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Questions and Answers
What age range is classified as early childhood?
What age range is classified as early childhood?
Which of the following is NOT a method of assessing growth?
Which of the following is NOT a method of assessing growth?
What is the expected weight gain during the first 4 months of infancy?
What is the expected weight gain during the first 4 months of infancy?
At what age does a child's weight triple approximately?
At what age does a child's weight triple approximately?
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Which of the following statements is true regarding weight increases in early childhood?
Which of the following statements is true regarding weight increases in early childhood?
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What is the body measurement expected at 4 months for an average infant?
What is the body measurement expected at 4 months for an average infant?
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What is the weight formula for children aged 1-6 years?
What is the weight formula for children aged 1-6 years?
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Which anthropometric measure is used to assess the growth of an infant's head?
Which anthropometric measure is used to assess the growth of an infant's head?
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What is the primary purpose of using percentile measurements in assessing child growth?
What is the primary purpose of using percentile measurements in assessing child growth?
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What does a child's position in a percentile chart represent?
What does a child's position in a percentile chart represent?
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Which of the following statements about growth measurement deviations is correct?
Which of the following statements about growth measurement deviations is correct?
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When should a child be investigated for abnormal growth based on percentile measurements?
When should a child be investigated for abnormal growth based on percentile measurements?
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How is the normal growth range defined for a child in percentile terms?
How is the normal growth range defined for a child in percentile terms?
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What indicates malnutrition based on a child's weight curve?
What indicates malnutrition based on a child's weight curve?
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What does plotting sequential measurements of a child's weight on a growth chart help evaluate?
What does plotting sequential measurements of a child's weight on a growth chart help evaluate?
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What is a common misconception regarding the percentile ranking system?
What is a common misconception regarding the percentile ranking system?
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What is the maximum rate of brain growth reflected by the Occipto-Frontal Circumference (OFC) during the first year?
What is the maximum rate of brain growth reflected by the Occipto-Frontal Circumference (OFC) during the first year?
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At what age should the OFC to chest circumference (CC) ratio equal 1?
At what age should the OFC to chest circumference (CC) ratio equal 1?
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How is body surface area (BSA) calculated?
How is body surface area (BSA) calculated?
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At what age does teething typically start?
At what age does teething typically start?
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What is the clinical significance of the OFC/CC ratio exceeding 1 beyond 6 months?
What is the clinical significance of the OFC/CC ratio exceeding 1 beyond 6 months?
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Which of the following statements about OFC is true?
Which of the following statements about OFC is true?
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What is the typical OFC at birth?
What is the typical OFC at birth?
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What measurement is taken at the level of the xiphoid process?
What measurement is taken at the level of the xiphoid process?
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How should length be measured for a child under 2 years old?
How should length be measured for a child under 2 years old?
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What is the expected height increase for a child during the second three months of life?
What is the expected height increase for a child during the second three months of life?
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At what age is a child's height measured by the formula: Height = age in years x 5 + 80?
At what age is a child's height measured by the formula: Height = age in years x 5 + 80?
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If a child is 12 years old, how would you calculate their expected height based on their birth length?
If a child is 12 years old, how would you calculate their expected height based on their birth length?
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Which of the following is NOT a step in measuring a child's length accurately?
Which of the following is NOT a step in measuring a child's length accurately?
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For children older than 2 years, what is the correct position for measuring height?
For children older than 2 years, what is the correct position for measuring height?
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What is the role of the second person during the length measurement in children under 2 years?
What is the role of the second person during the length measurement in children under 2 years?
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Which growth measurement is affected by long-standing malnutrition for at least 6-12 months?
Which growth measurement is affected by long-standing malnutrition for at least 6-12 months?
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At what age does the first carpal bone typically start ossification?
At what age does the first carpal bone typically start ossification?
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What is the significance of X-ray knee in newborns?
What is the significance of X-ray knee in newborns?
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How many carpal bones ossify by the age of 6?
How many carpal bones ossify by the age of 6?
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What does a flattening of the weight curve in a growth chart indicate?
What does a flattening of the weight curve in a growth chart indicate?
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At what age are 2 carpal centers typically present?
At what age are 2 carpal centers typically present?
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Which percentile range is considered abnormal for a child's growth?
Which percentile range is considered abnormal for a child's growth?
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How often does one additional carpal center appear after the first year?
How often does one additional carpal center appear after the first year?
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How many percentile curves are typically present in a growth chart?
How many percentile curves are typically present in a growth chart?
