pediatric obesity

Question 1

how is apnea defined?

Answer 1

• cessation of breathing lasting longer than 20 seconds

- may be associated with cyanosis, pallor, hypotonia, and/or bradycardia

Question 2

what are the three types of apnea?

Answer 2

obstructive
central
mixed

Question 3

how is bradycardia defined for pediatric patients?

Answer 3

a HR slower than 80 bpm

-MRP/resident should be notified

Question 4

what can cause apnea?

Answer 4

-infection, aspiration, cardiac problems, metabolic or endocrine disorders, neurologic conditions

Question 5

how is obstructive sleep apnea characterized?

Answer 5

-repetitive episodes of partial/complete airway obstruction that occurs during sleep, usually associated with a reduction in blood oxygen saturation

Question 6

what is the most common cause of obstructive sleep apnea?

Answer 6

• hypertrophy of adenoids and tonsils

- craniofacial abnormalities

Question 7

what are symptoms of obstructive sleep apnea?

Answer 7

• loud snorting
• chest retractions during sleep in young children
• high blood pressure
• overweight
• irritability
• possible a change in behavior

Question 8

why does blood pressure become high in those with obstructive sleep apnea?

Answer 8

-after long period of being apneic, BP may rise because of increased work for heart/body

Question 9

what are some long-term implications of obstructive sleep apnea?

Answer 9

• stroke
• irregular heartbeat
• pulmonary and systemic hypertension
• cognitive impairment

Question 10

what are some treatments for obstructive sleep apnea?

Answer 10

• weight loss
• side sleeping
• oral mouth devices
• c-pap
• bi-pap
• adenotonsilectomy
• O2 sat monitor
• may need oxygen or caffeine

Question 11

why is caffeine used as a treatment for apnea in neonates?

Answer 11

Caffeine increases breathing frequency, decrease the number of apneic spells, and reduce partial tension of carbon dioxide (PCO2) and the need for (and duration of) mechanical ventilation.

Peripheral chemoreceptors, found in the carotid and aortic bodies and stimulated by chemical changes in blood composition, provide feed-forward control of respiration, which can thus terminate apnea and initiate normal breathing. These receptors are believed to be an important target for caffeine action

Question 12

what are the two components of maturation?

Answer 12

timing and tempo

Question 13

what is the formula for calculating body mass index?

Answer 13

BMI (kg/m^2) = weight (kg) / height^2 (m^2)

Question 14

what are the classifications for BMI?

Answer 14

underweight <18.5
normal weight 18.5-24.9
overweight 25-29.9
obese >30

Question 15

how is BMI calculated for children?

Answer 15

using growth charts and based on percentiles
overweight is 85th-95th percentile
obese is greater than 95th percentile

Question 16

what age range counts as infant?

Answer 16

0-12 months

Question 17

what age range counts as toddler?

Answer 17

1-3 years

Question 18

what age range counts as preschool?

Answer 18

3-6 years

Question 19

what age range counts as school age?

Answer 19

6-12 years

Question 20

what age range counts as adolescence?

Answer 20

12-18 years

Question 21

at what age does the average boy start their growth spurt?

Answer 21

14.1 years (initiation is 13.5)

Question 22

at what age does the average girl start their growth spurt?

Answer 22

12.1 years (initiation 11.8 years)

Question 23

how much do boys usually grow and gain during their adolescent growth spurt?

Answer 23

20 kg

20 cm

Question 24

how much do girls usually grow and gain during their adolescent growth spurt?

Answer 24

16 kg

16 cm

Question 25

what are some complications of childhood obesity?

Answer 25

• poor self-esteem
• eating disorders
• sleep apnea
• asthma
• exercise intolerance
• gallstones
• steatohepatitis
• slipped capital femoral epiphysis
• blount’s disease
• forearm fracture
• flat feed
• pseudotumor cerebri
• dyslipidemia
• hypertension
• coagulotherapy
• chronic inflammation
• endothelial dysfunction
• type 2 diabetes
• precocious puberty
• polycystic ovary syndrome (girls)
• hypogonadism (boys)

Question 26

what are the long-term consequences of obesity in children

Answer 26

• high BP
• altered blood clotting
• strokes
• joint problems
• gallstones
• sleep apena
• type 2 diabetes
• CVD
• possibly cancer

Question 27

how is fast food different in general than home prepared food?

Answer 27

• higher energy density
• poor micronutrients
• low fiber
• high in glycemic index
• excessive in portion size

Question 28

how does screen time and sedentary activity affect children’s sleep?

Answer 28

every hour spent in sedentary activities delays bedtime by 3 minutes

the average children’s sleep duration has decreased 30-60 minutes

Question 29

what are the sedentary behavior guidelines?

Answer 29

• no more than 2 hours of recreational screen time per day

- at least 60 minutes of moderate to vigorous physical activity daily

Question 30

how long is it recommended children are exclusively breastfed?

Answer 30

6 months

Question 31

what are some factors that contribute to obesity in children?

Answer 31

• early childhood development
• genetics
• infant feeding
• school, community, family
• inactivity
• diet/nutrition
• SES, food security`

Question 32

how many young Canadians (2-17yrs) are overweight?

Answer 32

26%

8% are obese

1 in 3 school aged children

Question 33

how high does Canada rank in childhood obesity out of the 34 OECD Countries?

Answer 33

11th