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Paediatrics COPY > 1: Endocrine - Growth Faltering (FTT) > Flashcards

1: Endocrine - Growth Faltering (FTT) Flashcards

(51 cards)

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1
Q

What is failure to thrive now known as

A

Growth faltering

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2
Q

What is FTT

A

Failure to grow at expected rate

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3
Q

What is weight-faltering

A

Crossing down-centiles for weight

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4
Q

What is growth-faltering

A

Crossing down centiles for weight or height (length)

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5
Q

When is weight a batter indicator for growth

A

Weight is a better indicator in infants and small children

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6
Q

When is height a better indicator for growth

A

Height is a better indictor for children

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7
Q

What is the main cause of FTT

A

Insufficient food-intake

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8
Q

How can causes of FTT be divided

A
  1. Organic

2. Non-organic

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9
Q

What are the 4 categories of ‘organic’ FTT

A
  1. Impaired intake
  2. Malabsorption
  3. Increased energy requirement
  4. Inability to use nutrients
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10
Q

What are 4 causes of impaired intake

A
  1. Impaired suck - cleft palate
  2. Oromotor dysfunction
  3. Chronic illness causing anorexia
  4. Vomiting - GORD
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11
Q

What can cause impaired suck

A

Cleft palate

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12
Q

What can cause oromotor dysfunction

A

Cerebral palsy

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13
Q

What are 3 causes of increased energy expenditure

A
  • Malignancy
  • HF
  • Cystic Fibrosis
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14
Q

What are two causes of malabsorption

A
  • Coeliac disease

- Cystic fibrosis

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15
Q

What are 2 causes of failure to utilise nutrients

A
  • Chromosomal disorders
  • Congenital anomalies (eg. hypoT)
  • Congenital infections
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16
Q

How can non-organic causes of FTT be divided

A

Inadequate intake

Psychosocial

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17
Q

What are causes of decreased food availability

A
  • Poor breast feeding technique

- Poor timing of bottle-feeds

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18
Q

What are psychosocial causes of FTT

A

Poor bonding
Maternal depression
Abuse and Neglect

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19
Q

Explain weight change in neonates post-delivery

A

Following delivery, it is common for neonates to loose weight, which usually stops by day 3-4. Neonates then gain their birth-weight by 3W

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20
Q

When is it abnormal neonatal weight loss

A

> 10%

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21
Q

If infant looses more than 10% of their brith weight, what should be done

Study These Flashcards
A
  • Feeding History
  • Observe breast-feeding
  • Clinical exam
  • May require other investigations
22
Q

Define growth-faltering in infants/children

Study These Flashcards
A
  1. Crossing down 3 centiles for weight in more than the 91st centile
  2. Crossing down 2 centiles for weight, if 9-91st centile
  3. Crossing down 1 centile for weight, if less than 9th centile
23
Q

What determines growth in-utero

24
Q

What determines infantile growth

25
What determines childhood growth
GH Thyroid Genetics
26
What determines adolescent growth
Androgens | GH
27
How often should growth be measured in 0-1 years
5-recordings
28
How often should growth be measured in 1-2 years
3-recordings
29
How often should growth be measured in >2 years
Annually
30
How is weight and height plotted
On growth chart
31
When is child's head circumference plotted
Until 2-years
32
When is child's length plotted until and what takes over afterwards
2-year. Then use height
33
Explain how pre-terms are plotted on growth chart
Plot in pre-term section until 42W of age. When 42W plot on chart for correctional gestational age. Correctional gestational age: plot weight for child's actual age and then draw back to how many weeks child was pre-term Continue this until 2-years
34
In investigating growth-faltering what is first-thing to do
Plot values on growth chart
35
What should be calculated for growth concerns
Mid-parental height
36
Explain how mid-parental height is calculated for a girl
[(Dad's height - 14) + (Mum's height + 8.5)]/2
37
Explain how mid-parental height is calculated for a boy
[(Mums height + 14) + (Dad's height + 10)]/2
38
What type of history is taken in FTT
- Detailed Feeding history including weaning
39
What bedside tests should be ordered for FTT
Urinalysis | Urine MC+S
40
Why is MC and S ordered
Renal dysfunction
41
What blood-test is ordered for most cases of FTT
anti-TTG (coeliac screen)
42
What do other investigations depend on
History
43
What should be kept for all patients
Food diary
44
When should a child be referred to paediatrics for FTT
- Suspect NAI - Failure to respond to primary care interventions - Unexplained short-stature - Rapid weight loss
45
What does management of FTT generally depend on
Cause
46
How are neonates with FTT generally managed
Formula supplements
47
How is child with FTT managed
Oral nutritional supplements
48
If FTT in 1m, how often should they be weighed
Daily
49
If FTT in 1-6m, how often should they be weighed
1W
50
If FTT in 6-12m, how often should they be weighed
2W
51
If FTT in >1 year, how often should they be weighed
Monthly

Paediatrics COPY (61 decks)

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