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Gen Med: Peds > Growth & Development > Flashcards

Growth & Development Flashcards

1
Q

A child typically doubles birth weight by what age?

A

6 mo

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2
Q

A child typically triples birth weight by what age?

A

1 year

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3
Q

2/3 brain size is achieved by what age?

A

2.5-3 yrs

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4
Q

Areas typically surveyed during well child visits

A 
Growth
(Height, weight, head) circumference
Nutrition, elimination patterns, sleep
Language
Gross & fine motor skills
Personal & social behaviors
Safety
Anticipatory Guidance
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5
Q

Weight: Newborn

A

Loses about 5 - 10% of his or her birth weight (AFTER FIRST STOOLING)
By ≈ 2 weeks, infant should start to gain weight & grow quickly

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6
Q

Weight: 4-6 mo

A

Weight should DOUBLE the birth weight

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7
Q

Weight: 12 mo

A

Weight should TRIPLE birth weight

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8
Q

Between ages 1 & 2 yrs, a toddler will gain only…?

A

about 5 lbs

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9
Q

Between what ages will the childs weight remain about 5 lb/yr

A

2-5 yrs

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10
Q

Between what ages will the childs weight remain about 5 lb/yr

A

2-5 yrs

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11
Q

Between what ages will the childs weight remain about 5 lb/yr

A

2-5 yrs

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12
Q

Between what ages will a child continue to grow at a steady pace?

A

5-10 yrs

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13
Q

When does a childs final growth spurt start?

A

at the start of puberty (sometime between 9 & 15 yrs)

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14
Q

WCC Schedule

A 
1-2 weeks
2 months
4 months
6 months
9 months
12 months
 15 months
18 months
2 years 
3 years
4 years
5 years
Annually thru 21 years
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15
Q

Components of the WCC

A
  1. Hx
    a. Growth Pattern
    - Length, weight, HC, BMI
    - Flattening of curve is abnormal (RED FLAG)
  2. Developmental Milestones
  3. Nutrition
  4. Elimination Pattern
  5. Sleep Pattern
  6. Social Interaction
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16
Q

When is stuttering normal?

A

In toddler 3-4 yrs - normal language development

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17
Q

When should you refer to a speech pathologist?

A
  • There are other signs w/ stuttering such as tics, grimacing, or extreme self consciousness
  • Stuttering lasts > 6 mo
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18
Q

At what age might they start participating in games that have rules?

A

4 or 5 year olds

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19
Q

Up to what age should parents use a rear facing car seat?

A

birth up to age 2

20
Q

Up to what age should parents use a forward facing car seat?

A

age 2 up to at least age 5

21
Q

Up to what age should parents use a booster car seat till?

A

age 5 up until seat belts fit properly

22
Q

The poison control center phone number?

A

800-222-1222
open 24/hr 7 d/wk
Doesn’t have to be an emergency

23
Q

The poison control center phone number?

A

800-222-1222
open 24/hr 7 d/wk
Doesn’t have to be an emergency

24
Q

Components of WCC: Physical Exam

A
  1. Length (>2 yr Ht)
  2. Weight
  3. HC
    a. Up to 24 months (up to 2 yrs old then drop HC & pick up BMI)
  4. BMI
    a. > 2 yr
  5. Vision
    a. Begin screening @ 3 yr
  6. Hearing
    a. Annual sreening w/ audiometry beginning @ 4 yr
    If suspect hearing problems prior, refer to Audiologist
  7. BP
    a. 3 yrs & older
  8. Heart rate, resp rate
  9. General Appearance
  10. Skin
  11. HEENT
    a. Fontanelles (posterior will close before anterior, if sucken in = dehydration, if bulging = crying etc.), red reflex, corneal light reflex, visual tracking, ENT, dentition
  12. Neck (strength etc)
  13. Cardiac
  14. Respiratory
  15. Abd
    a. Auscultation, palpation, percussion
  16. Genitalia
  17. Femoral pulses
  18. Hips (checking for congenital dislocations)
    a.
25
Q

Components of WCC: Physical Exam

A
  1. Length (>2 yr Ht)
  2. Weight
  3. HC
    a. Up to 24 months (up to 2 yrs old then drop HC & pick up BMI)
  4. BMI
    a. > 2 yr
  5. Vision
    a. Begin screening @ 3 yr
  6. Hearing
    a. Annual sreening w/ audiometry beginning @ 4 yr
    If suspect hearing problems prior, refer to Audiologist
  7. BP
    a. 3 yrs & older
  8. Heart rate, resp rate
  9. General Appearance
  10. Skin
  11. HEENT
    a. Fontanelles (posterior will close before anterior, if sucken in = dehydration, if bulging = crying etc.), red reflex, corneal light reflex, visual tracking, ENT, dentition
  12. Neck (strength etc)
  13. Cardiac
  14. Respiratory
  15. Abd
    a. Auscultation, palpation, percussion
  16. Genitalia
  17. Femoral pulses
  18. Hips (checking for congenital dislocations)
    a.
26
Q

