SM_149b: Growth: Disease Specific Impact in Children Flashcards
Organic pediatric malnutrition has ___
Organic pediatric malnutrition has an underlying medical cause
____ should always be corrected when assessing growth
Children born <37 weeks premature until 24 months should always be corrected when assessing growth
Disturbances in ___ may be the first indication of an underlying disease state
Disturbances in growth may be the first indication of an underlying disease state
Describe the different growth curves
Growth curves
- CDC
- WHO: breast fed infants
- Premaature infants: 40 weeks - gestational age at birth (corrected = chronological age - adjustment for prematurityZ)
Describe daily weight gain in children
Daily weight gain in children
- 20-30 grams in first 3-4 months
- 15-20 grams in first year
- 5-10 grams at 12 months to 2 years
Describe height of children
Height of children
Girls = [(father height - 5 in) + mother height] / 2
Boys = [father height + (mother height + 5 in)] / 2
BMI is not applicable if ____
BMI is not applicable if age < 2 years
- Weight / length: assesses weight compared to height, indicator of acute malnutrition
- Length / heigh for age: indicator of chronic malnutrition and stunting
___ is the last growth parameter to decrease
Head circumference is the last growth parameter to decrease
Non-organic pediatric malnutrition has ___
Non-organic pediatric malnutrition has psychosocial origin leading to poor intake
Failure to thrive / growth faltering is ____ < 3 months and ____ > 3 months
Failure to thrive / growth faltering is acute < 3 months and chronic > 3 months
Describe anthropometry of children
Anthropometry of children
Describe appropriate growth charts
Appropriate growth charts
- WHO growth curve for children < 2 years of age
- BMI used for children > 2 years of age
- Weight / length < 2 years
Weight/length can indicate ____
Weight/length can indicate acute malnutrition
Length/height for age include ____ or ____
Length/height for age include chronic malnutrition or stunting
This is ____
This is normal weight
This is ___
This is obese
Failure to thrive or growth faltering is based on ____
Failure to thrive or growth faltering is based on established growth standards for age-sex
- Weight for age or weight/length < 5%
- Weight may cross more than 2 major percentiles
- Decrease in > 2 SD on growth charts over 3-6 months
Failure to thrive / growth faltering can occur due to ____, ____, ____, and ____
Failure to thrive / growth faltering can occur due to insufficient intake, losing calories, increased caloric demand, and inability to utilize calories appropriately
- Losing calories: vomiting / diarrhea, malabsorption
- Increased caloric demand: complex heart disease, liver disease, and pulmonary disease
- Inability to utilize calories appropriately: mitochondrial disease, chromosomal abnormality
Failure to thrive / growth faltering can occur in ___, ___, ___, and ___
Failure to thrive / growth faltering can occur in cystic fibrosis, IBD, celiac disease, and for social reasons such as poor maternal interaction with child and improper mixing of formula
Cystic fibrosis may present with ____, ____, and ____ and is a cause of ____
Cystic fibrosis may present with respiratory infections, poor weight gain, and fat malabsorption and is a cause of growth failure
- CFTR mutations
- Sweat Cl > 60 mmol/L on two separate occasions
- Immunoreactive trypsinogen concentration
Describe GI manifestations of cystic fibrosis
Cystic fibrosis GI manifestations
- Pancreatic insufficiency (∆F508) 90%
- Pancreatitis / pancreatic sufficiency: fat malabsorption (fat soluble vitamins A, D, E, and K)
- Meconium ileus / perforation leading to intestinal resection / short bowel syndrome
- Distal intestinal obstructive syndrome - severe constipation that may require intensive therapy
Describe functions of the pancreas
Pancreas functions
- Secretes alkaline fluid that neutralizes gastric acid
- Secretions have increased viscosity, blocking ducts of exocrine glands i.e. pancreas
- Contains multiple digestive enzymes to help with absorption
Goal for growth in a patient with cystic fibrosis is ____
Goal for growth in a patient with cystic fibrosis is > 50th percentile for weight/length and BMI
- Pancreatic enzyme replacement therapy is used to treat
Inflammatory bowel disease presents with ____, ____, ____, ____, and ____
Inflammatory bowel disease presents with abdominal pain, diarrhea, rectal bleeding, weight loss, and growth failure in pediatric populations
