Growth And Development Flashcards
(14 cards)
Obstructive sleep apnea in children:
- Night symptoms: snoring, apnea, night sweats
- Day symptoms: mouth breathing, dry mouth, headaches, difficulty waking up, poor appetite
- Other: new onset of behavioral issues and mood changes
- Causes: anatomical/functional narrowing, large tongue, small jaw, large tonsils/adenoids (most common), obesity, hypotonia, etc.
- Dx: polysomnography
- Tx: tonsillectomy, adenoidectomy, CPAP machine at night
Persistent Tic Disorders (PTD):
Def: involuntary and repetitive vocal or motor tics (never both)
DDx: Tourette disorder is both
Vocal tics: sniffing, clearing the throat, coughing partial words
Motor tics: eye blinking, knee jerking, shoulder shrugging, extending the extremities, foot tapping, imitation
Rumination disorder:
Definition: repeated regurgitation of food that is then rechecked, reswallowed or spit out
- it is not caused by an associated GI disease!
Risk factors: disturbed relationship with parents, neglect, stressful life situations
Treatment:
1. Behavioral analysis
2. Diaphragmatic breathing and postprandial gum chewing
3. When the health is jeopardized: bitter/sour flavors, withdrawal of positive attention (more reasonable in adolescents)
Thumb sucking phenomena:
A normal phenomena 25% of children < 2 years, and 15% of children ~5 years
- beyond 5 years may cause paronychia, anterior open bite
Management: encourage parents to ignore it and instead focus on praising the child for substitute behaviors, reward system, rare cases (devices out on the thumb, noxious bitter agents)
Newborn primitive reflexes:
- Moro reflex - sudden lifting of arms and legs when startled (lasts until 5-6 months)
- Rooting reflex - turning the head in response to a stroke of the cheek (lasts until 4-6 months)
- Sucking reflex - when the roof of the mouth is stimulated (lasts until 4 months)
- Tonic neck reflex - stroking the side of the spine leads to the baby’s head turning to that side (last until 6-7 months)
- Grasp reflex - touching the baby’s palm leads to them closing their hand (lasts until 5-6 months)
- Babinski reflex - stroking the sole of the foot will cause the big toe to move upward (lasts until 1-2 years)
- Stepping reflex - holding the baby up on a flat surface will cause them to move their legs as though they are trying to walk (last until 2 months)
Parachute reflex develops later at around 7 months of age - extending the arms in response to falling (forever)
** Picture is tonic neck reflex
Auditory function:
When hearing impairement is suspected in a young child, and audio gram provides the fundamental description of hearing sensitivity
Contraindications for breastfeeding:
- medical:
1. Galactosemia
2. Maple syrup urine disease
3. Phenylketonuria - maternal conditions:
1. Human T-cell lymphotrophic virus type 1 and 2
2. Active TB
3. Herpes infection on the breast
4. Treatment with radioactive products
5. Ebola virus
6. HIV in DEVELOPED countries
7. Certain illicit drugs; amphetamines, clozapine, doxorubicin, immunosuppressants, etc.
Colic in babies:
Definition: frequent, prolonged and intense crying or fussiness in an otherwise HEALTHY infant
Diagnosis of exclusion - usually resolved by 3-4 month of age
Complications: shaken baby syndrome (aggressive means by stressed, frustrated parents to quiet down the baby)
2 years developmental milestones:
- follow 2-step commands
- jump
- walking up and down the stairs 1 step at a time
- open doors
- putting 3 words together
- draws a horizontal line
- stacks 7 cubes
- handles spoon well
- helps undress themselves
Visual development:
- 1 month old baby is supposed to start to watch people and to follow a moving object
- 2 months old baby is supposed to follow moving objects 180 degrees
Restless Leg Syndrome (RLS):
Definition; irresistible urge to move the legs, usually accompanied by uncomfortable sensations in the lower limbs
- the urges are worse during the evening and at rest, and are somewhat relieved by movement, stretching or rubbing
- side effects: affects sleep and causes day time tiredness
- associated with low levels of serum IRON and has a strong genetic component
- treatment: iron supplements, adequate sleep, physical activity, avoidance of exacerbating factors such as caffeine
Failure To Thrive (FTT):
- most common mechanisms for pediatrics malnutrition are non-illness related and are secondary to insufficient caloric intake
- gastrointestinal reasons are often accompanied by vomiting and/or diarrhea, abnormal stools, crying with feedings and so on
- celiac disease presentation usually includes; FTT, chronic diarrhea, vomiting, abdominal distention, anorexia and irritability (history of gluten consumption)
- cow milk sensitivity usually presents with diarrhea, vomiting, FTT, malabsorption and abdominal distension
Cystic Fibrosis (CF):
Definition: multi systemic, autosomal recessive disease that is caused by a mutation in the CFTR protein
Affected systems:
- respiratory: bronchiectasis, bronchitis, pneumonia
- gastrointestinal: meconium ileus, rectal prolapse, intussusception, pancreatitis, cirrhosis
- genitourinary: all males are azoospermic, diminished female fertility
90% of patients will have exocrine pancreatic insufficiency, and fat malabsorption (steatorrhea), deficiency of fat-soluble vitamins (ADEK) and FTT
- diagnosis is usually based on a positive SWEAT TEST combined with clinical features or family history
Causes or a small fontanelle or early closure:
- carniosynostosis
- genetic syndromes
- hyperthyroidism
- hyperparathyroidism
- hypophosphatemia
- abnormal brain development
