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PMS: growth and development
asdfas
47
Aerospace Engineering
2nd Grade
07/31/2010

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Cards

Term
at what point do you stop measuring a child's head circumference?
Definition
about 3-4 yo
Term

What does this refer to:

 

maturation and development of physical characteristics including height, head circumference and weight.

 

Quantitative measure of physical development. 

Definition
GROWTH
Term

What is the most common cause for baby who is large for gestational age?

 

what are risks associated with LGA?

(BCHHH)

Definition

most common: maternal diet

 

other: diabetic mother

 

RIsks associated:

birth trauma

hypoglycemia

cardiomyopathy

hypocalcemia

hyperbilirubinemia

Term
What are 3 assoc risks of a baby that is small at gestational age?
Definition

fetal distress

hypoglycemia

hypocalcemia

Term

What are factors that make a child more prone to being born small for their gestational age? (7)

 

AMPPDCCA

Definition

Advanced maternal age >35

Multiples

poor maternal diet

placenta insufficiency

drugs/alcohol

CMV infections

Chromosomal abnormalities

Term
Growth charts are based on....
Definition
based on breast feeding baby with changes representing shit in formula usage.
Term
What is the purpose of growth charts?
Definition

allow for quantitative assessmen of growth

 

trend or track development

 

allow for guidance to diet, nutrition and physical activity assessment and guidance

 

opens the door for discussion in regards to feedings, bonding, advancement of solid foods

Term

Typical baby should ____ growth in first year of life.

 

THis is the reason nutrition is so imp.

Definition
TRIPLE
Term
What is included in a growth chart?
Definition

height

weight

head circumference

height to weight ratio

Term

True or False.

 

Predicted values for exclusively breast fed infants to plot high in first 6 months and lower from 6-12 mts of age.

Definition
true
Term
Uh oh- you notice a patient age 9 mts to 15 mts is not following "normal" growth curve. They appear to be declining. What do you think?
Definition

NORMAL!

 

bc starting to be more active

Term
How long can you use growth charts for infants?
Definition
up to 36 mts.
Term
What type of children receive special growth charts?
Definition

Down Syndrome

 

Low birth weight or preemie charts (adjusted for specific known or predicted alternation sin growth patterns)

Term
Causes of Growth Problems
Definition

Malnutrition

Inadequate calorie intake

Caloric intake inappro for stage and age

Caregiver and child bond 

Stress

Socioeconomic factors

Chronic disease: asthma celiac disease, cardiac

Term
What are the top reasons for growth problems?
Definition

hypothyroid

Cushings

IUGR (intrauterine growth restriction)

Term
What's the difference between familial short stature and constitutional growth delay?
Definition

Familial: follows inherited pattern of height

slow growth first 2-3 yrs then low to normal growth; bone age and chronological age match

 

Constitutional growth delay: growth patterns follows familial dshort stature BUT there is a lag in onset of puberty or skeletal maturation

Potential for catch up growth

Bone age lags

Term
What are pathologic causes of short stature? (2)
Definition

Endocrine: usual presentation is no nutritional deficit with a deceleration in linear growth

 

Congential: IUGR

Genetic variants such as Trisomy 21 or Turner syndrome: look for presence of dysmorphic features

Skeletal abnormalities- dwarfism

Term

Weight <5% on CDC growth chart

Weight: Heigh <5%

Decreased growth velocity in weight flling> 2 major percentiles over 3 to 6 mts.

 

What does this mean?

Definition

FAILURE TO THRIVE

 

Condition of under nutrition identified in the first 3 years of life.

Term

Proportionate deline in heigh and weight with normal head circumference.

 

What type for failure to thrive?

Definition
Type II
Term

Weight< heigh with normal head circumference.

 

What type for failure to thrive?

Definition
Type I
Term

All growth parameters are lower than normal.

 

What type for failure to thrive?

Definition
Type III
Term
What causes Type I of failure to thrive?
Definition

**MOST COMMON: OCCURRING IN 8% CHILDREN

 

cause by inadequate deliver of calories

 

-not enough intake

-malabsorption ie IBD or celiac disease

-excess energy expenditure

Term

Genetically determined short stature

Constitutional growth delay

Skeletal dysplasia

Renal Failure

Cardiac

Endocrine Disorders

 

What type for failure to thrive?

Definition
TYPE II
Term

Chromosomal abnormailities

Central nervous system abnormalities

In utero or peri-natal injury

 

What type failure to thrive?

