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BRS YR2 > Postnatal and Child Development > Flashcards

Postnatal and Child Development Flashcards

1
Q

How do genetics impact prenatal development?

A
  • minor overall effect
  • mainly determined by maternal genetic factors and maternal size
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2
Q

How do genetics impact postnatal growth?

A
  • largely determines final adult height
  • XY results in taller height than XX
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3
Q

Which hormones are most important in prenatal growth?

A
  • insulin and IGFs
  • IGF-2 for embryonic growth
  • IGF-1 for late fetal and infant growth
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4
Q

What is the most important hormone in post-natal growth?

A

Human Growth Hormone

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5
Q

How is nutrition provided to the fetus?

A

Placenta provides all nutrients

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6
Q

How can fetal nutrition impact prenatal growth?

A
  • placental insufficiency is most common cause of IUGR
  • placenta controls hormones necessary for fetal growth
  • placental nutrition is influenced by maternal diet
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7
Q

How does nutrition impact postnatal growth?

A

Poor nutrition can limit growth potential and delay puberty onset

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8
Q

How does the uterine environment influence prenatal development?

A
  • uterine capacity and placental sufficiency needed for optimal environment
  • placenta function more important than uterine capacity
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9
Q

Which environmental factors can influence postnatal development?

A
  • socioeconomic status
  • chronic disease
  • emotional status
  • altitude (low O2 sats)
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10
Q

What are the four phases of growth?

A
  1. fetal
  2. infantile
  3. childhood
  4. pubertal
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11
Q

What happens during the fetal growth phase?

A
  • fastest period of growth
  • accounts for 30% of final height
  • growth mainly driven by fetal hyperplasia
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12
Q

How many cycles of cell division are ther before birth and after birth?

A
  • 42 pre birth
  • 5 after birth
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13
Q

What is the infantile growth phase?

A
  • first 18 months after birth
  • 15% of final height
  • slower than fetal phase
  • largely dependent on nutrition
  • increase in length, head circumference and weight
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14
Q

What is the childhood growth phase?

A
  • 18months to 12 years
  • 40% of eventual height
  • steady, slow growth
  • increases 5-6cm and 3-3.5kg annually
  • determined by nutrition, good health and endocrine growth regulation
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15
Q

What is the pubertal growth phase?

A
  • pubertal growth spurt
  • 15% of final height
  • rising sex hormones and hGH
  • XY grow more than XX
  • sex hormones cause fusion of growth plates
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16
Q

What are the determinants of fetal growth?

A

Uterine environment

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17
Q

What are the determinants of infantile growth?

A
  • nutrition
  • good health and happiness
  • thyroid hormones
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18
Q

What are the determinants of childhood growth?

A
  • growth hormone
  • thyroid hormone
  • genes
  • good health and happiness
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19
Q

What are the determinants of pubertal growth?

A
  • testosterone and oestrogen
  • growth hormone
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20
Q

What is the development of the HPG axis?

A
  • fetal development of GnRH network and sexual organs
  • neonatal priming of HPG axis (mini-puberty)
  • childhood linear growth and developmental milestones with no HPG axis activity
  • adolescent sexual maturation (puberty)
  • reproductive capacity plateaus in adulthood
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21
Q

What is mini puberty?

A
  • gonadotrophin secretion begins at the end of the first trimester
  • peaks mid-pregnancy and then declines
  • HPG axis is activated again after birth after release from placental hormones
  • continues for 6 months after birth
22
Q

What is the purpose of mini-puberty?

A
  • contributes to normal gonadal development in males
  • may be important in development of mammary tissue in females
  • may influence body composition and linear growth in males
23
Q

What triggers puberty?

A
  • influenced by metabolic status
  • neurokinin KNDy neurons may regulate kisspeptin which stimulates GnRH release
24
Q

A mutation in which gene can cause pubertal delays?

A

KISS1R

25
Q

What is consonance?

A

Compliance with the typical sequence of pubertal milestones

26
Q

How has the onset of menarche changed over since the 19th century?

