Intro to Peds: Growth

Question 1

Weight

• Weight loss; in first few days __-__% of birth weight is normal
• Return to birth weight: __-__ days of age
• Double birth weight: __-__ months
• Triple birth weight: ___ years
• Daily weight gain
  
  • ___-__g for first 3-4 mths
  • __-__g for rest of first year

Answer 1

• 5-10%
• 7-10 days
• 4-5 mths
• 1 yr
  
  • 20-30g
  • 15-20g

Question 2

Measuring Growth

• Concern if kids ___ off their growth curve*
• Most important is staying on their ____ growth curve (ex if height 30% but parents are both short, probs okay)*

Answer 2

• fall*
• individual*

Question 3

Important Concepts

• When caloric intake is inadequate
  
  • The ____ percentile falls first
  • then the _____
  • then ____ _____ is last
• Big for gestational age will usually have a drop in weight around 6-18mths (catch ___ growth)
  
  • until they match their genetic programming , does not drop more than __ SD
  • must have normal ______
• Premature or small for gestation age will have”catch __ growth” around 6 mths
  
  • feed on ____
  • may need higher _____ intake
  • at risk for ____
• _____ measurement if change appears abnormal

Answer 3

• inadequate caloric intake
  
  • weight
  • height
  • head circumference
• catch down growth
  
  • 2SD
  • development
• catch up
  
  • demand
  • caloric
  • obesity
• Repeat

Question 4

Measuring Length

Better done with?

Answer 4

2 people

Question 5

Fetal Head

Answer 5

Question 6

Head Circumference

• Measures ____ growth
• Concern for in____ or ex____ head growth
• Measured in __ at birth and every well visit until age of __
• First 2 yrs of life greatest ____ growth
• Ave newborn HC __-__cm at birth
• Grows __cm for the first 3mths then __cm there after until age of 1

Answer 6

• brain
• inadequate, excessive
• cm, 2
• neurological
• 35-36
• 2cm first 3 mths, 1cm till 1yo

Question 7

Age of Fontanel Closure

• Posterior =
• Anterior Lateral (Sphenoid) =
• Posterior Lateral (Mastoid) =
• Anterior =

Answer 7

• Two months
• Three months
• One year
• Two years

Question 8

Suture Closure (in months)

Answer 8

Question 9

Craniosynostosis

=

• The fusion _____ the growth of the ____
• In order to accommodate the growing brain, compensatory skull growth occurs ____ to the affected suture
• Craniosynostosis is ____, affecting an estimated 1/1800-3000 children. 3/4 cases effect what gender?
• _____ craniosynostosis is the most common form of the condition 80-95% of all cases.

Answer 9

When one or more suture closes (fuses) early

• restricts growth of skull
• parallel
• rare, males
• Nonsyndromic

Question 10

Scaphocephaly

=

• Causes _____ head
• Most ____ cause of craniosynostosis

Answer 10

Closure of the sagittal suture

• elongated
• most common cause

Question 11

Brachycephaly

The head _____ uniformly, causing a _____ and ____ shape

Increased head ____ is also common

Answer 11

flattens, wider, shorter

height

Question 12

Plagiocephaly

=

• It’s called a _____ deformity bc if you look down on infants head from a bird’s eye view, this is the shape you will see
• ______ of ears

Answer 12

“Oblique Head”

• parallelogram
• Misalignment of ears

Question 13

HC Chart

Abnormal ehad growth is defined as a head circumference greater than __ SD’s ____ or ____ the mean for a given age, gender, and gestation

• Microcephaly =
• Macrocephaly =

Answer 13

2SDs above or below mean

• 2 SD below mean
• 2 SD above mean

Question 14

HC Patterns

1. Weight, length, HC all <5th percentile
   
   1. Diagnoses to Consider (4)
   2. Further Eval (4)
2. Discrepant percentiles (eg. weight 5th, length 5th, HC 50th, or other discrepancies)
   
   1. Diagnoses to Consider (3)
   2. Further Eval (4)
3. Declining Percentiles
   
   1. Diagnoses to Consider (3)
   2. Further Eval (3)

Answer 14

1. <5th percentile
   
   1. Familial short stature, Constitutional short stature, Intrauterine insult, Genetic abnormality
   2. Midparental heights, eval of pubertal development, Exam of prenatal records, Chromosome analysis
2. Discrepant percentiles
   
   1. Normal variant (familial or constitutional), Endocrine growth failure, Caloric insufficiency
   2. Midparental heights, Thyroid hormone, Growth factors/growth hormone testing, Eval of pubertal development
3. Declining Percentiles
   
   1. Catch down growth, Caloric insufficiency, Endocrine growth failure
   2. Complete HP, Dietary and social history, Growth factors/growth hormone testing

Question 15

Teeth Formation

• First teeth usually appear around __ mths
  
  • Which teeth?
• Appear at _____ times
  
  • Cannot age a person on teeth
• First dentest visit __-__yrs of age

Answer 15

• 6mths
  
  • Central Lower Incisors
• Different
• 1-2 yrs first dentist