Unhealthy Growth -Fahim Flashcards
What is the difference in Familial Short Stature (FSS) vs Constitutional Growth Delay (CGD)?
FSS:
- normal height/weight in first 2-3 years
- heigh decerase until reaching a lower curve then maintain normal growth velocities and normal bones
- short adult with mid parental height expectations)
CGD:
- slowing of growth in first 3 years.
- normal growth during prepubertal years
- puberty delayed several years
- after puberty, achieve normal adult height
A 7-year-old boy is brought to the pediatrician because of a chronic cough, fatty diarrhea, and failure to thrive. Pseudomonas aeruginosa is cultured from his respiratory tract. The physician informs the patient’s parents that their son has a disease that is caused by a mutation in a specific ion transporter. This patient has a mutation in the ion transporter of which of the following electrolytes? A. Bicarbonate B. Calcium C. Chloride D. Potassium E. Sodium
C. Chloride
CF linked to failure to thrive
What is the new diagnostic approach for failure to thrive?
It is a physical sign that the child is not receiving adequate nutrition for growth and development
What is failure to thrive?
- Weight below 3rd or 5th %ile more than once
- Weight drops 2 major percentile lines
- Weight is less than 80th% of ideal for age
What are the potential causes of FTT?
-Poor food intake (weight falls first, length and head circumference spared)
-d/t chronic medical condition (symmetric fall in weight/height)
-endocrine disorder (height < 50%ile, weight spared)
-lack of brain growth (early dec in Head circumference)
-increased metabolic demands
-malabsorption
Marasmus and Kwashiorkor
What results from a protein deficiency?
Kwashiorkor
- Edema
- Skin: dermatoses (hyperkeratosis, dyspigmentation)
- Hair: dry, brittle, and sometimes red or yellowish hair (if alternating periods of protein deprivation, they may have alternating bands of hair texture = flag sign),
- Abdomen: protruding with hepatomegaly (fatty infiltration)
What is Marasmus? What are some of the clinical findings?
Marasmus is massive (no food coming in)
"flaming kp nuts" FLAME -Fatty Liver -Low Albumin/Anemia -Malabsorption -Edema
-Acute phase reactants go NUTS high: Glucose, WBC, urine nitrogen, and serum ferritin
A 4-year-old child was born at term, with no congenital anomalies. She is now only 70% of normal body weight. On examination she shows dependent edema of the lower extremities as well as an enlarged abdomen with palpable fluid wave. Her desquamating skin shows irregular areas of depigmentation, and hyperpigmentation. Which of the following nutritional problems is most likely present in this child? A. Marasmus B. Scurvy C. Vitamin A toxicity D.Niacin deficiency E. Kwashiorkor
E. Kwashiorkor
What effect does breast feeding have on weight?
Protective value
along with being a part of a family with an active lifestyle, minimal TV, and non-obese parents
Should we hospitalize FTT pts immediately?
Not unless failed outpatient or symptomatic (will normally grow better at home)
What is overweight and obese in adult BMIS?
Adult overweight> 25
Obese > 30
A 8-year-old boy returns from a camping trip complaining of abdominal cramping, diarrhea, and excessive gas. A duodenal aspirate reveals the organism shown in the image. What is the most likely explanation for his symptoms?
A. Activation of enteral adenylate cyclase
B. Deficiency of an enzyme
C. Invasion of the lining of the intestine
D. Small bowel inflammation and villous atrophy
E. Viral infection of the cells of the small intestine villi
D. Small bowel inflammation and villous atrophy
- giardia trophozoites –> inflammation and villous atrophy
- NOT invasive
A 24-year-old man presets to the physician with diarrhea and abdominal cramps. A fecal is occult blood test is positive. On questioning, it is learned that the patient went swimming in a like during a camping trip 2 days ago. A stool sample is sent for laboratory evaluation. This patient is most likely infected with which of the following? A, Cryptosporidium B. Entamoeba histolytica C. Giardia lamblia D. Leishmania donovani E. Naegleria fowleri F. Toxoplasma gondii
B. Entamoeba histolytica
*bloody diarrhea (dysentery) with abd cramps and pus in stool
transmitted fecal-oral by cysts in the water
A 17-year-old girl who is being treated with antibiotics for recurrent sinus tract infections presents to the physician with intractable watery diarrhea and cramps. Which of the following is most often associated with this patient’s condition? A. Clostridium difficile B. Clostridium perfringens C. Escherichia coli D. Staphylococcus aureus E. Vibrio cholerae F. Yersinia enterocolitica
A. Clostridium difficile
psuedomembranous colitis
What are some characteristics of Campylobacter?
“camping chicken sliding on helical slides”
From poultry
gram - , helical