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What key component results in increased body size during growth?
What key component results in increased body size during growth?
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Which of the following factors does NOT directly affect growth?
Which of the following factors does NOT directly affect growth?
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During which stage of development does organogenesis occur?
During which stage of development does organogenesis occur?
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At what point does the most rapid physical growth and mental development typically occur postnatally?
At what point does the most rapid physical growth and mental development typically occur postnatally?
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Which hormone is primarily responsible for influencing growth rates?
Which hormone is primarily responsible for influencing growth rates?
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Which period does NOT fall under the definition of postnatal growth?
Which period does NOT fall under the definition of postnatal growth?
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What is one likely effect of being bedridden on growth?
What is one likely effect of being bedridden on growth?
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What aspect of development does NOT directly relate to acquiring new skills?
What aspect of development does NOT directly relate to acquiring new skills?
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What does a child's position in the percentile row represent?
What does a child's position in the percentile row represent?
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What should be investigated if a child's measurement falls below the 3rd percentile?
What should be investigated if a child's measurement falls below the 3rd percentile?
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What is indicated if a child's weight decreases from the 50th percentile at birth to the 15th percentile at 6 months?
What is indicated if a child's weight decreases from the 50th percentile at birth to the 15th percentile at 6 months?
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What action is recommended if a child's growth curve deviates more than 2 major percentiles?
What action is recommended if a child's growth curve deviates more than 2 major percentiles?
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What are the normal percentile boundaries for measuring children's growth?
What are the normal percentile boundaries for measuring children's growth?
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Which outcome is a purpose of plotting a child's weight on a growth chart?
Which outcome is a purpose of plotting a child's weight on a growth chart?
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What does the horizontal axis on a child's growth chart represent?
What does the horizontal axis on a child's growth chart represent?
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Why is it important to use percentile measurements when assessing child growth?
Why is it important to use percentile measurements when assessing child growth?
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What is the primary rate of weight increase during the second four months of infancy?
What is the primary rate of weight increase during the second four months of infancy?
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Which anthropometric measure is generally associated with assessing upper body growth in children?
Which anthropometric measure is generally associated with assessing upper body growth in children?
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What is a common weight gain expectation for a child during early childhood years after the age of 6?
What is a common weight gain expectation for a child during early childhood years after the age of 6?
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What age is typically associated with the onset of adolescence?
What age is typically associated with the onset of adolescence?
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How is the weight of a child at 8 months expected to be compared to their birth weight?
How is the weight of a child at 8 months expected to be compared to their birth weight?
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Which growth measurement method requires the comparison of a single measurement with established averages?
Which growth measurement method requires the comparison of a single measurement with established averages?
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What is the approximate body measurement for a typical newborn's average weight?
What is the approximate body measurement for a typical newborn's average weight?
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What is a key indicator of abnormal growth based on a child's growth chart?
What is a key indicator of abnormal growth based on a child's growth chart?
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What is the expected increase in length per month for an infant during the first 3 months of life?
What is the expected increase in length per month for an infant during the first 3 months of life?
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Which method is NOT appropriate for measuring a child's length under 2 years old?
Which method is NOT appropriate for measuring a child's length under 2 years old?
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At what age should a child's height first be calculated using the formula: Height = age in years x 5 + 80?
At what age should a child's height first be calculated using the formula: Height = age in years x 5 + 80?
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What should be done with a child's feet when measuring length accurately in the supine position?
What should be done with a child's feet when measuring length accurately in the supine position?
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How does a child's expected height at age 4 compare to their birth length?
How does a child's expected height at age 4 compare to their birth length?
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What is the expected rate of height increase for a child from 1 to 2 years of age?
What is the expected rate of height increase for a child from 1 to 2 years of age?
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What does a child’s length measurement depend on if malnutrition persists for a prolonged period?
What does a child’s length measurement depend on if malnutrition persists for a prolonged period?
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Which of the following statements is correct regarding the measuring of standing height?
Which of the following statements is correct regarding the measuring of standing height?
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What condition may cause the anterior fontanel to remain open beyond 6 months after birth?
What condition may cause the anterior fontanel to remain open beyond 6 months after birth?
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Which of the following is NOT a recognized cause of abnormal fontanel closure?
Which of the following is NOT a recognized cause of abnormal fontanel closure?
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At what age does teething typically commence?
At what age does teething typically commence?
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Which of the following ossification centers is NOT typically present at birth?
Which of the following ossification centers is NOT typically present at birth?
