Block 11 - Reproduction and the growing child (post-birth) Flashcards
(81 cards)
1
Q
When can a baby smile?
A
8 weeks
2
Q
What can hearing loss cause?
A
Speech delay
3
Q
8 stages of social skill and behaviour development
A
Smiling Waving Peek-a-boo Stranger danger Pointing Imaginative play Getting undressed then dressed Toilet training
4
Q
When are the health visitor check ups?
A
1 year
2-2.5 year
5
Q
Define consanguineous
A
Parents related
6
Q
6 generic red flags (not age specific)
A
Regression Not fixing and following Not responding to noise Early hand preference Abnormal tone Persistent toe walking
7
Q
5 specific red flag symptoms (age specific)
A
No smile at 8 weeks Not holding objects at 5 months Not sitting at 12 months Not walking at 18 months Not pointing at 2 years
8
Q
Define developmental delay
A
Isolated (1 domanin) or global (4 domains)
9
Q
Define developmental disorder
A
Skills aquired in a strange order but still moving forward
10
Q
7 causes of developmental problems
A
Antenatal insults Cerebral malformation Congenital infection Deprivation/abuse Genetic syndromes Perinatal hypoxia / hypoglycaemia Postnatal meningitis / trauma / metabolic insult
11
Q
How many centiles must the weight cross to be diagnosed with FTT?
A
2 centiles
12
Q
5 causes of FTT
A
- Inadequate intake (under-nutrition e.g. poor feeding or not given food)
- Inadequate retention (vomiting)
- Malabsorption (CF or short gut)
- Failure to utilise nutrients (renal/liver/metabolism disorder)
- Increased requirements (malignancy, infection, CF)
13
Q
What do intra-uterine conditions and pubertal hormones influence?
A
Growth
14
Q
What are the two classes of FTT?
A
Organic and non-organic
15
Q
Explain the different causes and classifications of short stature
A
Normal e.g. Genetics or late developer
Pathological can be proportionate or disproportionate
- Disproportionate e.g. rickets, skeletal dysplasia,
achondroplasia
- Proportionate can be prenatal or postnatal
- Prenatal e.g. genetics, TORCH, IUGR
- Postnatal e.g. reduced GH, hypothyroidism,
cushing's, psychological, other system diseases
16
Q
Define hypertrophy and hyperplasia
A
Hypertrophy: Increase in cell SIZE
Hyperplasia: Increase in cell NUMBER
17
Q
Explain the extrinsic and intrinsic pathway of apoptosis
A
Extrinsic: Death receptors in cell membrane –> CAPASE protein cascade + apoptosis
Intrinsic: DNA damage –> CAPASE protein cascade + apoptosis
18
Q
When is foetal GROWTH the greatest?
A
16-20 weeks
19
Q
What are cartilage stem cells called?
A
Chondroblasts
20
Q
Explain how bone is formed
A
Chondroblasts divide and lengthen bone, they enlarge and signal calcification –> calcified cartilage
Osteoclasts digest cartilage and osteoblasts replace it with bone –> trabeculae
21
Q
What are the indirect actions of growth hormone mediated by?
What are they similar to
A
Insulin-like growth factors (IGFs)
Similar structure to insulin
22
Q
What are the 2 types of IGFs involved in growth?
A
IGF-1 : Predominant pre-birth ; increased levels cause disproportinate growth
IGF-11 : Increases during childhood ; peaks at puberty then decreases
23
Q
6 mediators for tissue and organ growth (11)
A
Growth factor (fibroblast, platelet derived, nerve)
Thyroid and parathyroid hormones
Sex hormones (oestrogen, testosterone, prolacin, placental lactogen)
Insulin
Vitamin D
Glucocorticoids
24
Q
What are the 2 thyroid hormones called?
A
T3 and T4
25
5 roles of the thyroid hormones
```
Growth
Physiological function
Protein synthesis in the brain
Bone growth and maturation
Forms brain neurones, myelinates, branches dendrites
```
26
4 causes of insufficient thyroid hormones
Thyroid gland defect
Decrease in Thyroid-Stimuating Hormone
Decrease in Thyrotropin-Releasing hormone
Iodine insufficiency
27
Which hormone do you give babies with congenital hypothyroidism?
T4
28
Is cortisol a corticosteroid?
YES
29
What can increase levels of corticosteroids?
| What can this do to growth?
Cushing's syndrome or therapeutic steroids (e.g. asthma/eczema)
Interferes with bone growth plates
30
What is somatotrophin?
