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Child Health > Normal + Abnormal Growth > Flashcards

Normal + Abnormal Growth Flashcards

1
Q

What is Standard Deviation a measure of?

A

Variability

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2
Q

What percentage of people are within 1 SD from the median?

A

68%

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3
Q

What percentage of people are within 2 SD of the median?

A

95%

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4
Q

When is a child considered to show normal growth?

A

Measurements are within the normal range compared to children of their age
Rate of growth is within the normal range compared with children of their age

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5
Q

Up to what age should length be measured rather than height?

A

2 years

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6
Q

When should a child be described as being ‘on the X centile’ when referring to the growth chart?

A

If the point is exactly on the centile line or within 1/4 of a space of the centile line

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7
Q

If a child’s point on the growth chart is not within 1/4 of a centile line, how should it be described?

A

Between the Xth and Yth centile

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8
Q

What is the average age for a girl to enter puberty?

A

11

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9
Q

What is the average age for a boy to enter puberty?

A

12

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10
Q

What is precocious puberty?

A

Normal pubertal development occurring abnormally early

  • -> less than 8 years for girls
  • -> less than 9 years for boys
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11
Q

What is considered pubertal delay?

A

Absence of secondary sexual development in a girl aged 13 or a boy aged 14

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12
Q

What is the definition of faltering growth/failure to thrive?

A

Reduced growth in infancy, falling across 2 centile lines + manifesting in poor weight gain

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13
Q

When is weight loss in infancy normal?

A

Initial loss of up to 10% in first 3-4 days is normal

–> should be regained by 3 weeks

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14
Q

What are the causes of failure to thrive?

A

Non-organic/environmental (90%) - inadequate intake:

  • feeding problems: unskilled feeding, insufficient breast milk, difficult to feed (low appetite, weak suck)
  • maternal problems: neglect, postnatal depression

Organic:

  • GI: IBD, Coeliac, cow milk protein allergy, GORD
  • Swallowing: cleft palate, cerebral palsy
  • Chronic disease: kidney, liver or heart failure
  • Multi-system: Down’s, CF, hypothyroidism
  • Chronic infection
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15
Q

What is the definition of short stature?

A

Height < 2nd centile

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16
Q

What are the causes of short stature?

A

Familial short stature (80%) - short parents (check mid parental height)
Constitutional delay in growth + puberty (benign)
IUGR
Neglect, poverty
Genetic: Down’s, Turner’s, CF, dwarfism
GI: Coeliac, IBD
Endocrine: steroids, hypothyroidism, growth hormone deficiency

17
Q

How are overweight + obesity defined in children?

A

Overweight: BMI > 91st centile
Obesity: BMI > 98th centile

18
Q

What are the possible causes of obesity in children?

A 
Lifestyle (nearly always)
Underlying conditions: (often accompanied by short stature)
- hypothyroidism
- Cushing's
- Prader Willi
19
Q

What are the features of Prader-Willi syndrome?

A

At birth: very floppy, ability to suck weak or absent, tube feeding common
Childhood: hyperphagia (food seeking and lacking satiety)
Learning difficulties
Hypogonadism
Short stature

20
Q

What are the recommendations for vitamin supplements in babies?

A

By 2 weeks of age: breastfed babies should be given 8.5-10mg of vitamin D per day (formula has added vitamin D)

From 6 months:
- all children consuming < 500mls/d of infant formula should take vitamins A, C and D supplements

21
Q

What are the recommendations for vitamin supplements in breastfeeding mothers?

A

Should take vitamin D

22
Q

What are the recommended guidelines for exclusive breastfeeding?

A

Exclusive breastfeeding for the first 6 months of an infant’s life

23
Q

What is the absolute minimum age for weaning (introducing solid foods)?

A 
17 weeks (4 months)
Recommended around 6 months
24
Q

What are the benefits of breastfeeding?

A 
Immunological features
Anti-infective agents
Growth factors
Reduction in diarrhoea + respiratory infections
Improved colonic function
Reduction in atopic disease
Greater likelihood of higher IQ
Lower obesity risk 
Mower maternal breast cancer risk
25
Q

What is gestational correction in regard to the growth chart?

A

Adjusting the plot of a measurement to account for the number of weeks a baby was born early
Number of weeks early = 40 minus gestational age
(should not be used of infants 37+ weeks)

26
Q

How long should gestational correction be applied to a growth chart?

A

1 year for infants born 32-36 weeks

2 years for infants born before 32 weeks

Child Health (16 decks)

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