Intro week-normal child

Question 1

Average birth weight

Answer 1

Approximately 7 pounds/3.3kg 
		○ Double at 5 months 
		○ Triple at 1 year
		○ Gains 30g/d from day 10 - 3 months
1-10 years expected weight in kg =2x(age+4)

Question 2

Average head circumference of newborn

Answer 2

35-36cm

Question 3

When do children get their fist teeth

Answer 3

6 months

Question 4

Average birth height

Answer 4

50cm

Question 5

Average height at 1 year

Answer 5

75 cm

Question 6

Average height at 4 years

Answer 6

1 m

Question 7

Symptoms of pylori stenosis in children

Answer 7

• Loss of weight

* Projectile vomit (MILKY-not bilious)

Question 8

Classic sign of pyloric stenosis in children

Answer 8

olive shaped mass right hypochondrium with visible peristalsis

Question 9

how many calories should an infant get (0-1 years) ?

Answer 9

110 kcal/kg/d

Question 10

how many calories should a child (1+ years) get ?

Answer 10

1+ years 1000 +(100xage) kcal/d

• 150mls/kg/day after first week until weening 
• Approximately 30ml per Oz 
• E.g. 5kg, =750ml/day, which is 25Oz  Wean from 6 months: iron containing foods at 6 months; avoid egg and wheat until 6 months; puree to 7 months; doorstep milk and normal food at 12 months; full fat milk to 5 years

Question 11

How big should feeds be?

Answer 11

Feeds : 150mls/kg/d after first week until weaning

Question 12

how many calories in one 150ml feed?

Answer 12

110kcal

Question 13

How many ml in one Oz

Answer 13

30ml=1 Oz

Question 14

How much milk should a 5kg infant get?

Answer 14

The baby should get 110 kcal/kg/d which is the same as 150ml/kg/d…..150mlx5=750ml/day (25 Oz)

Question 15

At what age can you ween a baby from

Answer 15

6 months

Question 16

What maintenance fluids should adults receive?

Answer 16

1L bag every 8hr

Question 17

What maintenance fluids should children receive? For example a 28kg child?

Answer 17

• 1st 10 kg 100ml/kg/day
  
  • 2nd 10kg 50 ml/kg/day
  • 3rd and subsequent kg=20mls/kg/day

E.g. 28 kg child will require
(10x100) (10x50) + (8x20)/24=69mls/hr

Question 18

OVERWEIGHT BMI for adults vs children

Answer 18

adults is BMI of 25-29.9

Children is >91st centile

Question 19

OBESE T BMI for adults vs children

Answer 19

adults is BMI of 30-34.9

Children is >98th centile

Question 20

What age do children raise head 45 degrees (partial control)

Answer 20

6-8 weeks

Question 21

what age do children sit unsupported and state red flag age

Answer 21

6-8 months. RED FLAG is 9 months without sitting unsupported

Question 22

what age do children start to crawl

Answer 22

8-9 months

Question 23

what age do children cruise

Answer 23

10 months

Question 24

what age do children start to walk unsteadily

Answer 24

12 months

Question 25

what age do children start to walk steadily

Answer 25

15 months

Question 26

what age should children be able to run

Answer 26

18 months

Question 27

red flag age for not being able to walk unsupported

Answer 27

18 months-unless bumshuffler then 2 years

Question 28

what age should children be able to jump/ hop

Answer 28

2 years should be able to jump | 3 years should be able to hop

Question 29

what age should children be able to go on climbing frame and skip?

Answer 29

4 years: climbing frames | 5 years: skips

Question 30

Differentials for not walking at 18 months

Answer 30

1. Cerebral palsy 2. Duchenne's muscular dystrophy (Gowers sign) 3. Hip dysplasia (although should have been picked up) 4. Proximal muscle weakness (Get them to lie down and stand up-if they role over they have PMW-should do creatinine kinase

Question 31

when should babies loose their primitive reflexes

Answer 31

Persisting primitive reflexes -shouldn’t continue after 6 months (patients with dyspraxia may have persisting)

Question 32

reasons for uneven moro reflex

Answer 32

brachial plexus injury/ cerebral palsy

Question 33

what is tested for in the 1 week old Gutherie heel prick test?

Answer 33

``` PKU hypothyroidism CF haemoglobinopathies (sickle cell ) acylcarnitine • 8 weeks: general examination • 4-5years: orthoptist • School entry: height and weight; hearing Primary and secondary school: none ```

Question 34

what is involved in the birth neonatal exam?

Answer 34

examination of eyes, heart, hips; automated hearing screen

Question 35

when do babies have another general examination

Answer 35

around 8 weeks • 4-5years: orthoptist • School entry: height and weight; hearing Primary and secondary school: none

Question 36

When should children visit orthoptist for screening

Answer 36

age 4-5

Question 37

at what age is soiling abnormal

Answer 37

4 years

Question 38

At what age should children be dry in the day

Answer 38

2-3 years

Question 39

At what age should children be dry in the night

Answer 39

3-4 years

Question 40

why do you ask about urine stream in new born boys

Answer 40

posterior urethral valves obstruction

Question 41

when should babies produce me

Answer 41

95% meconium in first 48 hours (should never lose more than 10% of weight however losing 5% is normal)

Question 42

differentials for no meconium

Answer 42

Cystic fibrosis | Stenosis/atresia (E.g. duodenal, anal, Hershprungs-always from distal to proximal)

Question 43

what is normal birth time/premature/post mature?

Answer 43

Normal 40 weeks Premature<37 weeks Post mature >42 weeks

Question 44

when are night terrors and nightmares common

Answer 44

``` Night terrors (4-7 years) Nightmares (8-10 years) Sleep walking (5-10 years) ```

Question 45

When should children be able to sleep through night?

Answer 45

90% will sleep through the night by 6 months

Question 46

how much sleep should children get

Answer 46

``` • Birth 16 hours/d; • 6 months 14 hours/d; • 2 years 13 hours/d; • 4 years 12 hours/d; 18 years 8 hours ```

Question 47

what age is pincer grip?

Answer 47

9 months

Question 48

what age is palm grab

Answer 48

6 months