121 - Faltering Growth Flashcards

1
Q

What are the general causes of faltering growth?

A
Inadequate caloric intake
Inadequate absorption
Excessive calorie use
Genetic syndromes
Psycho-social reasons
Inborn errors of metabolism
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2
Q

Why is measuring growth important?

A

Indicator of good health
Indicator of child’s future
summary of adverse influences on child
Summary of populations socioeconomic state

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3
Q

What is PDA?

A

Patent ductus arteriosus
- ductus remains open at birth, blood shunted form high pressure aorta into pulmonaty artery - excessive pressure in pulmonary system

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4
Q

What does PDA cause?

A
Hyperactive precordial pulse
Breathlessness ( due to pul oedema)
Bounding pulse
Harsh murmur
Tachycardia, cold sweaty peripheries
Failure to thrive
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5
Q

What are the treatment options for PDA?

A

Diuretics (for oedema)
Increase nutrition
Close ductus - coil occlusion / metal clip via thoractomy

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6
Q

How does acute wasting impact on a child’s growth?

A

Normal height for age

Reduced weight/height ratio

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7
Q

How does chronic stunting growth impact on a child’s growth?

A

Reduced height for age

Normal weight for height ratio

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8
Q

What is marasmus malnutrition? What is the mortality?

A

Acute wasting due to starvation
Little old man
thin flaccid skin, reduced fat
Physiological processes ok.

Mortality - 10%

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9
Q

What is Kwashiorkor malnutrition?

A

Body’s physiological processes affected
Oedema. flaky paint dermatitis. dry depigmented hair. hepatomegaly. Apathy + misery

Mortality - 30-40%

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10
Q

What is normal growth in g/week of: 0-3 month old

A

200g/week

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11
Q

What is normal growth in g/week of: 4-6 month old?

A

150g/week

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12
Q

How much is normal growth in height per year in childhood?

A

5cm/year

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13
Q

Feeding: How much milk should a 2.5kg + baby have?

A

150-200 mls/kg/24hrs

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14
Q

How much milk should a 4-6 month old have?

A

140 mls/kg/24hrs

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15
Q

How much milk should a 1 year + old have?

A

600 mls milk/day + water

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16
Q

How many calories should a normal infant have a day?

A

100-120 Kcal/kg/day

17
Q

How many calories should an underweight infant have a day?

A

130-140 Kcal/kg/day ( or 110-120% that of its weight’s allowance)

18
Q

What does colostrum contain?

A

First 3 days.
High protein
Low fat
High growth factors and immunity

19
Q

What does mature breast milk contain?

A

40% caesin protien, 60% Whey protein
more fat
lactose
Iron - lower than formula, but very bioavailable

20
Q

What is Small for Gestational Age (SGA?)

A

below the 10th centile.

21
Q

What does Growth Hormone do?

A

Promotes protein synthesis
Inhibits carb and fat formation
Essential in chondrocyte proliferation

22
Q

What is typical if you have low GH?

A

often fat

short stature

23
Q

What happens if fetus is starved in later stages of pregnancy?

A

Asymmetrical growth - head is normal size, body small. Cerebrum protected.

24
Q

What happens if fetus is starved throughout pregnancy?

A

Symmetrical reduced growth - whole baby is small.

25
Q

What can cause macrosomia?

A

Diabetic mum

- High blood glucose, insulin produced by baby. Islet cells hypertrophied - produces GF - IGF-1, stimulates growth.

26
Q

What is Foetal alcohol syndrome?

A

Dysmorphic face - small narrow eyes, small head, flat brow/above lip
developmental issues
many issues - epilepsy, renal failure..

27
Q

What is most important in dif stages of growth?

A

Phase 1 + 2 - nutrition
Phase 3 - Hormones (GH + thyroid)
Phase 4 - Hormones (Sex hormones)

28
Q

What is Adrenarche?

A
  • 8yrs old

- onset on pubic and axilla hair gowth

29
Q

What is gonadarche?

A

Puberty

Increase nocturnal secretion of GnRH - increase sex hormones - growth spurt.