Growth hormone
31
How do levels of GH change throughout childhood?
Increase in infancy, plateau in childhood then increases at puberty
32
How do levels of TH change throughout childhood?
Increased in infancy then slowly declines
33
What is the most common cause of dwarfism?
Achondroplasia
34
What mutation causes achondroplasia?
| 4 impacts
Autosomal dominant mutation causing increased function of the fibroblast growth factor receptor
Reduced ossification
Inhibited proliferation of chondrocytes
Reduced cellular hypertrophy
Early closure of epiphyseal growth plates
35
What causes acromegaly?
| Common cause
Increased secretion of GH at any stage of life
| Commonly due to an adenoma of somatotroph cells
36
Treatment of acromegaly?
Glucose reduces the secretion of growth hormone
37
What happens in Pituitary Dwarfism?
| 5 causes
Reduced GH in childhood
Tumour, Infection, Infarction, Head trauma, Vascular malformation
38
Define panhypopiturism
All pituitary hormones are absent
39
What happens in Laron dwarfism?
| 2 characteristics of people
Mimics GH deficiency as there is a mutation in the GH receptor causing it to be unresponsive
Characterised by increased GH and decreased IGF-1
Short stature and appearance
40
What is the treatment for Laron dwarfism?
Recombinant IGF-1
41
```
How does a child's speech and language develop at:
3-6 months
1-2 years
2-3 years
3-4 years
4 years
Childhood
```
3-6 months: babbling
1-2 years: 1-2 words
2-3 years: 2-3 word phrases (telegraphic)
3-4 years: 3-4 word phrases
4 years: Understands and hold conversations
Childhood: Understands sophisticated words and grammar
42
Give 7 family beliefs which influence children
```
Values and beliefs
Acceptable and unacceptable behaviour
Gender roles
Beliefs about illness causes
Attitudes about transplant and transfusion
Birth and death
Ways of expressing emotion
```
43
6 factors which affect a child's communication
```
Hearing or visual impairment
Expressive language
Receptive language (e.g EFL)
Major life events
Having a bad day
Feeling unwell
```
44
Define social desirability
The child's response may not be true
| They may say what they think you would want them to say
45
What does WHO define as an adolescent?
10-19 years
46
What does the children's act state?
Children should be informed and participate in decisions about their future
47
What does the nature/nurture debate say about the stability of child development?
Nature: Development is stable over time
Nurture: Development can change e.g. traumatic events
48
What is Bronfenbrenner's theory?
5 socially organised subsystems that underpin and guide human growth
Made from the microsystem, macrosystem, protective factors and risk factors
49
What are the 3 predominant functions of emotions?
Adaptation, Communication, Survival
50
```
What emotional and social development occurs at:
0-1 year
1-3 years
3-6 years
6-11 years
Teen years
```
0-1 year : Trust / Mistrust
1-3 years : Autonomy /Shame (trying new skills)
3-6 years : Initiative / Guilt (overprotective parenting)
6-11 years : Industry /Inferiority (working with others)
Teen years : Identity / Confusion
51
3 social and emotional developments in childhood and adolescence
Childhood: Forming relationships; understanding and regulating emotions
Adolescence: Understanding of moral and social conventions, acceptance and identity
52
Define metacognitive thought
Thinking about thinking
53
What are the 4 stages of cognitive development?
1. Schemes: Basic unit of understanding about the world
2. Adaptation: Schemes develop through adjusting by assimilation and accommodation
3. Assimilation: Making information compatible with current understanding of the world
4. Accommodation: Alteration to incorporate new experiences or information
54
What are the 4 periods of cognitive development
| What age do they develop at?
Sensoriomotor period (0-2 years)
Pre-operational period (2-7 years)
Period of concrete operations (7-11 years)
Period of formal operations (11+ years)
55
What develops in the sensoriomotor period?
```
0-1 month: Reflex
1-4 months: Self-investigation
4-8 months: Reaching out
8-12 months: Goal-directed behaviour
12-18 months: Experimentation
18-24 months: Problem solving
```
56
What develops in the pre-operational period?
Reasoning and symbolic functions
57
What develops in the period of concrete operations?
Logical operations applied to concrete problems
58
What develops in the period of formal operations?
Hypothetical problem solving, testing of hypothesis and validating reasoning
Forming arguments, counter-arguments and reasoning
59
What was Gardner's theory?
| What was he the first person to state?
