Podcast
Questions and Answers
What is considered true microcephaly?
What is considered true microcephaly?
- Head circumference for age > -2 SD
- Head circumference for age < -2 SD
- Head circumference for age < -3 SD (correct)
- Head circumference normal for age
Familial microcephaly is caused by a dominant inheritance pattern.
Familial microcephaly is caused by a dominant inheritance pattern.
False (B)
What common maternal factor can cause secondary microcephaly during pregnancy?
What common maternal factor can cause secondary microcephaly during pregnancy?
TORCH infections
Phenylketonuria is caused by a deficiency of __________.
Phenylketonuria is caused by a deficiency of __________.
Match the following conditions with their associated features:
Match the following conditions with their associated features:
What is the primary purpose of measuring mid arm circumference (MAC)?
What is the primary purpose of measuring mid arm circumference (MAC)?
Skin fold thickness is measured at the abdomen, triceps, and wrist.
Skin fold thickness is measured at the abdomen, triceps, and wrist.
Name one of the organizations that developed growth monitoring charts for children under 5 years.
Name one of the organizations that developed growth monitoring charts for children under 5 years.
The Harpenden's calliper is used for measuring ______.
The Harpenden's calliper is used for measuring ______.
Match the mid arm circumference (MAC) color code to its nutritional status:
Match the mid arm circumference (MAC) color code to its nutritional status:
What is the primary instrument used to measure length in children under 2 years old?
What is the primary instrument used to measure length in children under 2 years old?
What is the age range for adolescence?
What is the age range for adolescence?
Height is measured in children older than 2 years while lying down.
Height is measured in children older than 2 years while lying down.
Thelarche refers to the development of breast tissue in males.
Thelarche refers to the development of breast tissue in males.
At what age is height equal to arm span?
At what age is height equal to arm span?
At birth, the head circumference is approximately ___ cm.
At birth, the head circumference is approximately ___ cm.
What are the two phases of postnatal growth?
What are the two phases of postnatal growth?
Match the following measurements with their respective values at birth:
Match the following measurements with their respective values at birth:
During puberty, males experience an increase in the size of the ______.
During puberty, males experience an increase in the size of the ______.
What happens to the arm span compared to height after the age of 11?
What happens to the arm span compared to height after the age of 11?
Match the following phases of growth with their respective time periods:
Match the following phases of growth with their respective time periods:
The growth spurt during puberty affects arm span but not height.
The growth spurt during puberty affects arm span but not height.
What is the typical increase in head circumference per month during early life?
What is the typical increase in head circumference per month during early life?
Which law of growth describes the pattern from head to toe?
Which law of growth describes the pattern from head to toe?
Brain tissue reaches 90% of its growth by the age of 4.
Brain tissue reaches 90% of its growth by the age of 4.
What is the Tanner stage where breast buds first appear in females?
What is the Tanner stage where breast buds first appear in females?
At what ages do males typically complete growth maturation?
At what ages do males typically complete growth maturation?
The average birth weight in India is between ___ kg.
The average birth weight in India is between ___ kg.
In Tanner stage IV for males, the testicular size is significantly darkened.
In Tanner stage IV for males, the testicular size is significantly darkened.
At what Tanner stage does pubic hair resemble the adult pattern?
At what Tanner stage does pubic hair resemble the adult pattern?
Match the following growth types with their descriptions:
Match the following growth types with their descriptions:
In Tanner stage II for females, the areola and nipple remain distinctly _____.
In Tanner stage II for females, the areola and nipple remain distinctly _____.
Match the Tanner stages with their corresponding descriptions for males:
Match the Tanner stages with their corresponding descriptions for males:
What is the maximum duration after birth to terminate treatment for HIE in neonates?
What is the maximum duration after birth to terminate treatment for HIE in neonates?
Stage 2/Stage 3 HIE can be treated in neonates who are born before 36 weeks of gestation.
Stage 2/Stage 3 HIE can be treated in neonates who are born before 36 weeks of gestation.
