The Normal Child

Question 1

Growth is the central task for childhood. There is huge variation between different children & it is no linear.

What is growth defined as?

Answer 1

Increased in height & weight

Question 2

Name the 4 phases of growth including the different factors that promote growth for each stage.

Answer 2

1. Intrauterine - good intrauterine environment
2. Infantile - love/nurture, nutrition, thyroid hormones
3. Childhood - love/nurture, nutrition, thyroid hormones, genes
4. Pubertal- GH, sex hormones

Question 3

The average normal birth weight is ____ kg or ____ pounds

The average normal head circumference is ____ cm

Answer 3

3.3-3.5 kg or 7 pounds

34-35cm

Question 4

When do teeth 1st appear?

When do permanent teeth come through?

Answer 4

First appear: 6 months –> 2yrs (hence weaning)

Permanent teeth: 6-12 yrs

Question 5

What tool is used to assess the health/ development/ nutrition & disease state of a child?

Answer 5

Growth chart

Question 6

What things inhibit growth in children?

Answer 6

Emotional distress (chronic release of cortisol)
Steroids
High oestrogens
Inflammatory markers (hence chronic D)

Question 7

In a growth chart, the speed of growth is more important than the percentile. There is a chart for each age group.

For which group does the growth chart have to be corrected for?

Answer 7

Premature babies (correct until 2yrs)

Question 8

Sometimes a wrist XR is done to measure the gap between the bones . What is this helping to determine?

Answer 8

Bone age

Bad if bone age is same or older than child’s age as means no room for growth

Question 9

What are the causes of short stature?

Answer 9

Constitutional (familial)
Malabsorption - IBD, Coeliac, CF
Inflammatory D
Endocrine - Hypothyroid, GH def, Delayed/ early puberty
Chromosomal ab - Turners
Psych - neglect, abuse, emotional disease
*Sign before disease presentation

Question 10

Which presentation is likely to indicate chronic disease?

• Short & fat
• Short & thin
• Tall & fat

Answer 10

Short & thin

Question 11

Puberty is a growth spurt in adolescence trigger by LH & FSH release from pituitary causing gonads to release sex hormones & leading to development of “2 sexual characteristics.

What ages are considered early & late puberty in boys & girls?

Answer 11

Girls:

• Early: <8yrs
• Late: >13 OR 15 with no menarche

Boys:

• Early: <9
• Late: >14