Normal Flashcards
what age range counts as adolescence
10-20yo
the system used to define pubertal stages
Tanner stages 1-5
STEP assessment of developmental stage stands for
Sexual maturation and growth
Thinking
Education/Employment
Peers/Parents
Things to discuss with young people - HEEADSSS
Home education/employment eating activities drugs sex suicide safety
prescribing drugs in obese teenagers - what do you calculate the dosage bY?
their ideal body weight
otherwise if went by their weight they would OD
infant = \_\_\_ led growth child = \_\_\_ led pubertal = \_\_\_\_ led
nutrient
growth hormone
sex hormone
sufficient for 3% of population with lowest nutritional needs =
LRNI
sufficient for 97% of the populations nutrient needs
RNI
if breastfeeding the mother will take ___ vit D supplements
10microns
if from 6months old and on <500ml formula milk = give ____ supplements
vit A C D
wean at what age
6m
can fully introduce full fat cows milk at what age?
12m
can introduce semiskimmed milk at what age?
2yo
can introduce skimmed milk at what age?
5yo
infants should be gluten free before what age?
<6m
avoid whole nuts and seeds until what age?
5yo
91st centile and above for BMI makes a child classed as __
overweight
98th centile and above for BMI makes a child classed as ___
obese
normal centiles for a childs BMI
between 25th and 75th
Tanner stage 1 =
pre puberty - no signs of puberty development
M = high voice
Tanner Stage 2-3 =
in puberty any breast (first sign) / axillary hair growth = F slight voice deepening, testes and penis growth, pubic and axillary hair growth = M
Tanner 4-5 =
completing puberty
started periods, breasts and axillary hair = F
broken voice, facial hair, adult penis and hair = M
age before which puberty is deemed precocious in girls and boys
8yo = F 9yo = M
account for premature birth when calculating age until the child is
2yo
4 areas of child development
gross motor
fine motor and vision
language and hearing
social behaviour and play
5 neonatal primitive reflexes
moro sucking and rooting palmar and plantar grasp ATNR stepping and placing
ATNR in neonates =
Asymmetrical tonic neck reflex - fencing - to stop rolling off unstable surface
normal = disappears by age 6m
if not walking by now start to worry
18m
variation from the mean =
standard deviation
___% lie within 1SD of the mean
68%
___% lie within 2SD of the mean
95%
height is measured on expiration or inspiration
expiration
premature = < ___ wk gestation
37wks
average age of puberty for boys and girls
boys = 11.5yo girls = 11yo
puberty is initiated by __
GnRH level increasing which then increases LH and FSH
pubertal delay age in boys and girls =
boys = 14yo girls = 13yo
Age of average peak height velocity for boys and girls
boys = 14yo girls = 12yo
mean adult height difference M:F =
12.5-14cm
Investigations for growth problems =
bloods (LFTs, growth factors, testosterone/oest, TFT, karyotype) bone age dynamic function tests MRI brain US uterus
Ix for precocious puberty
MRI head
US pelvis
LH stimulation test
Rx to stop precocious puberty
LHRH suppression therapy until 10yo and then will start puberty again at 11yo
babies can lose up to __% of their birth weight because ___
10%
pee it out
constitutional delay =
temporary delay in growth that then catches up
rescue breaths to chest compression in kids ratio
2:15
if kid isnt breathing normally first give ___ then __ chest compressions and then ___
5 rescue breaths
15
2 rescue
and repeat 15:2
if ineffective cough in a child and airway obstruction and conscious =
5 back blows then 5 thrusts (chest for infant, abdo if <1yo)
if ineffective cough, airway obstruction and child is now unconscious =
open airway - 5 rescue breaths and CPR 15:2
Newborn screening includes:
CF medium chain acyl coA dehydrogenase deficiency sickle cell congenital hypothyroidism PKU maple syrup urine disease isovaleric acidaemia glutaric aciduria type 1 homocystinuria
testes size ___ consistent with onset of puberty
> =4ml
mode of inheritance of sickle cell =
auto recessive
mode of inheritance neurofibromatosis
auto dom
MELAS mode of inheritance =
mitochondrial