#Paediatrics/ Growth and Development

Question 1

What three parameters should you plot on a growth chart at each well-child visit? 2 years Why is it important to plot these values over time?

Answer 1

1. Weight and length
2. Height until adulthood
3. Head circumference the first 2 years

The overall pattern of growth (ie, trajectory of the curve) is more important than the raw values.

Question 2

What are the most common causes of obesity in children?

Answer 2

Overeating and inactivity

Question 3

Increased incidence of obesity has led to an increased incidence of what other diseases among children?

Answer 3

• Type 2 diabetes mellitus
• hypertension
• hyperlipidemia

Question 4

A BMI at what percentile defines a child as being overweight?

Obese?

Answer 4

Overweight –> 85th-95th (age-specific)

Obese –> Greater than 95th (age-specific)

Question 5

What is failure to thrive (FTT)?

Answer 5

• Inappropriately low weight (<3rd-5th percentile for the patient’s age)
• growth curve that crosses two major percentiles
• loss of weight

Question 6

What accounts for 60%-80% of FTT?

Answer 6

Nonorganic and psychosocial causes (eg, poverty, neglect, mother with postpartum depression)

Question 7

What are the organic causes of FTT?

Answer 7

• Any medical condition that can cause inadequate caloric intake, absorption, or utilization (eg, gastroesophageal reflux disease [GERD], cystic fibrosis, food allergies, metabolic storage diseases)
• increased metabolic need (eg, congenital heart disease, chronic infection)

Question 8

What is the treatment of FTT?

Answer 8

• Frequent meals
• increasing high-calorie solid food intake with additional supplementation if necessary
• treatment of underlying medical condition

Question 9

What are the benefits of assessing a child’s physical, social, and cognitive development?

Answer 9

Delays are relatively easy to detect and give important information about a child’s health

Question 10

What is the Denver Developmental Screening Test?

Answer 10

A brief developmental assessment tool to screen 0-6 year olds

Question 11

When assessing the development of a baby born prematurely, up until what age do you adjust his/her chronological age?

Answer 11

2 years

Question 12

A nine-month-old baby who was born 3 months prematurely should be able to perform at what developmental level?

Answer 12

A 6-month-old

Question 13

Approximately , at what age should a/n infant/child have the following gross motor skills?

While prone, lifts the head to 90°

Answer 13

3-4 months

Question 14

Approximately , at what age should a/n infant/child have the following gross motor skills?

Rolls front to back

Answer 14

4 months

Question 15

Approximately , at what age should a/n infant/child have the following gross motor skills?

Sits up with back unsupported

Answer 15

6 months

Question 16

Approximately , at what age should a/n infant/child have the following gross motor skills?

Crawls, cruises, and pulls to a stand

Answer 16

9 months

Question 17

Approximately , at what age should a/n infant/child have the following gross motor skills?

Takes first steps

Answer 17

12 months

Question 18

Approximately , at what age should a/n infant/child have the following gross motor skills?

Walks up the stairs supported by a wall or railing

Answer 18

18 mthns

Question 19

Approximately , at what age should a/n infant/child have the following gross motor skills?

Runs well

Answer 19

2 years

Question 20

Approximately , at what age should a/n infant/child have the following gross motor skills?

Rides a tricycle

Answer 20

3 years

Question 21

Approximately , at what age should a/n infant/child have the following fine motor skills?

Purposefully grasps an object

Answer 21

4-5 months

Question 22

Approximately , at what age should a/n infant/child have the following fine motor skills?

Pincer grasp

Answer 22

9 months

Question 23

Approximately , at what age should a/n infant/child have the following fine motor skills?

Copies a line

Answer 23

2 years

Question 24

Approximately , at what age should a/n infant/child have the following fine motor skills?

Copies a circle

Answer 24

3 years

Question 25

Approximately , at what age should a/n infant/child have the following fine motor skills?

Copies a square

Answer 25

4 years

Question 26

Approximately , at what age should a/n infant/child have the following language skills?

Coos Babbles

Answer 26

2-3 months

Question 27

Approximately , at what age should a/n infant/child have the following language skills?

Says one or two distinct words

Answer 27

9-12 months

Question 28

Approximately , at what age should a/n infant/child have the following language skills?

Babbles 6 months

Answer 28

6 months

Question 29

Follows one-step commnads

Answer 29

12-15 month

Question 30

Uses 2-3-word phrases

Answer 30

2 years

Question 31

Speaks half intelligibly to a stranger

Answer 31

2 years

Question 32

Speaks three-fourths intelligibly to a stranger

Answer 32

3 years

Question 33

Speaks 100% intelligibly

Answer 33

4 years

Question 34

Names four colors and four body parts

Answer 34

4 years

Question 35

Social smile

Answer 35

2 months

Question 36

Laughs and squeals

Answer 36

4 months

Question 37

Waves “bye-bye”

Answer 37

10 months

Question 38

Plays alongside—but not with—other children (parallel play)

Answer 38

2 years

Question 39

Plays with a group of other children

Answer 39

3 years

Question 40

Approximately , over what ages do Piaget stages of cognitive development take place:

Sensorimotor (learns about the world through sensory perceptions and motor activities)

Answer 40

Birth-2 years

Question 41

Approximately , over what ages do Piaget stages of cognitive development take place:

Preoperational (learns to use language, represent objects by symbols, but has difficulty taking the viewpoint of others)

Answer 41

2-7 years

Question 42

Approximately , over what ages do Piaget stages of cognitive development take place:

Concrete operational (begins thinking logically about concrete events)

Answer 42

7-11 years

Question 43

Approximately , over what ages do Piaget stages of cognitive development take place:

Formal operational (develops deductive reasoning, abstract thought, and systematic planning to solve problems)

Answer 43

11 years and older

Question 44

On average , at what age do most babies begin to sleep 5-6 hours at a time?

Answer 44

6 months

Question 45

When do stranger and separation anxiety usually begin?

Answer 45

7-9 months

Question 46

When should toilet training begin in a child?

Answer 46

Every child is different, but usually between 18-30 months

Question 47

Bed-wetting is normal up to what age?

Answer 47

4 years in girls and 5 years in boys