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What is the expected state of the posterior fontanel at birth?
What is the expected state of the posterior fontanel at birth?
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Which of the following statements about secondary teeth is accurate?
Which of the following statements about secondary teeth is accurate?
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What would indicate an abnormally large anterior fontanel at birth?
What would indicate an abnormally large anterior fontanel at birth?
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Which of the following conditions is associated with premature closure of the fontanel?
Which of the following conditions is associated with premature closure of the fontanel?
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Study Notes
Growth Velocity Curves
- Growth velocity is highest during infancy and puberty
- Percentile: the relative position of a child's measurement compared to other children of the same age and sex
- Normal range of measurements falls between 3rd and 97th percentile
- Deviations outside this range may indicate abnormal growth and require further investigation
Using Growth Charts
- Plot a child's weight measurements over time to create a weight curve
- Deviations of greater than 2 major percentiles indicate abnormal growth
- Example: if a child's weight was at the 50th percentile at birth and drops to the 15th percentile by 6 months, it indicates potential malnutrition
Value of Growth Charts
- Follow up of growth
- Early detection of deviations from normal growth (e.g. growth retardation)
- Help in excluding organic problems as a cause of minor complaints (e.g. a mother complaining that her baby is not feeding "well" when the weight curve is not affected)
Stages of Childhood
- Early childhood: 2-6 years (toddler or preschool age)
- Late childhood (school age): 6-12 years
- Adolescence: 12-18 years
Assessing Physical Growth
- Anthropometric measures: physical measurements like weight, height, head circumference, etc.
- Teething: the eruption of teeth
- Fontanelles: soft spots on a baby's skull
- Osseous Growth (Bone age): assessing bone development through X-rays
- Growth Charts (Curves): graphical representations of growth measurements
Anthropometric Measures
- Weight
- Average weight at birth: 3-3.5 kg
- First 4 months: weight increases by 750 g/month (3/4 kg)
- Second 4 months: weight increases by 500 g/month (1/2 kg)
- Third 4 months: weight increases by 250 g/month (1/4 kg)
- Early childhood (1-6 years): Weight increases by 2 kg/year (Weight in kg = (Age in years X 2) +8)
- Late childhood (7-12 years): Weight increases by 2.5 kg/year (Weight in kg = (Age in years X 7) - 5 / 2)
- Length/Height
- Length is measured in supine position for children under 2 years
- Height is measured in standing position for children over 2 years
- At birth: 50 cm
- First 3 months: increases 3 cm/month
- Second 3 months: increases 2 cm/month
- From 7-12 months: increases 1.5 cm/month
- From 1-2 years: increases 1 cm/month
- After the 2nd year: Height = age in years x 5 + 80
- At 4 years: Birth length x 2
- At 12 years: Birth length x 3
- Occipto-Frontal head circumference (OFC)
- Reflects brain growth
- At birth: 35 cm
- First 3 months: increases 2 cm/month
- Next 9 months: increases 0.5 cm/month
- OFC and chest circumference (CC) ratio
- Measured at the level of the xiphiodprocess during mid-inspiration
- Suspect malnutrition if OFC/CC ratio > 1 beyond 6 months
- Age range and OFC/CC ratio: At birth > 1, at 6 months equal 1, at 1st year 95th centile
- Mid arm circumference
- Skin fold thickness
- Arm span – Height relationship
- Proportions of upper segment and lower segment
Teething
- Primary (deciduous or milky) teeth start erupting at 6-9 months and are completed by 24 months
Osseous Growth
- X-ray of the knee in newborns: helps assess intrauterine skeletal maturation and screen for congenital hypothyroidism
- Carpal bones:
- First carpal bone ossifies at about 2 months of age
- Second carpal bone ossifies by the end of the first year
- One carpal bone ossifies approximately each year until the 6th year
- The 8th bone usually ossifies at the 12th year of age
Growth Charts (Curves)
- Assess growth and normal growth variations among children
- Early predictor of malnutrition (flattening of weight curve)
- Monitor success of treatment for malnutrition
- Each chart is composed of 7 curves representing percentiles: 97th, 90th, 75th, 50th, 25th, 10th and 3rd
- Normal children should fall between the 3rd and 97th percentile curves
- Deviations from a child's own percentile curve on serial measurements is abnormal
Growth Velocity Curves
- Growth rate is most rapid during infancy and puberty.
- While some variation is normal, children with measurements below the 3rd percentile or above the 97th percentile should be investigated.