Within how many hours after birth does treatment for HIE begin?
Within how many hours after birth does treatment for HIE begin?
A contraindication for treatment in neonates with HIE is being __________.
A contraindication for treatment in neonates with HIE is being __________.
Match the following stages of HIE with their respective characteristics:
Match the following stages of HIE with their respective characteristics:
What condition is a possible outcome of parasagittal infarction in term babies?
What condition is a possible outcome of parasagittal infarction in term babies?
Selective neuronal necrosis primarily affects the motor cortex of the upper limbs.
Selective neuronal necrosis primarily affects the motor cortex of the upper limbs.
What is the initial drug of choice for treating seizures in neonates?
What is the initial drug of choice for treating seizures in neonates?
The temperature range for therapeutic hypothermia is _____°C to _____°C.
The temperature range for therapeutic hypothermia is _____°C to _____°C.
Match the following neonatal complications with their associated conditions:
Match the following neonatal complications with their associated conditions:
What color represents boys on the WHO growth chart?
What color represents boys on the WHO growth chart?
Standard deviation (SD) measures frequency distribution of a given value.
Standard deviation (SD) measures frequency distribution of a given value.
What is the threshold for stunted growth according to the height for age status?
What is the threshold for stunted growth according to the height for age status?
The WHO growth chart uses ______ color for girls.
The WHO growth chart uses ______ color for girls.
Match the following statuses with their corresponding height for age interpretations:
Match the following statuses with their corresponding height for age interpretations:
What defines the condition of birth asphyxia according to the WHO?
What defines the condition of birth asphyxia according to the WHO?
The National Neonatology Forum's criteria for evaluating birth asphyxia include an APGAR score of 4 to 6 as moderate asphyxia.
The National Neonatology Forum's criteria for evaluating birth asphyxia include an APGAR score of 4 to 6 as moderate asphyxia.
What is considered severe birth asphyxia according to the National Neonatology Forum criteria?
What is considered severe birth asphyxia according to the National Neonatology Forum criteria?
Profound metabolic acidosis is assessed using the umbilical cord ______.
Profound metabolic acidosis is assessed using the umbilical cord ______.
Match the following definitions of birth asphyxia to their corresponding organizations:
Match the following definitions of birth asphyxia to their corresponding organizations:
Study Notes
Measuring Growth in Children
- Length: Measured in supine position using an infantometer for children up to 2 years old
- Height: Measured in standing position using a stadiometer for children older than 2 years old
- Arm Span: Measured in uncooperative children as the distance between middle fingers of outstretched arms
- Head Circumference (HC): Indicates brain growth, measured in centimeters
- Chest Circumference (CC): Measured at the 4th intercostal space, compared with HC
- Mid-Arm Circumference (MAC): Measured in age groups of 1-5 years, depends on muscle mass and fat, indicator of nutritional status
Growth and Development
- Growth Monitoring: Plotted on growth charts, types include WHO charts (< 5 years), Indian Academy of Pediatrics (IAP) chart (5-18 years), and consolidated charts
- WHO Chart: Internationally used since 2006, based on multicenter growth reference study (MGRS) with children from developed and underdeveloped countries
- Interpretation of MAC: Normal: ≥10 mm, Severe malnutrition: < 6 mm
Abnormal Head Size and Shape
- Microcephaly: Indicative of small brain size, head circumference for age < -2 SD = low value, head circumference for age < -3 SD = Pathological
Phases of Growth
