Lecture 46 - Normal and Abnormal Growth Flashcards
Somatic growth is fastest during the _____ trimester.
CNS growth is 80% complete by age _____ and 95% complete by age _____.
Lymphoid growth actually reaches 200% of what you’ll have as an adult by age ___-___.
2nd
2
5
9-10
Neonates below the 10th percentile for birthweight are considered SGA, but it doesn’t necessitate pathology. What appearance of the neonate’s skin might suggest placental insufficiency?
Wrinkles –> used to be fat, but it was depleted bc of placental insufficiency.
Interestingly, a ______ environment is necessary for appropriate child growth
Nurturing environment
Children need about _____kcals/kg/day to sustain growth. For those with Failure to Thrive (FTT), this should be increased to _____kcals/kg/day.
Refeeding Syndrome (especially _______) can occur with excessive re-introduction of calories due to rapid cellular uptake of ____, ____, and _____.
120kcals/kg/day
150kcals/kg/day
Especially Hypophosphatemia
Potassium, Magnesium, and Phosphate
The only absolute contraindication of the newborn to breastfeeding is if the newborn has _______.
If the mother has an active ____, TB, or _____ infection, breastfeeding is suspended until the infection resolves.
Galactosemia
Syphillis
Varicella
There are about ____ cals/oz of breast milk or formula and there are about ___cc/oz.
20cals/oz
30cc/oz
Cow’s milk should not be given to children under _____months of age.
12
Babies are not physiologically ready to consume solid foods until about ___-___ months of age. When they start to wean off breast milk, they should be given whole milk until about age 2-3. Why?
They need the fat content for CNS development and myelination of nerves.
Babies lose about 10% of their birth weight within the first ____-____days of birth. They then increase at about ___-___g/day for the first 6months of life –> that means they basically double their birth weight by 4-6months and triple their birth weight by 1 year. How much do they gain per year after that until puberty?
10-14 days
20-30g/day
5lbs/year until puberty
Failure to thrive is defined as:
Weight < ____ percentile (need multiple data points to show the child was above this at some point)
Weight for Height < ____ percentile
Triceps skin fold thickness ____mm or less
< ___g/day weight gain from 0-6 months OR < ____g/day weight gain 6-12 months OR falloff from previously established growth curve by _____ or more major percentiles.
Documented weight loss not due to ______.
< 3rd percentile
< 5th percentile
5mm or less
< 20g/day 0-6months
< 15g/day 6-12 months
Falloff by 2 or more
Not due to dehydration
If length of a child is Unaffected in their failure to thrive, what is unlikely to be the cause?
Anything thyroid –> TSH or free T4
Children double in birth length by age ____. They grow on avg ___cm/year from this age until puberty. During puberty, this increases to ___-___cm/year.
4yrs
5cm/year
9-10cm/year
If ______ age = Chronologic age, then a child is said to have entered puberty at a normal age.
Bone age
______ Growth Delay is a normal variation of growth, typically of parents who were “late bloomers.” These infants will be normal size at birth but will have delayed ______, so their _____ age will be less than their chronologic age. They will have normal adult height.
Constitutional Growth Delay
Puberty
Bone
Head Circumference increases about ____cm by 6months of age, with an additional ____cm by 12months. Head growth is complete by about age _____.
9cm
3cm
10years old
Anterior fontanelle should close between ___-___months. If it doesn’t, think ____ or ______.
12-18months
Rickets or Hypothyroidism
What is Iatrogenic Positional Plagiocephaly?
Bc docs recommend babies sleep on their backs to reduce the chance of SIDS, the back of the skull becomes flattened. Parents should be encouraged to give their child “tummy time” when they can observe the child to avoid this.
