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Reproduction and the growing child > Physical milestones and failure to thrive > Flashcards

Physical milestones and failure to thrive Flashcards

1
Q

Development =

A

Increase in the complexity of the organisms due to maturation of the nervous system

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2
Q

Types of development:

A 
Physical
Emotional
Functional
Psychological 
Social
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3
Q

4 areas of development:

A
  1. gross motor
  2. fine motor and vision
  3. hearing, speech and language
  4. social skills and behaviour
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4
Q

Ex of gross motor skills =

A

Walking, running, climbing, jumping

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5
Q

Why should you always assess all areas of development?

A

Not every issue is a global issue

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6
Q

Red flags =

A

Points at which you should refer

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7
Q

Gross motor is a what progression?

A

Cephalo-caudal progression

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8
Q

3 months GM =

A

Hold head up 45 degrees prone

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9
Q

6 months Gm =

A

Sit up without support

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10
Q

Red flag for sit up =

A

9 months

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11
Q

9 months GM =

A

Crawling

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12
Q

12 months GM =

A

Walking

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13
Q

Running and jumping by

A

2.5 years

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14
Q

Red flag for walking =

A

18 months

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15
Q

Why is the red flag for walking when it is?

A

2 SD from mean

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16
Q

Most children with a walking delay will be

A

Normal late walkers, smaller risk of neurological/muscular disease

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17
Q

Neurological disease which can cause walking delay

A

Cerebral palsy

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18
Q

Muscular disease which can cause walking delay

A

Duchenne muscular dystrophy

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19
Q

Ex of fine motor skills =

A 
Grabbing
Transferring from hands
Building blocks
Radial/palmar grasp
Mature pincer grip
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20
Q

Scribbling:

A

Line - 2 yrs
Circle - 3 yrs
Square - 4 yrs
Triangle - 5 yrs

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21
Q

6 months FM =

A

Palmar grasp

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22
Q

10 months FM =

A

Mature pincer grip

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23
Q

Red flag for mature pincer grip =

A

12 months

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24
Q

Tower of 3 =

A

18 months

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25
Q

Tower of 6 =

A

2 years

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26
Q

Tower of 8 =

A

2.5 years

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27
Q

Speech vs language =

A

Speech - sounds

Language - content and organisation

28
Q

Types of hearing loss:

A

Conductive
Sensorineural
Mixed

29
Q

What can cause problems with speech and language?

A 
Hearing loss
Forming words (muscles, palate)
Wernickes, Broca's area from hypoxia/ischemia 
global develoment problem
Environmental deprivation
Autism spectrum disorder
30
Q

Ex of social and behavioural behaviour =

A 
Waving
Smiling
Peek-a-boo
Stranger danger
Pointing
Imaginative play
Toilet training
31
Q

Smiling =

A

6 weeks

32
Q

Smiling red flag =

A

8 weeks

33
Q

Stranger danger =

A

8-10 months

34
Q

Speech 3 months =

A

1 syllable

35
Q

Speech at 10 months =

A

2 syllables

36
Q

Speech at 12 months =

A

2-3 words

37
Q

What do children need in psychological needs?

A 
Security
Role models
Opportunity to learn
Independence
Self respect
Personal identity 
Attention
Play
38
Q

Who checks on development?

A 
Patents/grandparents
GP
Health visitor
Nursery
Pediatrician 
Speech and language therapists
Play therapists
39
Q

Times when development can be surveyed:

A
  • Newborn exam
  • 6-8 week check at GP
  • 1 year health visitor
  • 2-2.5 health visitor
40
Q

Regression =

A

Having a skill and losing it

41
Q

Ex of red flag with hand preference =

A

Early hand preference (before 18 months). Before this could be a sign of something wrong with the hand they’re not using

42
Q

Persistent toe walking is a sign of =

A

Increased tone

43
Q

Isolated delay =

A

1 domain

44
Q

Delay in 4 domains =

A

Global delay

45
Q

Problems with weight:

A

Obesity

Failure to thrive

46
Q

4 phases of growth =

A
  1. Fetal
  2. Infancy
  3. Childhood
  4. Puberty
47
Q

Fastest growth is at what age?

A

in first 2 years

48
Q

In week 1, how much weight can a baby lose?

A

10% of birth weight

49
Q

Should regain birth weight at

A

2 weeks

50
Q

Weight by 5 months =

A

doubles

51
Q

Weight by 12 months -

A

trebled

52
Q

What influenced growth?

A 
Genetic potential
Intra-uterine conditions
Post-natal nutrition
Diet
Hormonal status
Health
Nurturing social environment
53
Q

Why can poor health slow growth?

A

Some conditions have high nutritional/metabolic demands

54
Q

In FTT, patient should fall =

A

2 centiles

55
Q

Traditionally, FTT can be spilt into:

A

Organic

Non-organic

56
Q

Organic FTT makes up what %?

A

<10%

57
Q

4 broad causes of FTT =

A 
Inadequate intake
Inadequate retention
Malabsorption
Failure to utilise
Increased requirements
58
Q

Ex of inadequate intake =

A

Poor technique
Wrong milk
Social
Palate

59
Q

Ex of inadequate retention =

A

Vomiting

GORD

60
Q

Ex of malabsorption =

A

Cows milk protein intolerance
Cystic fibrosis
Short gut

61
Q

Ex of failure to utilise:

A

Renal, liver disease

62
Q

Ex of increased requirements:

A 
Thyrotoxiosis
Cystic fibrosis
Chronic infections
Malignancy
Heart disease
63
Q

How to assess FTT:

A
  • Hx and FHx
  • Accurate social history
  • Observe parent-child interaction
  • Nutritional assessment: weights, height, dietary diary, FBC, albumin, vitamins, minerals
64
Q

Things to remember with Marfans’s =

A

Heart (aortic dilation), eyes (lens displacement)

65
Q

Signs of DMD =

A

Waddling gait
Slow to walk
Calf pseudohypertrophy
Gower’s sign

66
Q

DMD can lead to =

A

Respiratory failure

Dialted cardiomyopathy

67
Q

DMD is a mutation in =

A

Dystrophin gene - dystrophin stabalises sarcolemma

Reproduction and the growing child (15 decks)

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