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Peds > Growth & Development > Flashcards

Growth & Development Flashcards

1
Q

When does average newborn regain birthweight?

A

3rd week

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2
Q

When does birthweight double?

A

5 months

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3
Q

When does birthweight triple?

A

1 year

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4
Q

Infant younger than 3 weeks who hasn’t regained birthweight…

A

Reassure and re-evaluate in 1 week

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5
Q

Average infant height (50%)?

A

50cm

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6
Q

Birth length goes up 50% by age…?

A

1

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7
Q

Birth length is doubled by…?

A

4

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8
Q

Birth length is tripled by…?

A

13

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9
Q

Growth rate first year of life?

A

20 cm/year

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10
Q

Birth size reflection of?

A

Maternal factors and in utero conditions (vs. genetic growth potential)

Infant can cross percentiles in 1st 12-18 months as genetic, hormonal, and environmental factors overcome maternal ones

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11
Q

When are you half your adult height?

A

2

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12
Q

When do you worry about abnormality of growth?

A

Shifts across 2+ percentile lines on growth curve after 2

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13
Q

What has significant effect on linear growth velocity?

A

Chronic diseases

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14
Q

Normal head circumference at birth for full term newborn?

A

35cm

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15
Q

Normal head growth for first 6 months?

A

~1 cm/month

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16
Q

Normal head growth from 6-12 months?

A

~1/2 cm/month

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17
Q

Head circumference above 98 percentile for age?

A

Macrocephaly

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18
Q

Infant with increasing head circumference, but normal development…?

A

Measure parents’ heads- Normal familial macrocephaly

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19
Q

Is hydrocephaly present at birth?

A

Can be, doesn’t have to be

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20
Q

Signs of hydrocephaly

A

Irritability, lethargy, poor appetite, persistent vomiting, bulging fontanelle, neurological findings in infant with rapidly enlarging head

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21
Q

Normal development, no signs increased ICP, parents with big heads

A

Macrocephaly

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22
Q

Irritability, vomiting, bulging fontanelle, impaired upward gaze

A

Hydrocephaly

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23
Q

Which is scary… Large anterior fontanelle v. Bulging fontanelle?

A

Bulging…associated with increased ICP

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24
Q

Is a bulging fontanelle associated with papilledema?

A

No ( it’s chronic, not acute)

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25
Q

Weight drop first, then decreased length, spares head circumference

A

Inadequate calorie intake

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26
Q

Short stature with normal or elevated weight

A

Endocrine disorders

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27
Q

Microcephaly + Dysmorphic features

A

Chromosomal abnormalities

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28
Q

Weight and height decrease together

A

Chronic medical conditions

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29
Q

Head circumference below 5th percentile for age

A

Microcephaly

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30
Q

Acquired Microcephaly

A

Occurs in infants who had normal head circumference at birth

If head circumference decreases while weight and height stay the same, has to be a cause

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31
Q

A physical sign that a child is receiving inadequate nutrition for optimal growth and development.

A

FTT

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32
Q

Weight below 5th percentile for age

A

FTT

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33
Q

Weight that drops 2 major percentile channels

A

FTT

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34
Q

Weight less than 80% of ideal weight for age

A

FTT

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35
Q

Weight below 5th percentile on the weight-for-length curve

A

FTT

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36
Q

Which kids have specific growth charts?

A

Down, Turner, William’s

Don’t call growth abnormal unless comparing to the specific chart

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37
Q

When is it normal for kids to change % up to 2 channels up or down?

A

Between birth and 2

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38
Q

Consideration in FTT…?

A

New caretaker, improper mixing of formula

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39
Q

First thing to check with FTT?

A

Most cases from non-organic causes…evaluate diet first then look at mother/child interaction (feeding technique)

Labs/tests are not first step!

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40
Q

4 categories of organic causes of FTT?

A
  1. Chronic renal failure
  2. Thyroid and other metabolic disorders
  3. Disorders leading to inadequate absorption
  4. Disorders leading to inadequate utilization

*Something in history will suggest these causative factors

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41
Q

Throw ball while standing?