- Growth charts are used to track a child's growth over time, looking for deviations greater than 2 major percentiles.
- A significant drop in percentile can indicate malnutrition.
Growth Chart Value
- Growth charts are used to monitor a child's growth.
- Growth charts help identify abnormal growth, such as growth retardation.
- Growth charts can help rule out organic concerns when a child's weight curve is normal despite a parent's concern.
Growth Definitions
- Growth is the natural increase in body size.
- Growth results from cell multiplication and enlargement.
- Measured by weight, height, head circumference, etc.
- Development includes functional maturation of organs and systems, skill acquisition, adapting to new situations, and assuming responsibilities.
- Development is measured by gross motor, fine motor, language, and social milestones.
- Growth and development occur concurrently, not separately.
Factors Affecting Growth
- Genetics
- Endocrine System - Growth hormone and thyroid hormones are important.
- Nutrition - Poor maternal and child nutrition during pregnancy and lactation can limit growth.
- Chronic infections
- Physical activity
- Socioeconomic Status
- Environment
Stages of Growth and Development
-
Prenatal:
- Embryonic stage (first 12 weeks of gestation) is marked by organogenesis.
- Fetal stage (12th to 40th week of gestation) is a period of rapid growth and development.
- The second trimester is characterized by length growth, while the third trimester is characterized by weight gain.
- Perinatal: From the 20th week of fetal life to the 28th day after delivery.
-
Postnatal:
- Neonatal period: First 4 weeks after birth.
- Infancy (1-24 months): Rapid physical growth and mental development.
- Early childhood (toddler age or preschool age): 2-6 years.
- Late childhood (school age): 6-12 years.
- Adolescence: 12-18 years.
Assessing Growth
- Anthropometric measures - including weight, height, head circumference, mid-arm circumference, skin-fold thickness, and arm span
- Teething
- Fontanelles
- Osseous growth (bone age)
- Growth charts
Weight
- At birth: Average weight is 3-3.5 kg
-
Infancy:
- During the first 4 months, weight gains average 750 g/month.
- During the second 4 months, weight gains average 500 g/month.
- During the third 4 months, weight gains average 250 g/month.
- Early childhood (1-6 years): Weight increases by approximately 2 kg/year.
- Late childhood (7-12 years): Weight increases by approximately 2.5 kg/year.
Length or Height
- Under 2 years: Length is measured in a supine position.
- Over 2 years: Height is measured in a standing position.
- At birth: Average length/height is 50 cm.
- First three months: Increase in Length of 3 cm/month.
- Second three months: Increase in Length of 2 cm/month.
- From 7-12 months: Increase in Length of 1.5 cm/month.
- From 1-2 years: Increase in Length of 1 cm/month.
Length or Height Calculation
- After 2 years: Height = (Age in years x 5) + 80
- 4 years: Birth Length x 2
- 12 years: Birth Length x 3
Teething
-
Primary (deciduous teeth):
- Eruption starts at around 6-8 months and is usually complete by 2.5 years.
- The lower jaw incisors erupt before the upper jaw incisors.
-
Secondary (permanent teeth):
- Eruption starts at around 6 years and is usually complete by 22 years.
- Permanent teeth erupt immediately following exfoliation or may lag by 4-5 months.
Fontanelles
-
Posterior Fontanelle:
- Typically closed at birth or opened < 0.5 cm and closes within 2 months.
- If open > 1 cm or not closed within 4 months, it may indicate prematurity, increased intracranial tension, mongolism, cretinism, or other conditions.
-
Anterior Fontanelle:
- Closed at 18 months.
- Three fingerbreadths (3-4 cm) at birth.
- Two fingerbreadths at 6 months.
- One fingerbreadth at 12 months.
- Large Fontanelle: (Delayed closure; before 6 months) May indicate Down syndrome, achondroplasia, congenital hypothyroidism, rickets, osteogenesis imperfecta, hypopituitarism, or increased intracranial tension.
- Small Fontanelle: (Premature closure; before 6 months) May indicate craniosynostosis or congenital hyperthyroidism.
Osseous Growth
- At birth, there are five secondary ossific centers:
- Lower end of femur.
- Upper end of tibia.
- Talus.
- Cuboid.
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Description
This quiz explores the importance of growth velocity curves and weight charts for monitoring a child's growth during infancy and puberty. Understand the significance of percentiles and how deviations may indicate potential health issues. Dive into the methods of plotting weight measurements and identifying abnormal growth patterns.