A

Decreased by 4+ years

27
Q

What are the four developmental domains?

A
  • gross motor skills
  • fine motor skills
  • speach, language and hearing skills
  • social behaviour and play skills
28
Q

Which developmental skill should be present in newborns?

A
  • flexed posture
  • fixes on and follows faces
  • stills to voice and startles to loud noises
  • smiles responsively
29
Q

Which developmental skills are present at 7 months?

A
  • sitting without support
  • transferring objects from hand to hand
  • polysyllabic babble and turning to voice
  • finger feeding and fearing strangers
30
Q

Which developmental skills should be present by 12 months?

A
  • standing independently
  • pincer grip
  • knowing a few words and understanding name
  • drinking from a cup and waving
31
Q

Which developmental skills should be present at 15-18months?

A
  • walking independently
  • immature grip of pencils/crayons
  • knowing 6-10 words and being able to point to four body parts
  • feeding self with spoon and starting to dress self
32
Q

Which developmental skills should be present at 2.5 years?

A
  • running and jumping
  • drawing
  • short sentences and understanding joint commands
  • playing with others
33
Q

How many children are born with a genetic disorder?

A

1 in 25

34
Q

How many children are born with congenital defects?

A

1 in 45

35
Q

How many children experience some sort of developmental delay during childhood?

A

1 in 10

36
Q

What is the NHS Healthy Child Programme?

A
  • prevent diseases and promotes good health
  • universal
  • reduces health inequalities
37
Q

What does the NHS Healthy Child Programme provide?

A
  • health promotion
  • obesity prevention
  • supporting care giving and care givers
  • screening
  • immunisation
  • identifying individuals who need additional support
  • signposting for accident prevention and dental hygiene§
38
Q

What are some important early childhood screening programs?

A
  • newborn check
  • new born hearing check
  • blood spot check
39
Q

What are the fundementals of a good screening program?

A
  • able to identify disease before critical point
  • disease is treatable
  • prevents morbidity and mortality
  • easy to administer
  • cost effective
  • reproducible and accurate results
40
Q

What does the newborn physical exam measure?

A
  • weight
  • eyes
  • heart
  • hips
  • testes
41
Q

What does the blood spot test test for?

A
  • cystic fibrosis
  • sickle cell
  • congenital hypothyroidism
  • inherited metabolic disorders
42
Q

What is a newborn hearing test?

A

Hearing test done in hospital before discharge, can be up to 3 months

43
Q

What is an infant physical exam?

A
  • done at 6-8 weeks by GP
  • measures length and head circumference
  • oppurtunity to discuss vaccinations
44
Q

What is the Sure Start program?

A
  • helps support low-income families with children under 5 years old
  • provides parent and child education
  • health promotion
44
Q

What are the two different types of developmental delays?

A
  • global development delays
  • specific developmental disorder
45
Q

What is a global developmental delay?

A

Significant delay in reaching two or more developmental milestones

46
Q

What is a specific developmental disorder?

A

Delays in specific developmental domains in absence of sensory deficits, subnormal intelligence or poor education conditions

47
Q

What are the causes of global developmental delays?

A
  • chromosomal abnormalities
  • metabolic e.g hypothyroidism
  • antenatal and perinatal factors
  • environmental-social issues
  • chronic illness
48
Q

What are some antenatal and perinatal factors which can cause global developmental delays?

A
  • infections
  • drugs
  • toxins
  • anoxia
  • trauma
  • folate deficiency
49
Q

What are some screenings which asses language skill development?

A
  • schedule of growing skills
  • Griffith’s developmental scale
  • Bayley Scales of Infant Development
49
Q

What are some causes of motor skill developmental delays?

A
  • cerbral palsy
  • congenital hip dislocation
  • muscular dystrophy
  • neural tube defects
  • social deprivation
49
Q

What are some causes of language skill developmental delays?

A
  • hearing loss
  • autism spectrum disorders
  • lack of stimulation
  • imparied language comprehension
  • impaired speech production e.g. stammer, dysarthia

BRS YR2 (67 decks)

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