A

18 months

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42
Q

Throw overhand?

A

24 months

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43
Q

When can you stop factoring in prematurity for milestones?

A

2 years

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44
Q

28 week GA infant, now 2.5 months old… What aged milestones?

A

Full-term baby…corrected age is 38 weeks

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45
Q

Can follow mom around room through 180 degree arc

A

2 months (2 Sides)

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46
Q

Lift head and chest while prone

A

2 months (#2 rolling up)

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47
Q

Coo

A

2 months (two rhymes with coo)

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48
Q

Scratches/grabs clothes

A

4 months

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49
Q

Clutch/hold rattle

A

4 months (Looks like rattle)

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50
Q

Put objects deliberately in mouth

A

4 months

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51
Q

Sit up

A

6 months (6 looks like baby sitting, 6 month olds can sit)

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52
Q

Transfer cube from one hand to other

A

6 months

53
Q

Crawl on bellies

A

6 months

54
Q

Walk with hand held

A

12 months (1 year old can walk with one hand held)

55
Q

Point

A

12 months (Need 1 finger to point)

56
Q

Say one word besides mama and dada

A

12 months

57
Q

Walks fast, falls occasionally, walks upstairs with hand held, climbs into and sits in chair

A

18 months

58
Q

Feed themselves

A

18 months

59
Q

How many cubes at 18 months?

A

2-3

60
Q

How many cubes at 24 months?

A

4-6

61
Q

How many cubes at 36 months?

A

8

62
Q

6-cube tower?

A

2 years

63
Q

Walk up stairs with alternating feet?

A

3 years

64
Q

Ride a tricycle

A

3 years (3 wheels for 3 years)

65
Q

Hop 3 times

A

3 years

66
Q

Identify opposites

A

4 years

67
Q

Draw 4 body parts

A

4 years

68
Q

Rule of 4’s (6 items)

A
  1. Count to 4
  2. Recite a 4-word sentence
  3. Identify 4 primary colors
  4. Draw a 4-part person
  5. Build a gate out of blocks (4 looks like a gate)
  6. Stranger understands 4/4 of what they say
69
Q

Tie a knot

A

5 years

70
Q

Correctly grab a pencil

A

5 years

71
Q

Print letters

A

5 years

72
Q

Draw a square

A

5 years

73
Q

Walk backward heel-to-toe

A

5 years (avoids school by walking backwards)

74
Q

Draw circle

A

3 years

75
Q

Draw cross

A

4 years

76
Q

Draw square

A

5 years

77
Q

Draw triangle

A

6 years

78
Q

Draw diamond

A

7 years

79
Q

Worry with lack of visual attention/fixation

A

2 months

80
Q

Worry with lack of visual tracking

A

4 months

81
Q

Worry with lack of steady head control while sitting

A

4 months

82
Q

Worry with failure to turn to sound or voice

A

6 months

83
Q

Worry with lack of smile or joyful expressions

A

6 months

84
Q

Worry with inability to sit

A

9 months

85
Q

Worry with lack of reciprocal vocalizations, smiles, or other facial expressions

A

9 months

86
Q

Worry with failure to respond to name when called

A

12 months

87
Q

Worry with absence of babbling

A

12 months

88
Q

Worry with inability to walk independently

A

18 months

89
Q

Worry with lack of simple pretend play

A

18 months

90
Q

Worry with lack of language/gestures

A

18 months

91
Q

Worry with lack of 2-word meaningful phrases

A

24 months

92
Q

Worry with loss of previously acquired speech or social skills

A

Any age

93
Q

50% intelligible speech

A

2 years

94
Q

75% intelligible speech

A

3 years

95
Q

100% intelligible speech

A

4 years

96
Q

Stuttering can be normal until what age?

A

3 or 4 years (often disappears once vocab increases)

-Normal/reassure

97
Q

When do you refer for stuttering?