Definition
Type III
Term
What are reasons for a child to grow too fast?
Definition

Idiopathic

Familial

Precocious puberty:

early onset in which child initially tall for age, but rapid bone maturity results and growth stops at an early age

 

Genetic disorder such as Marfans

Term
What labs do you want to get when you suspect growth problems?
Definition

CBC

CMP

LFTs

UA

TGT

IGF (insulin like growth factor)

celiac panel

bone age

Term

Mom comes in complaining their baby has

 

non bilious vomiting

fussy

arching back

frequent gagging

 

 

What could it be?

How do you diagnose?

Definition

Clinical diagnosis and or upper GI (barium swallow)

 

REFLUX!!!

Term
What are the rules of 3 for diagnosing colic?
Definition

3 hrs of crying

3 or more days/week

for 3 weeks

Term

Mom comes in complaining of child who has

 

non bilious vomiting

may or may be projectile

always progressive

most prevalent at 6 wks.

 

What could it be? How do you diagnose?

Definition

Pyloric Stenosis

 

Diagnose: US and palpable olive

Term

1 in 5000

Male>Female

Absence of ganglion cells in bowel wall extending proximally from anus

Presentation usually early but can be later

None or late passage of meconium

Worsening constipation

Surgical intervention

Definition

Hirschspring disease: reason baby can't leave hospital till they poop

 

On exam: feel palpable stool in belly in LLQ- on digital rectal exam you will not palpate stool

Term
Proximal bowel mucosa injury from gluten exposure
Definition
Celiac Disease
Term

Baby presents:

 

loose skin folds

diarrhea, foul smelling stools

vomiting

proximal muscle wasting

full abdomen

Definition
Celiac disease
Term

this is usually undetected till puberty.

 

hypotonia at birth

failure to thrive

developmental delay common (speech and coordination)

ages 2-4 compulsive eating, obesity, temper tantrum

Definition
Prader Willi
Term
Is development different from growth?
Definition

YES!

 

How a child becomes able to do more complex things

Term
Do milestones tell you how a child's growth is doing?
Definition

NO

 

check how child is developing!

Term
What are the Piaget stages of development?
Definition

sensory-motor (0-2) INFANCY

preoperational (2-7) PRESCHOOL

Concrete operations (7-11) SCHOOL AGE

Formal Operations (11 onward) ADOLESCENT

Term
is it normal if you skip stages in development?
Definition
NO!
Term
What's the difference btw development surveillance and development screening?
Definition

Surveillance: flexible, longitudina, continuous, and cumulative process allowing healthcare professionals to identify children who may have developmental problems

 

Screening: administration of brief standardized tool to identify children at risk for development disorders. Typically done at 9,18 and 30 mts.

Term
What is the social emotion domain of development?
Definition
blending fine motor, adaptive, communication and cognitive function
Term

Motor: Raises head from pront- lifts cheat and holds heat up

 

Cognitive/Visual: tight grasp follow to midline- past miline- hands open at rest

 

Language: alert to sound- smiles socially and coos

 

Social: Regards face- recognizes parent- reaches for familiar things- anticipates feedings

 

What developmental milestone?

Definition
0-3 months
Term

Motor: Rolls over- sits unsupported- crawls- pulls to stand- cruises- walks alone

 

Cognitive: hands to midline- raking grasp- transfer object- holds bottle or throws object- pincer grasp

 

Language: laugh, babbles, mama/dada, 2 words

 

Social: stranger- pat a cake- imitate actions

Definition
Developmental milestone 4-12 mts.
Term

Motor: walks backward- creeps upstairs- runs- throws object while standing- stairs independantly

 

Cognitive: two blocks/imitate scribble-3 blocks/scribble on own- block tower/imitate pencil hold

 

Language: 4-6 words- 7-10 words, knows 5 body parts-2 word sentences/50 word vocabulary

 

Social: spoon and cup- imitates actions, plays in company of another child- parallel play

Definition
Developmental Milestone 15 to 24 mts.
Term

Language: 3 word sentence- pronouns- two step commands- plurals

 

Cogntive copy circle and undress self

 

Social plays with others, shares, group play

Definition
30 mts to 36 mts
Term

Motor: hop- skip- alternating feet- jump over low obstacles

 

Cogntiive: dress independantly- catch ball- ties shoe

 

Language: colors- song from memory- print name- asks why?

 

social: tall tales- cooperative play with group- competitive play- abides by rules?

Definition
4 to 5 yrs
Term
What's difference btw delay, deviancy and disassocation?
Definition

delay: below avg or 75% in one or more ares

 

deviancy: atypical development in single area; abnormal pattern

 

disassociation: development in one area out of proportion with other areas

Term
name 5 general screening tools
Definition

ages and stages questionaire

brigance screens II

child development inventory/review

dever II developmental

parents' evaluation of developmental status

Term
What is the M-CHAT used for?
Definition

screening for autism

 

Interest in other kids

proto-declarative pointing

show and tell

imitation

respond to name when called

polite to point

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