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
