RDA- Childhood

Question 1

1. How do you measure height correctly

Answer 1

1. Equipment
   
   2. Position child properly to get an accurate height
   3. Get rid of things that could interfere

Question 2

2. What is cumulative height

Answer 2

1. Total of all growth they have done upto now from conception

Question 3

What is height velocity

Answer 3

1. How fast a child is growing in cm per year calculated over a whole year

Question 4

1. What is a normal growth pattern

Answer 4

Along a centile from 2/3 years of age

Question 5

2. What influences growth upto when you plot them on a centile chart

Answer 5

1. Events before birth such as poor fetal growth, low birth weight, prematurity
   
   2. Medical issues = malnutrition, chronic disease, GH deficiency
   3. Genetic factors
   4. Randomness

Question 6

3. What can cause abnormal growth (short)

Answer 6

1. Poor nutrition
   
   2. Chronic disease
   3. Endocrine (GH/Thyroid)
   4. Genetic disorders affecting bone growth
   5. Psychological distress and neglect

Question 7

4. What can cause abnormal growth (tall)

Answer 7

1. Marfan syndrome
   
   2. Soto syndrome
   3. GH excess from a tumour
   4. Precocious puberty

Question 8

1. Define obesity in children

Answer 8

BMI centile position

Question 9

2. Define obesity in adults

Answer 9

1. > 30kg/m^2

Question 10

4. Why is obesity a concern

Answer 10

1. T2 DM
   
   2. CVD
   3. Cancers
   4. Orthopaedic factors

Question 11

1. What is child development

Answer 11

1. Global impression of a child which encompasses growth, inc in understanding, acquisition of new skills and more sophisticated responses and behaviour

Question 12

2. What are the developmental domains

Answer 12

1. Gross motor and posture
   
   2. Fine motor and vision
   3. Language and hearing
   4. Social, emotional and behaviour

Question 13

1. What are the three patterns of developmental delay

Answer 13

1. Slow but steady
   
   2. Plateau
      Regression

Question 14

2. How can a child present with developmental concerns

Answer 14

1. Identification of antenatal/postnatal risk factors
   
   2. Developmental screening
   3. Concerns raised by parents or other healthcare professionals

Question 15

4. Describe cerebral palsy

Answer 15

1. Disorder of movement and posture arising from a non-progressive lesion before age of 2 years
   
   2. Most causes are antenatal
   3. Associate with learning difficulties, epilepsy, visual impairment, hearing loss

Question 16

1. What are the features of autism

Answer 16

mpaired social interaction

2. Speech and language disorder
3. Imposition of routines with ritualistic and repetitive behaviour

Question 17

2. What is the management of autism

Answer 17

1. Intensive support for child and family

Question 18

3. What are the diagnostic criteria for ADHD

Answer 18

1. Inattention
   
   2. Hyperactivity
   3. Impulsivity
   4. Lasting for more than 6 months
   5. Commencing at younger than 7 years and inconsistent with child’s developmental level
   6. More than one setting

Question 19

What are children with ADHD at risk of

Answer 19

1. Conduct disorder
   
   2. Anxiety
   3. Aggression

Question 20

5. What is the management of ADHD

Answer 20

1. Psychotherapy
   
   2. Family therapy
   3. Drugs such as methylphenidate, amphetamines
   4. Diet

Question 21

What age is adolescence in girls and boys

Answer 21

1. Early = 11-14
   
   2. Middle = 14-17
   3. Late = 18+

Question 22

1. Define puberty

Answer 22

1. Process of physical changes through which a child’s body matures into an adult body capable of sexual reproduction

Question 23

2. What are the main endocrine factors associated with puberty

Answer 23

1. Neurokinin B and Kisspeptin
   a. Switches on GnRH from hypothalamic neurones
   
   2. GnRH
   3. LH
   4. FSH
   5. Testosterone
   6. Estradiol
   7. IGF1 (growth spurt)
   8. Leptin (targets hypothalamus)

Question 24

What age does puberty happen in girls and boys

Answer 24

1. 8 in girls -16, 10 -18 in boys

Question 25

4. What are the changes in the onset of puberty since mid 19th century

Answer 25

1. Starting earlier a. Improved healthcare b. Improved socioeconomic factors

Question 26

5. What are the adolescent attitudes to pubertal development

Answer 26

1. Boys enjoy it bc inc status and athletic | 2. Girls ambivalent about adiposity and onser of menarche

Question 27

What is the main psychological development in adolescence

Answer 27

1. Formal-operational thinking (piaget) a. Being able to abstract, hypothetical and idealistic manner 2. Conventional -> post-conventional moral development (kohlberg) a. Desire to please others, awareness of social order TO b. Abstract thinking, develop own personal moral compass 3. Identity vs confusion (ericksons)

Question 28

ow do friendships develop in adolescence

Answer 28

1. -> normative stage with common values and beliefs, loyalty, sharing support cooperation 2. -> empathic stage -> make active attempts to understand one another, share personal information, respond sensitively 3. More formal groups of friends

Question 29

1. What are the features of anorexia

Answer 29

1. Body weight maintained 15% below expected weight 2. BMI <17.5 3. Weight loss is self induced 4. Psychopathology 5. Endocrine disturbance

Question 30

2. What is the aetiology of anorexia

Answer 30

1. Genetic predisposition 2. Perfectionist temperament 3. Specific subculture 4. Childhood abuse and adversities 5. Higher social class

Question 31

What is the symptom cluster for depression

Answer 31

1. Affective (sadness loss of enjoyment irritiabiltiy) 2. Cognitive (self-blame, hopelessness, guilt) 3. Biological (disturbed sleep, reduced appetite

Question 32

2. What are the developmental considerations for depression

Answer 32

1. Endocrine changes 2. Changes in family relationships 3. Peers 4. Responsibilities and hassles

Question 33

3. What are the causes of depressive disorder

Answer 33

1. Familial aggregation (genetic factors) 2. Effects of family interaction 3. Life events 4. Adversities

Question 34

1. What are the main features of conduct disorder

Answer 34

1. Looses temper and argues 2. Defies adult requests 3. Bullies, fights or intimidates 4. Stealing, breaking into cars or houses, destroys properties 5. Running away, truanting

Question 35

2. What are the therapies than can be used

Answer 35

1. CBT 2. Family therapy 3. Interpersonal therapy

Question 36

3. What drugs can be used

Answer 36

1. Antidepressants 2. Stimulants 3. Melatonin 4. Antipsychotics 5. Short-term medications