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Paeds > Lecture Day 1 Normal Development > Flashcards

Lecture Day 1 Normal Development Flashcards

1
Q

Average brith weight?

When does it double by

A

3.3kg

double it by 3 months

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2
Q

Average head circumference at birth?
1 yr
2 yr

A

35cm
47cm
49cm

(big compared to rest of body)

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3
Q

When do teeth first appear?

A

6 months-2years

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4
Q

Phases of growth

A

pre-natal
infantile
childhood
pubertal

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5
Q 
What drives growth in each stage:
fetal
infantile
childhood 
pubertal
A

fetal 30%: uterine environment
Infantile (0-18 months) 15%: genetics, nutrition, health & happiness, thyroid
Childhood (40%): GH, TH, good health, genes
Pubertal 15% : Testosterone, oestrogen, GH

At end of puberty, the epiphyseal growth plates fuse & cause cessation of growth. Therefore, if puberty is early final growth will be reduced.

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6
Q

Normal requirement after first week until weaning:

- estimate for 5kg baby

A

150mls/kg/day

- 750mls/day

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7
Q

how to convert Oz to Mls

A

30mls per Oz

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8
Q

When to wean?

A

From 6 months

- iron containing food at 6 months

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9
Q

What foods to avoid before 6 months

A

egg and wheat

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10
Q

Puree when?

A

7 months

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11
Q

When doorstep milk and normal food

A

12 months

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12
Q

how many liters of maintenance fluids does an adult need

A

1 L 8 hourly

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13
Q

How do you calculate mainntence fluids for a child

A

1st 10kg: 100 mls/kg/day
2nd 10kg: 50 mls/kg/day
3rd +: 20mls/kg/day

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14
Q

Freddie is 28Kg and is vomiting requiring maintenance IV fluids calculate his hourly IV fluid requirement

A

(10 x 100) + (10 x 50) + (8 x 20)/24 = 69 mls/h

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15
Q

How is overweight/obesity classified in children

A

BMI (wt/h2) centiles
> 91st overweight
> 98th obesity

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16
Q

Effects of obesity in children

A

Type 2 diabetes

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17
Q

How much physical activity does a young child need?

How many steps a day? (for adults)

A

60 mins every day

12,000 steps (10,000)

18
Q

What are the four categories for children

A

Gross motor
Fine motor
Speech & language
Social

19
Q

When is develop most rapid

A

First 4 years of life

20
Q

Gross motor development

A 
6-8 weeks- Raises head to 45 degrees	
6-8 months – Sits without support	
8-9 months - crawling	
10 months - 	walks around furniture
12 months – walking unsteadily 	
15 months – walks steadily	
18 months – can run
2 years – jumps
3 years – hops
4 years – climbing frames
5 years – hops & skips
21
Q

Causes of not walking

A 
cerebral palsy 
Duchennes (Músculo-dystophy)- gower test- lie flat & stand without using hands (proximal weakness)
MSK problem
Neglect 
Bottom shufflers
22
Q

Red flag:

9 months

A

can’t sit without support

23
Q

Developmental warning signs

A
  • Family history
  • Maternal concern

• Persisting primitive reflexes: moro reflex (dropping head-symmetrical arms arising present at birth - 3 months), palmar grasp, sucking reflex, fencing reflex (turn head)

  • Discordant development
  • Regression- losing skills
24
Q

Screening ar birth

A

eyes (red reflex), heart, hips; automated hearing screen

25
Q

Screening at 1 week

A

Guthrie (PKU, hypothyroidism, CF, haemoglobinopathies, acylcarnitine)

26
Q

8 weeks:

A

general examination

27
Q

4-5 yrs

school entry

A

orthopedist

yearly height & weight, hearing

28
Q

Describe eye development

A

birth 6/180
1 month 6/90
6 months 6/30
3-5 years 6/6

29
Q

How many boys are red colour blind

A

6%

30
Q

What is enuresis

  • percentage at 5, 10 & teenagers
A

inappropriate voiding of urine after the age at which bladder control should have been achieved: dry day: 2-3 years; dry night 3-4 years

10% at 5, 5% at 10, 1% teenagers

31
Q

What is encopresis

A

passage of faeces into the clothes by day or night. Soiling after 4 years is abnormal

32
Q

2 year old with a history of asthma has a RR of 12 and a HR 80
12 year old with a history of asthma has a RR of 12 and a HR of 80

Which one do you attend to first?

A

2 year old as HR should be faster.

1st cause of bradycardia: hypoxia

33
Q

Newborn:

  • when should pass first urine
  • pass meconium
A
  • micturate in 24 hrs

- meconium in 48 hours

34
Q

Causes of not passing meconium

A

Obstruction of bowel

CF: meconium ileus

35
Q

How does the childs birthweight change after birth. When is it abnormal?

A

5% lose birthweight, regain by day 10, > than 10% weight loss abnormal.

  • not feeding well, dehydrated
36
Q

At 6 months, what percentage sleep through the night

A

90%

37
Q

When are night terrors

A

(4-7 years)

38
Q

When nightmares

A

(8-10)

39
Q

Sleep walking

A

(5-10 years)

40
Q

During prenatal growth, what foetal growth factors modulate growth

A
  • IGF-2
  • human placental lactose
  • Insulin (hence why hyperinsulinaemia can result in macrosomia)

Paeds (20 decks)

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