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Paediatrics > Normal Development > Flashcards

Normal Development Flashcards

1
Q

What are the four stages of normal growth?

A

Inter-uterine, infantile, childhood and pubertal

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2
Q

What is hirschsprungs disease?

A

It is caused by an aganglionic segment of bowel due to a developmental failure of the parasympathetic Auerbach and Meissner plexuses.

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3
Q

At what age would you refer a baby that wasn’t sitting up by itself?

A

12 months (should be sat upright at 7-8)

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4
Q

What is the daily requirement of fluid in mls for a baby?

A

150mls/kg/day of fluid

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5
Q

On days 1,2 & 3, how many mls of liquid does a child require?

A

60, 80 & 100 respectively and 150 every day after that

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6
Q

How many calories per day does an infant need in its first year?

A

110 kcals per kg per day

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7
Q

How many calories per day does an infant after 1 require?

A

1000 kcals

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8
Q

How many calories are in 150mls of milk?

A

110kcals

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9
Q

Why are so little calories needed in the first few days of life?

A

Term babies have glycogen reserves as well as excess fluid.

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10
Q

Due to reserves, how much weight can a baby normally lose in the first few days?

A

5-7%

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11
Q

When should a term baby’s birth weight be doubled by?

A

5 months

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12
Q

When should a term baby’s birth weight be trebled by/.

A

1 year

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13
Q

What conditions can breast feeding help protect against?

A

SIDS and NEC

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14
Q

How long does it take a pre-term baby to double in weight? (28-40)

A

6 weeks

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15
Q

How long does it take a pre-term baby to treble in weight?

A

12 weeks

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16
Q

Why does a preterm baby have to have NG or OG feeding?

A

A preterm baby less that 35/36 weeks cannot suck or swallow

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17
Q

What is breast milk jaundice?

A

A type of neonatal jaundice associated with breast feeding. It persists longer than neonatal jaundice and it has no pathological cause.

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18
Q

What deficiency can happen in breast fed only babies?

A

Vitamin K deficiency, there is insufficient vitamin k in breast milk to prevent hemorrhagic disease of the newborn.

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19
Q

What complications can GBS infection cause?

A

Meningitis, pneumonia and septicaemia.

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20
Q

How many breast feeds should a baby be having each day by 1?

A

6 feeds per day with up to 4 hour gaps

21
Q

How many times a day should a baby be feeding at 6 months?

A

4 feeds per day

22
Q

How many mls in an ounce?

A

30 mls around

23
Q

Precocious puberty is defined as the development of secondary sexual characteristics before what age in females and males?

A

8 years of age in females and 9 years of age in males.

24
Q

What is rickets?

A

A failure in mineralisation of the growing bone or osteoid tissue
• Failure of mature bone to mineralise is called osteomalacia

25
Q

What are the causes of rickets?

A

o Dark-skinned
o Decreased exposure to sunlight
o Vit D deficiency
o Low calcium diets
o Strict vegan diets
o Defective production of 25(OH)D3 – liver disease
o Increased metabolism of 25(OH)D3 – enzyme induction by anticonvulsants

26
Q

What are the clinical features of rickets?

A 
o Frontal bossing of skull
o Craniotabes
o Delayed closure of anterior fontanelle
o Harrisons sulcus
o Expansion of metaphyses especially in wrists
o Bowing of weight-bearing bones
o Seizures (late)
27
Q

How is rickets diagnosed and managed?

A
  • Diagnosis made by dietary history of vitamin and calcium intake
  • Blood tests – low calcium, low phosphorous, increased ALP, low 25(OH)D
  • Wrist x-ray – cupping and fraying of metaphyses and widened epiphyseal plate
  • Managed by daily administration of cholecalciferol
28
Q

What is craniotabes?

A

Craniotabes is softening or thinning of the skull in infants and children, which may be normally present in newborns.

29
Q

Name the four stages of growth?

A

Foetal, infantile, childhood, pubertal

30
Q

Which period is the fastest?

A

Foetal- accounts for 30% of a persons eventual height

31
Q

What is the size at birth determined by?

A

The size of the mother and by placental nutrient supply.

32
Q

When is infantile growth and what is growth dependant on?

A

0-18 months and its largely dependant on nutrition and good health and happiness.

33
Q

When is the childhood phase and what is growth dependant on here?

A

18 months -12 years.
Largely based on Growth hormone secretion acting to produce insulin-like growth factor 1 at the epiphyses
▪ thyroid hormone, vitamin D and steroids also effect cartilage cell division and bone formation
Profound chronic unhappiness can decrease growth hormone secretion and accounts for psychosocial short stature

34
Q

When is the pubertal phase and what is growth dependant on here?

A 
Sex hormones (mainly testosterone and oestradiol), causes the back to lengthen and boost GH secretion
Same sex steroids cause fusion of the epiphyseal growth plates and a cessation of growth.
35
Q

When is the frankfurt plane used to measure kids?

A

Under 2, this is when the eye socket should be level with the ear hole, with possible upward pressure on the mastoid process.

36
Q

How do you work out the date of birth as a decimal?

A

Its taken away from todays year.todays decimal date - birthyear.thatdaysdecimal

37
Q

What is a short stature defined as?

A

Usually defined as a height below the second or 0.4th centile (-2.6 SD)

38
Q

What are foetal growth factors and how are they determined?

A

IGF-2, human placental lacotgen and insulin- they are determined by mothers size and sufficiency of the placenta. Therefore hyperinsulinaemina in mothers can result in macrocosmic babies as insulin is a GF here.

39
Q

What is the breakdown for height determined in each of the phases of growth?

A

Foetal- 30% of height determined here
Infantile- 15%
childhood- 40%
Pubertal- 15%

40
Q

When does the childhood phase begin and end?

A

18 months-12 years

41
Q

What determines growth in the infantile phase?

A

Genetics, health, happiness, nutrition and thyroid function. ‘failure to thrive’

42
Q

What determines growth in the childhood phase?

A

Pituitary GH and insulin-like GF 1 (IGF-1), good nutrition, vitamin D and steroids. Chronic profound unhappiness reduces secretion of GH and can cause short stature

43
Q

What determines growth in the pubertal phase?

A

Sex hormones (test and oest) boost GH secretion and cause fusion of the epiphyseal plates

44
Q

How do you calculate mean parental height?

A

mothers ht in cm + fathers height in cm/2 + 6.5 (for boys). and -6.5 for girls

45
Q

After which month should prematurity not impact on development?

A

24 months

46
Q

Growth charts must be corrected for gestation if the infant is born before….?

A

37 weeks

47
Q

What is the average weight at birth?

A

3.3kg

48
Q

How do you calculate expected weight ages 1-10?

A

2(age+4) kg

49
Q

What percentage is head circumference at birth to overall body?

A

19% SA (35cm on average) and by 15 it is 9%

Paediatrics (23 decks)

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