Recommended Screening: Lead

A

@ 1 yr & pre-school (ask how old house is? City water or well water? (if floride water (city)) Need to start those on well water on lead gtts

27
Q

Recommended Screening: Iron Def Anemia

28
Q

Recommended Screening: Cholesterol

A

@ 9-11 yrs then 17-21 yrs

29
Q

Normal Growth: 5 Periods

A
  1. Newborn
    - First 28 days of life**
  2. Infancy
    - 1 month – 1 yr
  3. Toddler
    - 13 months – 2 yr
  4. Preschool years
    - 3- 5 yr
  5. Middle childhood years
    - 6 – 9 yr
  6. Adolescence
    - 10 – 19 yr
30
Q

Potential Problems: Newborn

A
  1. Skin mottling, hemangiomas, nevi, Mongolian spots, birthmarks
  2. Jaundice
  3. Anterior or posterior fontanelle, shape, moulding, caput succedaneum (craddle cap), cephalohematoma (not uncommon with a difficult vaginal birth)
  4. Red reflex, subconjunctival hemorrhages (not uncommon with diff vaginal births)
  5. Abdominal masses
  6. Genitalia
  7. Cardiac murmurs, femoral pulses
  8. Clavicle deformities, hip dysplasia, foot abnormalities
31
Q

Potential Problems: Infants

A
  1. Cardiac murmurs
  2. Hip dysplasia
  3. Abdominal masses
  4. Thrush (oral nystatin, nursed babies & bottle fed)
  5. Cradle cap (normal, baby oil & fine comb)
  6. Diaper rashes (keep babies opened up as much as possible, a&d ointment is debs favorite)
  7. Tooth eruption in older infants (> 6 months)
32
Q

Potential Problems: Toddlers & Pre-School

A
  1. Early childhood caries
    a. Baby bottle tooth decay, NO BOTTLES IN CRIB
  2. Excessive bruising or injuries PRETIBIAL BRUISES – VERY COMMON
  3. Gait (look for tibial torsion?)
33
Q

Potential Problems: Middle Childhood

A
  1. Caries, dental anomalies, malocclusions
  2. Early puberty (hormones in meats?)
  3. Scoliosis
    - Start screening at age 10 (Deb starts earlier at school age)
34
Q

Potential Problems: Adolescence

A
  1. Tanner stages
    a. Older adolescence  teach self breast & testicular self exams
  2. Scoliosis
  3. Evidence of eating disorders (look at chart)
  4. Sports injuries
  5. Dental problems
  6. Acne (bring it up!)
  7. Tattoos, piercing
35
Q

Potential Problems: Puberty

A
  1. Exact age a child enters puberty varies due to:
    a. Genetics, Nutrition, Gender
  2. During puberty, hormone production  body changes & the development of secondary sex characteristics:
    a. Ovaries begin to increase production of estrogen & progesterone → menarche
    b. Testicles increase in size
    c. ↑ Axillary sweating, body odor, axillary & pubic hair
36
Q

Potential Problems: Puberty Female

A
  1. Normal sequence of changes occur over 2 yrs:
    a. Breast development – 1st sign
    b. ↑ Height
    c. ↑ Hip size
    d. Clear or whitish vaginal secretions
    e. Pubic, axillary & leg hair growth
  2. Menarche
    a. Irregularity initially common
  3. Puberty is usually complete by age 17
  4. Full physical maturity reached by 17 yr, but educational & emotional maturity continue
37
Q

Female Tanner Stages: 1

A

Prepubertal with no pubic hair

38
Q

Female Tanner Stages: 2

A

Sparse, straight hair along lateral vulva

39
Q

Female Tanner Stages: 3

A

Hair is darker, coarser, and curlier extending over the mid-pubis

40
Q

Female Tanner Stages: 4

A

Hair is adult like in appearance, but does not extend to the thighs

41
Q

Female Tanner Stages: 5

A

Hair is adult in appearance, extending from thigh to thigh

42
Q

Puberty Males: Sequence of changes

A
  1. Enlargement of testicles – 1st sign
  2. Faster growth, especially height
  3. Hair growth in axilla, on face, & pubic area
  4. ↑ Shoulder width
  5. Growth of the penis
  6. Nighttime ejaculations
  7. Voice changes
43
Q

Male Tanner Stages: 1

A

Prepubertal with no pubic hair

44
Q

Male Tanner Stages: 2

A

Sparse, straight pubic hair along the base of the penis

45
Q

Male Tanner Stages: 3

A

Hair is darker, coarser, and curlier, extending over mid-pubis

46
Q

Male Tanner Stages: 4

A

Hair is adult like in appearance, but does not extend to the thighs

47
Q

Male Tanner Stages: 5

A

Hair is adult in appearance, extending from thigh to thigh

Gen Med: Peds (6 decks)

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