```
Theory of multiple intelligence's
First person to state that IQ is not fixed
1. Linguistic
2. Musical
3. Logio-mathematical
4. Spatial
5. Bodily-kinesthetic (athletic)
6. Interpersonal (people)
7. Intrapersonal (yourself)
8. Naturalist (outdoor)
```
60
4 signs of social well-being (and dysfunction)
Positive self esteem (negative self esteem)
Communication (withdrawal)
Appropriate social behaviour (inappropriate behaviour)
Rewarding relationships (poor relationships)
61
4 signs of emotional well-being (and dysfunction)
Stable and secure attachments (unstable and insecure)
Appropriate emotions (inappropriate)
Positive self esteem (negative self esteem)
Happy and optimistic (anxiety and depression)
62
4 signs of cognitive functioning (and impairment)
Age appropriate (underachievement)
Appropriate progress (lack of expected progress)
Positive or realistic perception of ability (negative or unrealistic)
Opportunities to reach potential (may need special education)
63
Give 8 examples of psychopathology in children
```
Childhood schizophrenia
Childhood depression
Attention deficit disorder
Autistic spectrum disorder
Specific learning difficulty (e.g. dyslexia)
Sensory impairment
Homeless/poverty
Toxicity (e.g. lead)
```
64
What is the difference between cognitive impairment, learning difficulty and specific learning difficulty?
Cognitive impairment: Wide range of problems
Learning difficulty: Global cognitive impairment
Specific learning difficulty: In one area
65
What is the difference between plasma and serum?
Plasma is blood with no cells
| Serum is blood with no cells or coagulation proteins
66
What does it mean if the blood is orange?
Increased levels of bilirubin
67
Define selective requesting
| 4 purposes
Tests carried out on the basis of an individuals clinical situation
Diagnosis, Assess severity, Monitor disease, Detect side effects
68
What do dynamic function tests test for?
The body's response to external stimuli
69
Define analytical variation
Whether you trust that the test gave you the actual results
70
Define sensitivity
How little of the analyte the test can detect
71
Define specificity
How good the assay is at discriminating between the required analyte and interfering substances
72
What is tested for in the liver function tests? (6)
| What do they indicate?
Bilirubin: haem breakdown, secreted in bile, increased if blockage
Aminotransferases: ALT+AST (increased in liver damage)
Alkaline phosphatase: Increased with cholestasis
Glutamyltranspeptidase: Increased with cholestasis
Plasma proteins: Decreased in liver disease
Prothrombin time: Coagulation protein (increased in liver disease)
73
What is the difference between a core and specialised test?
Core: Ions, glucose, Urea, Creatinine, Protein, Bilirubin, Amylase, ALT, AST, Amylase
Specialised: Hormones, Specific proteins, Trace elements, Vitamins, Drugs, DNA, Lipids
74
What do the blood results look like in someone who is jaundiced?
3 causes
Causes: haemolytic, cholestatic, hepatocellular
Increased bilirubin, ALP and AST
Normal prothrombin time
Bilirubin in the urine
75
What do the blood results look like in someone who has acute liver disease?
2 causes
Causes: poisoning, hepatic failure
Increased bilirubin, ALP, AST, Prothrombin time
Decreased albumin
76
What do the blood results look like in someone who has chronic liver disease?
3 causes
Causes: alcoholic fatty liver, bilary cirrhosis, chronic active hepatitis
Increased prothrombin time and cirrhosis
77
3 causes of lipoprotein disorders
Heart disease, Pancreatitis, Cataracts
78
How do you measure the levels of LDL and VLDL in the body?
Most plasma cholesterol is present in LDL so plasma cholesterol is an estimate of LDL
Most plasma triglycerides present in VLDL so plasma triglyceride is an estimate of VLDL
79
Give 4 examples of secondary hyperlipoproteinemias
| What do the blood results look like
Toxins
Renal dysfuncion
Metabolic disorders e.g. diabetes, obesity
Hormonal e.g. hypothyroid, pregnancy
Increased VLDL and LDL
Decreased HDL in obesity but increased in pregnancu
80
What are the 6 metabolic disorders which the newborn screening test looks for?
```
Phenylketonuria (PKU)
Maple syrup urine disease (MSUD)
Isovaleric acidemia (IVA)
Glutaric aciduria type 1 (GA1)
Homocystinuria (HCU)
Medium chain acyl-CoA dehydrogenase deficiency (MCADD)
```
81
Explain what happens in the metabolic disease PKU
Phenylalanine --> Tyrosine in the liver by PAH (phenylalanine hydroxylase)
No enzyme = increased Phenylalanine = mental retardation
