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Paediatrics > Growth Development + Health > Flashcards

Growth Development + Health Flashcards

1
Q

What is a neonate?

A

<4 weeks

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2
Q

What is an infant?

A

<12 months

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3
Q

What is a toddler?

A

1-2 years

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4
Q

What is pre-school age?

A

2-5 years

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5
Q

What are the main childhood objectives?

A 
Grow
Develop
Attain optimal health
Develop independence
Be safe
Be cared for
Be involved
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6
Q

What is development

A

Gaining functional skills

  • Its a gradual yet rapid process
  • Typically occurs up to 5 years

Cell growth, migration, connection, pruning and myelination

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7
Q

What are the key developmental fields?

A 
Gross motor (head, torso, pull up then steps and so on)
Fine motor
Social and self help
Speech and language
Hearing and vision
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8
Q

When do you refer if a child is not reaching a milestone?

A

If not achieved by limit age (2SD from the mean)

Walking = 50% by 12 months
-Refer if not walking by 18 months (limit age)

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9
Q

When is it a red flag not to socially smile?

A

2 months

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10
Q

When is it a red flag not not sit up unaided?

A

9 months

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11
Q

When is it a red flag not to speak by?

A

18 months / 2 years

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12
Q

Why is development important?

A

Leaning functional skills for later life
Hone skill in a safe environment
Equip us with tools needed to function as older children and adults

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13
Q

What are the influencing factors?

A 
Genetics
Environment
Positive childhood experiences
Developing brain vulnerable to insults
-Antenatal
-Post natal
-Abuse and neglect
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14
Q

What are some antenatal adverse environmental factors?

A

Infection
-CMV, rubella, VZV
Toxins
-Alcohol, smoking, anti-epileptics

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15
Q

What are some postnatal adverse environmental factors?

A 
Infection (meningitis, encephalitis)
Toxins (mercury, leads)
Trauma (head injuries)
Malnutrition (iron, folate, vitamin D)
Metabolic (hyperglycaemia)
Maltreatment, under stimulation and domestic violence
Maternal mental health status
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16
Q

Why do we do a developmental assessment?

A 
Reassurance and shows progress
Early diagnosis and intervention
Positive stimulation
Provision of information
Improving outcomes
Genetic counselling
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17
Q

Who does a developmental assessment

A

Parents and wider family
Health visitors, nursery and teachers
GP’s, A+E, FY’s, ST’s and students
Paediatricians and community paediatricians

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18
Q

What is assessed in a developmental assessment?

A
  • Healthy child programme (HCP)
  • Screening may not always be sensitive and specific
  • Listen to concerns
  • Review video of the child
  • Consult the red book
  • Observe them
  • Medical history and examination
19
Q

How do you assess their development?

A
  • Bricks (grasp, hand to hand, build a tower etc)
  • Crayons
  • Balls (how do they interact with it)
  • Imaginary play (tea set)
  • Books for language
20
Q

How do you decide whats normal?

A

Not always easy

  • Think about each field
  • Sequence and pattern
  • What has been achieved
  • What has not been achieved
  • Is one field falling behind the other
  • Are the skills gained appropriately
21
Q

How to recognise normal variations?

A 
Early developers
Late normal
Bottom shufflers = walking delay
Bilingual = language delay 
Familial traits
22
Q

What are developmental red flags?

A 
Loss of skills
Parental concern
Hearing loss
Low muscle tone
Asymmetry of movements
Clinician uncertain
23
Q

Where do you record progress?

A

In the red book

24
Q

What does the new-born exam screen for?

A 
PKU
CHT
CF
MCADD
Sickle cell
Maple syrup urine disease
GA1
HCU
25
Q

When does the hearing screen take place?

A

By day 28

26
Q

When is the 2 reviews done?

A

6-8 weeks

27-30 weeks

27
Q

When is vision screened?

A

4-5 years

28
Q

What happens in the 6-8 week review?

A 
ID
Feeding
Parental concerns
Developmental
Measurements
Examination of body
Sleeping position
29
Q

What happens in the 27-30 week review?

A 
ID
Developmental
-Social, behavioural, attention and emotional
-Communication, speech and language
-Gross and fine motor
-Vision and hearing
Physical measurements
30
Q

What is covered in the healthy child programme?

A 
Smoking
Alcohol/drugs
Nutrition
Hazards and safety
Dental health
Support service
31
Q

What happens in Growth monitoring - 3 physical measurements?

A

Weight
Length / height
Head circumference

32
Q

What are the normal weights?

A 
B = 3.3
4 = 6.6
12 = 10
3y = 15
33
Q

What is the normal length?

A 
B = 50
4 = 60
12 = 75
3y = 95
34
Q

What is the normal OFC?

A 
B = 35
12 = 45
35
Q

What is Failure to thrive?

A

Child growing too slowly in form and usually in function at the expected rate for the age

36
Q

What are the causes for failure to thrive - maternal?

A

Maternal

  • Poor lactation
  • Incorrectly prepared feeds
  • Unusual milk or other feeds
  • Inadequate care
37
Q

What are the causes for failure to thrive - infant?

A

Infant

  • Premature
  • Small for dates
  • Oro-palatal abnormalities
  • NM disease
  • Genetic disorders
38
Q

What are the the causes for failure to thrive - increased metabolic demands?

A 
Lung disease
Heart disease
Liver disease
Renal disease
Infection
Anaemia
CF
Thyroid disease
IBD
Malignancy
39
Q

What are the causes for failure to thrive - nutrient loss?

A 
Reflux
Pyloric stenosis
Gastroenteritis
Malabsorption
-Allergy
-Diarrhoea
-Coeliac
-Pancreatic insufficiency
-Short bowel syndrome
40
Q

What are the causes for failure to thrive - non-medical causes?

A 
Economic status
Dysfunctional family interactions
Difficult parent-child interactions
Lack of support
Neglect
Emotional deprivation
Poor feeding or feeding skill disorder
41
Q

What should a child achieve by 6 months?

A 
Roll over
Scoot or crawl
Grasp for things
Makes simple words
Recognises people
Plays with simple things
42
Q

What should a child achieve by 12 months?

A

Understands simple words
Can pull to stand and walk
Drinks on their own
Copies actions

43
Q

What should a child achieve by 2 years?

A 
Runs
Grasps and self helps
Can recognise pictures
Understands simple language
can take of clothes
Perform simple tasks when asked
Plays with other children
44
Q

What should a child achieve by 3 years?

A 
Walks backwards
Throw and catch ball
Uses sentences
Toilet trained
Follows simple instructions

Paediatrics (15 decks)

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