Poor Growth/Failure to thrive Flashcards
1
Q
Red flags in a child presenting with poor growth.
A
- Signs of dehydration
- Signs of dehydration
- signs of abuse or neglect
- Signs of poor attachment
- Poor carer understanding - non-english,intellectual disability
- SIgns of family vulnerability e.g. drug and alcohol, domestic violence, social isolation
- Parental MH issues
- Previous child protection services
- DNAs
2
Q
Causes of poor growth due to inadequate caloric intake/retention?
A
- Inadequate nutrition (breast, formula, food)
- Breast feeding difficulties
- Restricted diet (low fat, vegan)
- Structural cause - cleft palate
- Persistent vomiting
- Anorexia of chronic disease
- Error in formula dilution
- Early or late intro of solids.
3
Q
Psychosocial factors to consider in a child with poor growth.
A
- Parental depression, anxiety, other mood disturbance.
- Substance abuse
- Attachment difficulties
- Disability or chronic illness
- Coercive feeding
- Difficulties at meal times
- Poverty
- Behavioural disorders
- Poor social support
- Exposure to traumatic event, DV
- Neglect
- Current/past CPS involvement
4
Q
Causes of poor growth due to inadequate absorption.
A
- Coeliac disease
- Chronic liver disease
- Pancreatic insufficiency
- Chronic diarrhoea
- Cow milk protein intolerance
5
Q
Causes of poor growth due to excessive caloric utilisation.
A
- Chronic illness
- UTI
- Chronic resp. disease e.g. CF
- COngenital heart disease
- Diabetes mellitus
- Hyperthyroidism
6
Q
Other medical causes of poor growth.
A
- genetic syndromes
- Inborn errors of metabolism.
7
Q
Ix to consider if significantly concerned about growth of child.
A
- Ix according to features on hx and exam When no specific pointers - FBC, UEC, LFTs, - ESR - Iron studies - Calcium, phosphate - TFTs - BSL - Urine MCS - Coeliac serology (if on solid food with gluten) - Stool microscopy and culture - Stool for fat globules and fatty acid crystals.