- Prenatal: Zygote/fertilized ovum (< 2 wks), Embryo (3-8 wks), Fetus (>9 wks)
- Perinatal: Newborn (1st 4 wks, early: 0-7 days, late: 7-28 days)
- Postnatal:
- Infancy (1st year)
- Toddler (1-3 yrs)
- Preschool child (3-6 yrs)
- School age (6-12 yrs)
- Adolescence: 10-19 yrs (Early: 10-13 yrs, Mid: 14-16 yrs, Late: 17-19 yrs)
Pubertal Changes
- Females: 8-13 yrs, sequence: thelarche, pubarche, growth spurt, menarche
- Males: 9-14 yrs, sequence: ↑ size of testis, ↑ size of penis, pubarche, voice changes, pubic hair, spermarche, growth spurt, axillary & facial hair
Tanner's Sexual Maturity Rating (SMR)
- Used to assess puberty based on external appearance
- Females:
- Breast Changes: Prepubertal (No changes), I, II, III, IV, V
- Pubic Hair Changes: Prepubertal, I, II, III, IV, V
- Males:
- Testicular Volume (mL) and Penis Size (cm): < 4, 4, 10, 16, 25
- Changes: I, II, III, IV, V
Laws of Growth
- Pattern of Growth:
- Cephalocaudal (Head to toe): Growth of head (in utero) → Growth of the lower body and limbs (After birth)
- Limbs: Distal growth → Proximal growth (Example: Fingers grow first, then arms)
- Different tissues grow at different rates: Brain tissue (90% growth completed in 2 years), Gonadal growth (Increases around puberty), Lymphoid growth (Rapid growth during ages 4-8), Skeletal growth (Steady process until puberty)
- Completion/maturation: Fusion of epiphysis (Females: 18 years, Males: 20-22 years)
Anthropometry
- Methods to assess growth: Weight (Average birth weight in India: 2.8-3 kg)
Neonatal Reflexes, HIE & Neonatal Seizures
- Start: within 6 hours after birth
- Indication: Stage 2 / Stage 3 HIE who are > 36 weeks
- Termination: ≤ 72 hours after birth
Neonatology - Complications
- Term Babies:
- Parasagittal infarction: Bilateral (B/L), leads to Spastic quadriplegia
- Focal ischemic necrosis: Hemiplegic cerebral palsy
- Selective neuronal necrosis: Dystonic/extrapyramidal cerebral palsy
- Pre-term Babies:
- Periventricular leukomalacia: Bilateral (B/L), affects motor cortex of lower limbs, leads to Spastic diplegia
Investigations
- Diffusion weighted imaging (DWI) MRI: IOC
Management
- Supportive Management:
- Maintain: Normal temperature, Stable vitals, Blood glucose level between 75-100mg/dL
- Treat seizures: Initial drug: Phenobarbitone
- Therapeutic (Induced) Hypothermia:
- Gaining popularity as an established treatment modality d/t improved outcome
- Mechanism: ↓ metabolism (esp.brain), ↓ free radicals
- Methods: Cooling crystals, Whole body cooling
- Temperature range: 33.5°C to 34.5°C
Definitions of Birth Asphyxia
- WHO definition: Failure to initiate and sustain breathing after birth
- National Neonatology Forum (NNF) criteria: Based on APGAR score 1 minute after birth
- Moderate: 4 to 6/10
- Severe: 0 to 3/10
- Essential criteria: American Association of Pediatrics (AAP) criteria: Most important
- Profound metabolic or mixed acidosis: Umbilical cord pH
WHO Growth Chart Interpretation
- Colour of WHO Chart: Blue: Boys, Pink: Girls
- Variants: Percentile (Frequency distribution), Standard Deviation (SD)
- Stature/Height for age:
- Stunting/Short Stature: < 3rd percentile or <-2SD
- Normal: 2-97th percentile
- Tall Stature: > 97th percentile or >2 SD
- Weight for age:
- Wasting/Underweight : < 3rd percentile or <-2 SD
- Normal: 2-97th percentile
- Overweight: > 97th percentile or >2 SD
- Weight for height/length:
- Normal: 2-97th percentile
- Overweight: > 97th percentile
- Underweight: < 3rd percentile
- Note: For all categories except weight for height/length, a standard deviation of 2 or more indicates a significant deviation from the average
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Description
This quiz covers essential methods for measuring growth in children, including length, height, arm span, head circumference, and other relevant indicators. It also discusses growth monitoring techniques and the different growth charts, such as the WHO chart and IAP chart. Enhance your understanding of pediatric growth assessment with this quiz.
