Growth & Development Notes PDF

GROWTH & DEVELOPMENT  Difference between Growth & Development:  Temperament: is the way individuals respond to their external and internal environment. may persist throughout the lifespan.  The weight of child doubles at the fourth month.  The weight of child trip...

GROWTH & DEVELOPMENT  Difference between Growth & Development:  Temperament: is the way individuals respond to their external and internal environment. may persist throughout the lifespan.  The weight of child doubles at the fourth month.  The weight of child triples at the end of the first year.  Infants 0-12 months: weight (kg) = (0.5 × age in months) + 4  Children 1-5 years: weight (kg) = (2 × age in years) + 8  Children 6-12 years: weight (kg) = (3 × age in years) + 7  The baby doubles his length at the age of 4 years.  LENGTH OR HEIGHT VELOCITY:- At birth : 50 cm Gain 1st year : +25 cm (75 cm) Gain during 2nd year: +12.5 (87.5cm) Gain during 3rd year: +7.5-10cm Gain during 3-12 years: +5-7.5 cm  Girl 12-16 year=8cm/year.  Boys 14-18 year =10cm/year.  (CM)UP TO 12 YEARS (WEECH’S FORMULA)=(AGE IN YEARS X 6 )+77 CM  PREDICTION OF ADULT HEIGHT: Boys=(Mother’s height +Father’s height) x 0.5 + 6.5 cm Girls=(Mother’s height +Father’s height) x 0.5 - 6.5 cm  Birth to 3 months : +2cm/month 3-6months: +1cm/month 9-12months: +0.25cm/month   2 yrs – copies vertical line.  2 ½ yrs –copies horizontal line.  3 yrs – circle.  Values below 5th percentile → abnormal → underweight, short stature, small head.  Values above 95th percentile → abnormal → overweight, tall stature, large head. ‫باقي المحاضرة كلها أرقام مهمة الزم تتذاكر‬  GENETICS  Euploidy: normal number of chromosomes (i.e., 46).  Aneuploidy: abnormal number of chromosomes.  Autosomal Dominant (AD): the trait appears in All generations (Spherocytosis, Celiac disease ).  Autosomal Recessive (AR): consanguinity may be present (Thalassemia, Sickle cell anemia, Galactosemia ).  X linked Dominant (XD): Affect both males & females, homozygous or heterozygous (Familial hypophosphatemic Rickets, Rett syndrome).  X linked Recessive (XR): only in homozygous state (G6PD deficiency, Hemophilia A, B).  Examples of Y-linked inheritance: -Hypertrichosis of the ears. -Webbed toes. -Porcupine man.  Examples of mitochondrial disorders include -MELAS. -MERRF. -Kearns-Sayre syndrome.  Examples of Multifactorial inheritance: -Neural tube defect. -Cleft lip and cleft palate. -DM. -Hypertension.  Indications of Karyotyping:** -Spontaneous abortion. -Congenital malformation and dysmorphic features -Mental retardation. -Ambiguous genitalia. -Malignancy. -Amenorrhea.  TYPES OF CHROMOSOMAL ABERRATIONS  NEONATAL SEPTICEMIA  Escherichia coli is the commonest organism of EOS.  Staphylococcus epidermis is the commonest organism of LOS.  Urine cultures are usually not recommended for evaluating EOS.but should be considered for evaluating LOS  Neutropenia has better specificity than neutrophilia as a marker.of neonatal sepsis  Ampicillin and Aminoglycosides in EOS (GBS, E. coli, and L..(monocytogenes  Vancomycin and Aminoglycosides.in LOS (staph.) TTN  A mother who has diabetes, asthma, or a C-section without labor.is more likely to have a baby with TTN  Chest x-ray: May show hyperinflation, prominent perihilar.vascular markings, or fluid in the fissures  Meconium aspiration syndrome (MAS) .The first treatment for MAS is suction  ?What are the complications of meconium aspiration syndrome.Pneumonia.Asthma.Pulmonary hypertension of the newborn (PPHN).Collapsed lung (pneumothorax).Hypoxia NEONATAL APNEA  Types of neonatal apnea: 1-Central apnea: there's no signal going from the brain to the baby's diaphragm to make their lungs breathe. 2-Obstructive apnea: when the baby's pharynx collapses or lung muscles are too weak. 3-Mixed apnea: a mixture of central & obstructive.  The most common cause of neonatal apnea is premature birth.  TTT: Oral Caffeine Citrate to neonates who have recurrent episodes, which relaxes smooth muscles, such as lungs. It also stimulates the baby's CNS and cardiac muscles to create breathing.  NEONATAL RDS  Occurs from a deficiency of surfactant.  Surfactant production begins in the alveolar type 2 cells around 20 weeks gestation.  The most important risk factors are prematurity and low birth weight.  Chest radiography findings pathognomonic of RDS include a ground- glass reticulo-granular appearance. PREMATURITY  The most common cause of prematurity is idiopathic.  All preterm infants are usually low birth weight except infant of diabetic mother.  The most common cause of apnea of prematurity is Mixed.  The testes descend in the 30th week.  Problems of prolonged high Oxygen therapy: -Retinopathy of prematurity. -Bronchopulmonary dysplasia.  Maximum caloric requirements for preterm is 150 Cal/Kg/day.  Discharge from the incubator when Infant > 1800 gram.  What are the indications of discharge from incubator? Infant > 1800 grams. Good suckling of adequate oral feeding (150 ml/kg/day). Good temperature & vital signs outside the incubator. No critical illness.  Normal respiration (no apnea, no RD).  Problems (complications) of prematurity? Hematological Disorders of Neonate  All blood cells are made from stem cells Start in the yolk sac during 3rd week of gestation.  Liver early in pregnancy during the 1st 12 weeks.  Bone marrow predominates from 22 weeks gestation forward.  Reticulocytes: -At birth, the count is 4% -7%, dropping to 2-3% by 7 days of age. -↑ count indicative of chronic blood loss or hemolysis.  Iron supplementation 2mg/kg/day as prophylaxis and 6mg/kg/day as therapy.  POLYCYTHEMIA: Hemoglobin > 22 g/dL or Hematocrit >65% in the 1st week of life.  Partial exchange transfusion: (PET) removing some of the baby's blood and replacing it with fluid IV line (normal saline, 5%albumin or fresh frozen plasma).  Thrombocytopenia: platelet count