant of normal? Neurological signs?
31
What are the possible causes for delayed walking?
Cerebral palsy Muscular dystrophy Global delay as part of syndrome Neurology related (maternal drinking, head injury, malnutrition)
32
How would you assess delayed walking?
``` When did the parents walk? Significant FH Has carer been encouraging walking Assess tone and muscle control Babinski reflex ```
33
What are some primary causes of speech delay?
Receptive language disorder | Expressive language disorder
34
What are some secondary causes of speech delay?
``` Structural defects - cleft lip, tongue tie Deafness Autism Selective mutism Learning disability Familial ```
35
How is speech delay assessed?
Hearing test Can they understand and not speak or not understand? Assess non-verbal
36
What is prenatal growth dependent on?
Maternal size and nutrition Intrauterine environment Insulin, insulin like growth factor and human placental lactogen
37
What is infantile growth dependent on?
Nutrition
38
What is childhood growth dependent on?
Growth hormone | General health
39
What is pubertal growth dependent on?
Sex steroids - oestrogen and testosterone | Growth hormone
40
What is failure to thrive?
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
Is it worrying if a child falls through the height centile in the first 2 years of life?
Depend on how child is: If healthy and happy, no need for concern, likely genetic Consider parental height
42
What is the normal pattern of weight change for a newborn?
Lose 10% of weight in first few days but regain within 2 weeks
43
What are most cases of failure to thrive due to?
Undernutrition - 95%
44
What are some other causes for failure to thrive?
Excess food loss Inadequate absorption Increased energy requirements
45
What could cause a child to have inadequate intake?
Feeding disorders - reflux, Hx of NG tubes | Structural issues - oesophageal stricture, atresia, TOF
46
What are some causes for excess food loss?
Severe vomiting - GORD, pyloric stenosis, raised ICP, malrotation Diarrhoea - Coeliac, cow milk protein allergy, short gut syndrome Urine - diabetes
47
What can cause malabsorption?
``` Coeliac IBD - UC/Crohns Cystic fibrosis Cow milk allergy Short gut syndrome Parasite ```
48
How do you correct for premature babies?
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
When should premature babies reach a normal head circumference?
18 months
50
When should premature babies reach a normal weight?
24 months
51
When should premature babies reach a normal height?
40 months
52
What areas are important to explore in the history and examination of a child who is failing to thrive?
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
What strategies should be used before investigating failure to thrive?
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
When should children be reviewed by the GP for Failure To Thrive?
Below 2nd centile for height
55
When should children be reviewed by a paediatrician for FTT?
Below 0.4th centile for height OR Drop 2 centiles
56
Who else should be involved in the management of Failure To Thrive?
Dietician Psychology Social services
57
What investigations can be done for Failure To Thrive?
Bloods Immunoglobulins - coeliac screen Sweat test, IEM screen, karyotype, oesophageal pH Image - barium swallow, CXR, OGD, Small intestine biopsy, Abdo USS, Echo
58
What prenatal aspects can cause Failure To Thrive?
IUGR Chromosome abnormalities Toxin exposure Premature
59
What can increase metabolic demand and such lead to Failure To Thrive?
Hyperthyroidism Chronic heart or lung failure Malignancy

Child Health (30 decks)

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