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Average newborn should regain birthweight by
3 weeks
Birthweight doubles by
5 months
Birthweight triples by
1 year
Average birth length
50 cm
Birth length goes up by __ by age 1
50%
Birth length doubles by age
4 years
Birth length triples by age
13 years
Average newborn head circumference
35 cm
Head circumference growth
1 cm / month for the first 6 months
1/2 cm / month for 6-12 months
Macrocephaly definition
Head circumference > 98th percentile
Familial - normal neurological development
Hydrocephalus
subset of macrocephaly
Signs of ↑ ICP: Irritability, lethargy, poor appetite, persistent vomiting, bulging fontanelle, other neurologic findings
Initial weight drop, then decreased length and sparing of head circumference
Inadequate caloric intake
Short stature with normal or high weight
Endocrine disorders
Weight and height falling together
Chronic medical condition
Failure to thrive
Weight < 5th percentile for age
Weight that drops > 2 major percentiles*
Weight < 80% ideal weight for age
Weight < 5th percentile on weight-for-length curve

*It is normal for infants & toddlers to change percentiles up to 2 percentile channels between birth and 2 YOA
Failure to thrive: organic causes
Chronic renal failure
Thyroid / metabolic problems
Inadequate absorption
Inadequate utilization
Constitutional growth delay
Reduced rate of growth with normal final height
Usually has a family history ("late bloomers")
Delayed bone growth & secondary sexual development
Prader-Willi Syndrome
Characteristics: fetal & infantile hypotonia, small hands & feet, postnatal acquired obesity / insatiable appetite, developmental delay, hypogonadism, almond-shaped eyes

snRNP abnormalities on 15q11-q13.

Inheritance: Most have deletion of paternal sequence, 20-25% have uniparental disomy
Laurence-Moon-Bardet-Bidell
Characteristics: retinitis pigmentosa, hypogonadism, developmental delay
-Laurence-Moon: spastic paraplegia
-Bardet-Bidell: obesity, polydactyly

Inheritance: autosomal dominant
Pseudohypoparathyroidism
Characteristics: short stature, developmental delay, short 4th & 5th digits

Resistance to PTH → hypocalcemia, ↑ serum phosphorous
Turner syndrome
Characteristics: short stature, shield chest, widespaced nipples, wide carrying angle, high arched palate, gonadal failure, kidney dysplasias with normal function, aortic arch abnormalities.
Girls a/w autoimmune disorders

Inheritance: 45XO or mosaic karyotype
Classic congenital / idiopathic GH deficiency
MCC congenital & acquired GH deficiency

Characteristics: normal birth weight & length with decreasing velocity most noticeably after 2-3 years of age - progressively become shorter for age with increasing weight/height ratio
Cherub-like appearance (chubby, immature, high pitched voice)
Possible microphallus
If a/w ↓ ACTH also may have severe hypoglycemia
Laron syndrome
GH resistance or insensitivity

Characteristics: prominent forehead, hypoplastic nasal bridge, delayed dentition, sparse hair, blue sclerae, delayed bone maturation, osteoporosis, progressive adiposity, hypercholesterolemia, low blood glucose

↑ GH with ↓ IGF-1 and IGF-BP3