A
  1. Persistence beyond preschool age
  2. Persists for more than 6-8 weeks
  3. Marked parental concern
  4. Associated symptoms like facial tics
98
Q

Can serious language delays be explained by bilingual home, second child with siblings, or parents speaking for child?

A

No

99
Q

First thing to do with language delay?

A

Hearing test

100
Q

History of TORCH infection, hyperbilirubinemia, or meningitis + language delay?

A

Hearing evaluation

101
Q

What impacts language and emotional development as well as ability to read?

A

Chronic hearing loss (including loss due to chronic otitis media)

102
Q

Hearing loss that starts after what age has less of an impact than if it occurs before?

A

5 years

103
Q

Most important intervention for language development in infant with congenital hearing loss?

A

Family involvement (including non-verbal communication)

  • Family use of verbal and nonverbal communication has been shown to have the most positive impact on language acquisition in children with hearing loss
  • This is more important than specific formal interventions
104
Q

Goal of early intervention?

A

Provide services to aid in developmental progress (speech therapy, occupational therapy, physical therapy)

105
Q

What outlines guidelines for education of children in U.S. who have developmental delays or other problems that may interfere with learning?

A

Individuals with disabilities education act ( IDEA)

106
Q

Part C of IDEA covers what?

A

Early intervention services for kids under 3

  • Goal is for kids to reach developmental potential and improve cognitive outcome
  • Programs must be family based and culturally relevant
107
Q

Does Feingold diet show benefit in managing ADHD or learning disabilities?

A

No

108
Q

Is restricting sugar beneficial for managing/treating ADHD or behavioral disorders?

A

No, but don’t use sugar/candy as reward for good behavior

109
Q

Mega vitamin therapy?

A

Increases disruptive behavior (no role with managing learning disabilities or behavioral problems)

110
Q

Solutions for autism and other developmental disorders that have not been proven to be effective?

A

Sensory integration therapy, eye exercises, chelation therapy, hyperbaric O2 chambers

111
Q

Systematic monitoring “structured surveillance” of a child’s development using standardized screening tools has been proven to identify delays in children much more often than physician questioning and observation alone “unstructured surveillance”

A

Yup

112
Q

When do you use universal post-partum mood disorder screening?

A

First year after birth

113
Q

When do you do general structured developmental screening?

A

9, 18, and 24 or 30 months

114
Q

When do you do autism specific screening?

A

18 and 24 months

115
Q

When do you do social emotional screening?

A

Whenever a screening instrument is abnormal

116
Q

Average newborn loses up to what % of birthweight?

A

10%

117
Q

What has been proven to identify delays in children much more often than physician questioning and observation alone?

A

Systematic monitoring: “Structured surveillance”

118
Q

When do you do universal post-partum mood disorder screening?

A

In first year after birth

119
Q

When do you do general structured developmental screening?

A

9, 18, and 24 or 30 months

120
Q

When do you do autism specific screening?

A

18 and 24 months

121
Q

When do you do social emotional screening?

A

Whenever a screening instrument is abnormal

122
Q

When do you do kindergarten readiness screening?

A

4 years

123
Q

What should be done at every health supervision visit from ages 5-18?

A

Social-emotional/mental health/psychosocial function screening

124
Q

What do you do at every health supervision visit throughout adolescence?

A

Substance abuse-specific screening

125
Q

Name 2 general developmental screens

A
  1. Ages and stages questionnaire (ASQ)

2. Parents’ evaluation of developmental status (PEDS)

126
Q

Name a specialized developmental screen

A

Modified checklist for autism in toddlers (MCHAT)

127
Q

Name 3 mental health/behavior screens

A
  1. Pediatric symptoms checklist (PSC)
  2. Connors 3
  3. Vanderbilt scales
128
Q

3 ways development can go astray?

A
  1. Delay in development
  2. Deviation in order of skills acquisition or an atypical pattern of development
  3. Dissociation where different areas of development advance at different rates

-3Ds of developmental deviation

Peds (35 decks)

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