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Dev/Age > Postnatal and child development > Flashcards

Postnatal and child development Flashcards

1
Q

Genetic impact on prenatal growth

A

Minor overall effect
Maternal factors are the main determinants, with maternal size affecting birth size

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2
Q

Genetic impact on postnatal growth

A

Largely determines final height
sex chromosomes influence it

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3
Q

Endocrine impact on prenatal growth

A

Insulin/IGF prenatal hormones affecting growth
IGF-1, later fetal and infant growth
IGF-2, embryonic growth

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4
Q

4 phases of growth

A

Fetal
Infantile
Childhood
Pubertal

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4
Q

Nutrition impact on prenatal growth

A

Placenta provides nutrients and hormones
Placental insufficiency commonest cause of FGR
Maternal diet influences nutrient availability

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4
Q

Endocrine impact on postnatal growth

A

human growth hormone (hGH) major hormone controlling growth

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4
Q

Nutrition impact on postnatal growth

A

Adequate nutrition rq for growth
poor nutrition may delay puberty onset
malabsorption of nutrients -> red. growth

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5
Q

Environmental impact on prenatal growth

A

Uterine capacity/ Placental sufficiency provide optimal environment for fetal growth

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5
Q

Environmental impact on postnatal growth

A

factors influencing growth:
socioeconomic status
chronic status
emotional status e.g. stress
altitude

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6
Q

When do cranial sutures close

A

18mths

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7
Q

Describe the fetal growth phase

A

Fastest period of growth
fetus doubles in size over gestation
growth driven by hyperplasia (cells increase in number)

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8
Q

Describe the infantile growth phase

A

0-18mths
rapid but decelerating growth
nutrition dependent growth
increase in length, head circumference, weight

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9
Q

Describe the childhood growth phase

A

18mths - 12yrs
steady, slow growth
Increased endocrine growth regulation

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10
Q

Describe the pubertal growth phase

A

Rising levels of sex hormones boost hGH
Temporary growth spurt as hGH causes fusion of growth plates
driven predominantly by hormones

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11
Q

What is a mini-puberty

A

Gonadotrophin secretion begins at the end of the first trimester and declines to zero at birth.
HPG axis transiently activated post birth ≈6mths
due to lack of inhibition by placental hormones

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12
Q

Role of mini puberty in males

A

Normal gonadal development
- testicular tissue and penile development

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13
Q

Role of mini puberty in females

A

largely unclear
follicular development
patterning and development of mammary tissue

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14
Q

Role of mini puberty in body composition and growth

A

May affect growth velocity as testosterone is greater in boys than girls

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15
Q

What is puberty onset driven by

A

Transition to pulsatile GnRH release
Regulated by KNDy neuronal control of kisspeptin

16
Q

Consonant puberty

A

Follows the typical sequence of development for their gender

17
Q

What are the 4 developmental domains

A

Gross motor skills - crawling, walking
Fine motor skills - handling small objects
Speech, language, hearing skills
Social behaviour and play skills

18
Q

Median age for development of gross motor skills

A

Newborn - raises head whilst on stomach
7mths - sit w/o support
8-9mths - crawling
1yr - stand independently
15-18mths - walks independently
2.5yrs - runs and jumps

19
Q

Median age for development of fine motor skills

A

Newborn - turns head to follow object
4-6mths - palmar grasp
7mths- transfer objects btw hands
10-12mths - pincer grip/pts
15-18mths - marks with crayon
2-5yrs - draws shapes

20
Q

Median age for development of language skills

A

Newborn - startles at loud noises
3-4mths - vocalises, laughs
7mths - responding to sounds
12mths - few words
18mths - recognise body parts
2yrs - simple phrases

21
Q

Median age for development of social/behavioural skills

A

6wks- smiles responsively
6-8mths - finger feeds
1 year - play games e.g. peekaboo
- drink from cup
18mths - hold spoon and feed
2 years - symbolic play e.g. feeding teddy
- potty trained

22
Q

What is an example of a planned programme of reviews for child development?

A

NHS Healthy Child Programme

23
Q

What are the four elements to the healthy child programme?

A

Screening,
Immunisation,
Child Health Reviews,
Health Promotion

24
Q

Aims of the NHS Healthy Child Programme

A

Prevent disease and promote good health
by reducing health inequalities

25
Q

Fundamentals of a Good Screening Test

A

Acceptable/easy to administer
Cost effective
Reproducible and accurate results
Early identification of a treatable disease

26
Q

Important Early Childhood Screening types

A

Newborn Check
Newborn Hearing Screen
Blood spot check

27
Q

What does the Newborn physical test check for

A

done w/in 72hrs
weight, eyes, heart, hips and testes

28
Q

What does the Blood spot test check for

A

done w/in 7d
CF, Sickle Cell, congenital hypothyroidism, inherited metabolic diseases (eg PKU)

29
Q

Newborn hearing test

A

done @ 3-5wks
sometimes done in hospital before discharge, can be done up to 3 months

30
Q

What is the Infant physical exam

A

done @ 6-8 wks
with GP, measures length + head circumference – opportunity to discuss vaccinations.

31
Q

What is Global developmental delay

A

significant delay in reaching two or more developmental milestones

32
Q

What is Specific developmental disorder

A

delays in developmental domains in the absence of sensory deficits, subnormal intelligence or poor educational conditions

33
Q

What are the two types of developmental delay

A

Global and Specific

34
Q

Types of specific developmental disorder

A
  • learning disorders
  • motor skill disorders
  • communication disorders
35
Q

Causes of Global developmental delay

A

Chromosomal abnormalities e.g. Downs
Metabolic issues e.g.hypothyroidism
Antenatal/perinatal factors e.g. infection, drugs
Environmental-social issues
Chronic illness

36
Q

Causes of motor skill developmental delay

A

Cerebral palsy
Congenital dislocation of the hip
Muscular dystrophies
Neural tube defects
Social deprivation

37
Q

Causes of language skill developmental delay

A

Hearing loss
Autism spectrum disorders
Lack of stimulation
Impaired comprehension of language – e.g. developmental dysphasia
Impaired speech production – e.g. stammer, dysarthria

38
Q

What are some examples of prenatal causes of impairment?

A

Maternal nutrition (iron, folate)

39
Q

What are some examples of perinatal causes of impairment?

A

Delivery problems - trauma, low oxygen, drugs in ICU

40
Q

What are some examples of postnatal causes of impairment?

A

Trauma, Meningitis

41
Q

What are some commonly used assessment tools for development?

A

Standardised Tests (such as Denver developmental screening tests)

Dev/Age (4 decks)

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