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BRS D&A > 1b// Postnatal and Child Development > Flashcards

1b// Postnatal and Child Development Flashcards

1
Q

What is the transition from prenatal to postnatal growth for genetics?

A
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2
Q

What is the transition from prenatal to postnatal growth for endocrine?

A
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3
Q

What is the transition from prenatal to postnatal growth for nutrition?

A
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4
Q

What is the transition from prenatal to postnatal growth for environment?

A
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5
Q

Is growth proportional?

A

No, Head disproportionately large for the body (1/3rd vs 1/7th in adulthood) at birth

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6
Q

When does growth sloe down?

A

Grows rapidly for the first 2 years, before slowing

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7
Q

When are cranial sutures open, and when do they close?

A

Cranial sutures open at birth, close by 18 months

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8
Q

What are the 4 recognised phases of growth?

A

Fetal
Infantile
Childhood
Pubertal

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9
Q

Describe the growth curve between 0-18 y/o.

A
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10
Q

What is the fastest period of growth over a life course?

A

foetal

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11
Q

How much does foetal growth account for eventual height?

A

30% of eventual height

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12
Q

How much does foetus grow over gestation?

A

doubles in size over gestation

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13
Q

What is growth mainly driven by in foetal phase? And how many cell division are there before and after birth?

A

hyperplasia during foetal life

~42 cycles of cell division before birth,
~only further five cycles of cell division occur from birth to adulthood

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14
Q

How long does the infantile phase cover?

A

0-18 months after birth

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15
Q

How much of eventual height does the infantile phase account for?

A

15% of eventual height

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16
Q

What is the velocity like for growth in the infantile phase?

A

Rapid, but decelerating growth (vs fetal phase)

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17
Q

How much does the baby grow during the infantile phase and what is its change in weight?

A

Length increases by 50%,

head circumference by 30%

weight triples vs birth

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18
Q

What timeframe does the childhood phase cover?

A

18 months to 12 y/o

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19
Q

How much does the childhood phase account for, for eventual height?

A

40%

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20
Q

What is the velocity like for growth during the childhood phase?

A

Steady, slow prolongued growth

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21
Q

How much do you increase in weight and height during the childhood phase?

A

5-6 cm annual increase in height, and 3-3.5kg annual increase in weight

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22
Q

What is helping growth during the childhood phase?

A

Good nutrition and health important, but endocrine growth regulation increasing

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23
Q

How else is the pubertal phase known?

A

pubertal growth spurt

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24
Q

How much of eventual height does the pubertal phase account for?

A

15%

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25
Q

What happens hormonally during pubertal phase?

A

Rising levels of sex hormones boost hGH production

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26
Q

What happens to height during pubertal phase?

A

~25cm (XY boys) ~20cm (XX girls) increase in height over 3-4 years

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27
Q

______ growth happens during pubertal phase. Fill in the blank and why does it happen?

A

Temporary growth spurt as sex hormones also cause fusion of growth plates

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28
Q

Describe the stages of reproductive hormone changes over childhood.

A
  1. development of sexual organs and GnRH network
  2. Priming of HPG axis/ mini-puberty
  3. Linear growth and development milestones
  4. sexual maturation
  5. Reproductive capacity
29
Q

what is mini-puberty

A

Gonadotrophin secretion commences towards the end of the first trimester, peaks mid- pregnancy, then declines

HPG axis is transiently activated after birth (mini-puberty), after release from restraint by placental hormones

30
Q

How long does mini-puberty last?

A

Continues for around 6 months after birth before declining

31
Q

What is the point of mini-puberty in males?
- what happens to cells
- does spermatogensis occur and why

A

Elevated sex steroids in males during mini-puberty seems to be important for normal gonadal development (testicular tissue and penile development)

transition between foetal and adult leydig cells

however spermatogenesis does not occur because sertoli cells don’t have androgen receptors yet

32
Q

What is the point of mini-puberty in females?

A

Role of mini-puberty less clear in female infants

Estradiol levels fluctuate through first few months after birth

Follicular development occurs in the ovary

Important for patterning and development of mammary tissue (suggested bc more breast tissue in young females than males)

33
Q

What is elevated during mini-puberty for both males and females?

A

elevated sex steroids

34
Q

What does the elevated sex steroids in mini-puberty influence?

A

Elevated sex steroids in mini-puberty may also influence programming of body composition and linear growth.

High testosterone levels in boys during mini-puberty, may partly explain the higher growth velocity observed in boys compared to girls.

35
Q

What triggers puberty?

A

Control of puberty onset remains unclear, but influenced by metabolic status.

Release of neurokinin KNDy neurons may regulate release of Kisspeptin peptides, which act on GnRH neurons to promote pulsatile GnRH release

36
Q

What happens if there are mutations ni KISS1R?

A

Mutations in KISS1R affect puberty timing, implicating Kisspeptin- KISS1R signalling in regulation of this process.

if inhibited= no puberty
if activated too much= early puberty

37
Q

What are the female development milestones during puberty?

A
38
Q

What are the male development milestones during puberty?

A
39
Q

How would you describe the developmental events of puberty?

A

The developmental events of puberty typically follow a predictable pattern

40
Q

What is it called compliance with the sequence of developmental events of puberty?

A

consonance

41
Q

Has the age of menarche increased over time?

A

Age of menarche decreased by ~4 years 1850-1960, then by a further 3 months per decade from 1977-2013

1850= 17/18
1960= 13 y/o

42
Q

What are the developmental domains? (4)

A

Gross motor skills
Fine motor skills
Speech, language and hearing skills
Social behaviour and play skills

43
Q

What is the development of gross motor skills for a baby?

A
44
Q

What is the development of fine motor skills for a baby?

A
45
Q

What is the development of language skills for a baby/ child?

A
46
Q

What is the development of social behaviour for a baby?

A
47
Q

What are the median ages for developmental milestones? (5)

A

newborn

7 months

1 yr

15-18 months

2.5 yrs

48
Q

using the median ages for development, describe the development of gross motor skills.

A

newborn=> flexed posture

7 months=> sits without support

1 yr=> stands independently

15-18 months=> walks independently

2.5 yrs=> runs and jumps

49
Q

using the median ages for development, describe the development of vision and fine motor skills.

A

newborn=> fixes and follows face

7 months=> transfers objects from hand to hand

1 yr=> pincer grip (10 months) and points

15-18 months=> immature grip of pencil and random scribbles

2.5 yrs=> draws

50
Q

using the median ages for development, describe the development of hearing, speech and language.

A

newborn=> stills to voice, and startles to loud noise

7 months=> turns to voice, polysyllabic babble

1 yr=> 1-2 words, understands name

15-18 months=> 6-10 words, points to four body parts

2.5 yrs=> 3-4 word sentences, understands 2 conjoined commands

51
Q

using the median ages for development, describe the development of social, emotional and behavioural skills.

A

newborn=> smiles- by 6 weeks

7 months=> finger feeds, fears strangers

1 yr=> drinks from cup, waves

15-18 months=> feeds self with spoon, beginning to help with dressing

2.5 yrs=> parallel play, clean and dry

52
Q

What NHS programme aims to prevent disease and promote good health in children?

A

NHS Healthy Child Programme

53
Q

What does the NHS Healthy Child Programme include?

A

Health Promotion (Obesity prevention is a key aspect)

Supporting care giving and care givers

Screening

Immunisation

Identification of high-risk families/ individuals for additional support

Signposting
- accident prevention
- dental hygiene

54
Q

What are the fundamentals of a good screening test?

A
55
Q

What are the NHS Screening programmes during and after pregnancy?

A
56
Q

What are the 4 NHS health and development baby reviews?

A

Newborn physical exam

blood spot test

newborn hearing test

infant physical exam

57
Q

When is a newborn physical exam taken, and what is measured

A

(within 72h) – weight, eyes, heart, hips and testes

58
Q

When is a blood spot test taken, and what is measured?

A

(within 7d, ideally d5) – CF, Sickle Cell, congenital hypothyroidism, inherited metabolic diseases (eg PKU)

59
Q

When is a newborn hearing test taken?

A

(3-5 weeks) – sometimes done in hospital before discharge, can be done up to 3 months

60
Q

What is in an infant physical exam, and within how long of being born is it taken?

A

(6-8 weeks) – with GP, as newborn physical, with length and head circumference – opportunity to discuss vaccinations.

61
Q

What is Sure Start?

A

High level of investment in children’s community centres

Aims to help support families with under 5 year old children in low income households

Parent & child education

Health promotion

62
Q

What are the types of developmental delay?

A

global developmental delay

specific developmental disorder

63
Q

What is global developmental delay?

A

significant delay in reaching two or more developmental milestones

64
Q

What is specific developmental delay disorder?

A

refers to delays in developmental domains in the absence of sensory deficits, subnormal intelligence or poor educational conditions

-  learning disorders
- motor skill disorders
- communication disorders
65
Q

What are causes of global developmental delay? (5)

A

Chromosomal abnormalities
e.g. Down’s syndrome, Fragile X

Metabolic
e.g. hypothyroidism, inborn errors of metabolism

Antenatal and perinatal factors
Infections, drugs, toxins, anoxia, trauma, folate deficiency

Environmental-social issues

Chronic illness

66
Q

What are causes of motor skill developmental delay?

A

As an aspect of global developmental delay

Cerebral palsy

Congenital dislocation of the hip

Muscular dystrophies

Neural tube defects

Social deprivation

67
Q

What are causes of language skill developmental delay? (5)

A

Hearing loss

Autism spectrum disorders

Lack of stimulation

Impaired comprehension of language – e.g. developmental dysphasia

Impaired speech production – e.g. stammer, dysarthria

68
Q

What are causes of language skill developmental delay?

A

Schedule of growing skills (0-5y) – standardised test examining 8 criteria (Locomotor, manipulative, self-care, social skills, hearing and language, speech and language, visuals and cognitive)

Griffiths developmental scale (0-6y) – measures trends indicative of functional mental growth and the domains listed above through play activities.

Bayley Scales of Infant Development (1m-42m) – assesses cognitive, motor and language skills

Denver developmental screening tests (0-6y) – assesses ability in domains relative to %age blocks of children from a population who could achieve a skill by a particular age.

BRS D&A (8 decks)

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