Growth & Development

Head circumference with age Remember 3, 9, and multiples of 5:

Newborn 35 cm
3 mos 40 cm
9 mos 45 cm
3 yrs 50 cm
9 yrs 55 cm

Weights of children with age Newborn 3 kg

6 mos 6 kg (2x birth wt at 6 mos)
1 yr 10 kg (3x birth wt at 1 yr)
3 yrs 15 kg (odd yrs, add 5 kg until 11 yrs)
5 yrs 20 kg
7 yrs 25 kg
9 yrs 30 kg
11 yrs 35 kg (add 10 kg thereafter)
13 yrs 45 kg
15 yrs 55 kg
17 yrs 65 kg

Pediatric milestones in development 1 year:

-single words
2 years:
-2 word sentences
-understands 2 step commands
3 years:
-3 word combos
-repeats 3 digits
-rides tricycle
4 years:
-draws square
-counts 4 objects

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Short stature: differential ABCDEFG:
Alone (neglected infant)
Bone dysplasias (rickets, scoliosis, mucopolysaccharidoses)
Chromosomal (Turner's, Down's)
Delayed growth
Endocrine (low growth hormone, Cushing's, hypothyroid)
Familial
GI malabsorption (celiac, Crohn's)

Dentition: eruption times of permanent dentition "Mama Is In Pain, Papa

Can Make Medicine":
1st Molar: 6 years
1st Incisor: 7 years
2nd Incisor: 8 years
1st Premolar: 9 years
2nd Premolar: 10 years
Canine: 11 years
2nd Molar: 12 years
3rd Molar: 18-25 years

Perez reflex Eliciting the PErEz reflex will make the

baby PEE.

Cerebral palsy (CP): most likely cause CP: Cerebral

Palsy
Child Premature
The premature brain is more prone to all the possible
insults.

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 NUTRITION
Milk protein: women vs. cows Woman: Whey (mostly)
Cow: Casein (mostly)

Breast feeding: benefits ABCDEFGH:

Infant:
Allergic condition reduced
Best food for infant
Close relationship with mother
Development of IQ, jaws, mouth
Mother:
Econmical
Fitness: quick return to pre-pregnancy body shape
Guards against cancer: breast, ovary, uterus
Hemorrhage (postpartum) reduced

Vitamin toxicities: neonatal Excess vitamin A: Anomalies (teratogenic)

Excess vitamin E: Enterocolitis (necrotizing enterocolitis)
Excess vitamin K: Kernicterus (hemolysis)

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 Infectious Disease
Rubella: congenital signs "Rubber Ducky, I'm so blue!" (like the "Rubber
Ducky" song):
Rubber: Rubella
Ducky: Patent Ductus Arteriosus, VSD and pulmonary artery stenosis.
I'm: Eyes (cataracts, retinopathy, micropthalmia, glaucoma).
Blue: "Blueberry Muffin" rash (extramedullary hematopoesis in skin +purpura)
Also, deafness, growth retardation, and some more.

Measles: complications "MEASLES COMP" (complications):

Myocarditis
Encephalitis
Appendicitis
Subacute sclerosing panencephalitis
Laryngitis
Early death
Sh!ts (diarrhoea)
Corneal ulcer
Otis media
Mesenteric lymphadenitis
Pneumonia and related (bronchiolitis-bronchitis-croup)

Septic Arthritis: most common cause

Staphylococcus Aureus is the most common cause of

Septic Arthritis in the pediatric population.

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 Respiratory System
Croup: symptoms 3 S's:
Stridor
Subglottic swelling
Seal-bark cough

Cough (chronic): differential When cough in nursery, rock the "CRADLE":

Cystic fibrosis
Rings, slings, and airway things (tracheal rings)/ Respiratory infections
Aspiration (swallowing dysfunction, TE fistula, gastroesphageal reflux)
Dyskinetic cilia
Lung, airway, and vascular malformations (tracheomalacia, vocal cord
dysfunction)
Edema (heart failure)

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 GI System
Pyloric stenosis (congential): presentation Pyloric stenosis is 3 P's:
Palpable mass
Paristalsis visible
Projectile vomiting (2-4 weeks after birth)

Gastroschisis: usual location GasTRoscHIsis usually occurs on the

RIGHT side of the umbilicus.
(Unscramble the letters).

Duodenal atresia vs. Pyloric stenosis: site of obstruction

Duodenal Atresia: Distal to Ampulla of vater.

Pyloric stenosis: Proximal to it.

Bilirubin: phototherapy BiLirUbin absorbs light

maximally in the
BLUe range.

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 CVS
Cyanotic heart diseases: 5 types Use your five fingers:
1 finger up: Truncus Arteriosus (1 vessel)
2 fingers up: Dextroposition of the Great Arteries (2 vessels transposed)
3 fingers up: Tricuspid Atresia (3=Tri)
4 fingers up: Tetralogy of Fallot (4=Tetra)
5 fingers up: Total Anomalous Pulmonary Venous Return (5=5 words)

Cyanotic congenital heart diseases 5 T's:

Truncus arteriosus
Transposition of the great arteries
Tricuspid atresia
Tetrology of Fallot
Total anomalous pulmonary venous return

Cyanotic heart diseases: 5 types 5 T's:

Tetralogy of Fallot
Transposition of the great arteries
Truncus arteriosus
Tricuspid atresia, pulmonary aTresia
Total anomalous pulmonary venous drainage

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 Renal System
Hemolytic-Uremic Syndrome (HUS): components

"Remember to decrease the RATE of IV fluids in these patients":

Renal failure
Anemia (microangiopathic, hemolytic)
Thrombocytopenia
Encephalopathy (TTP)

Haematuria: differential in children ABCDEFGHIJK:

Anatomy (cysts, etc)
Bladder (cystitis)
Cancer (Wilm's tumour)
Drug related (cyclophosphamide)
Exercise induced
Factitious (Munchausen by proxy)
Glomerulonephritis
Haematology (bleeding disorder, sickle cell)
Infection (UTI)
In Jury (trauma)
Kidney stones (hypercalciuria)

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 Genetics
Cystic fibrosis: exacerbation of pulmonary infection CF PANCREAS:
Cough (increase in intensity and frequent spells)
Fever (usually low grade, unless severe bronchopneumonia is present)
Pulmonary function deterioration
Appetite decrease
Nutrition, weight loss
CBC (leukocytosis with left shift)
Radiograph (increase overaeration, peribronchial thickening, mucus plugging)
Exam (rales or wheezing in previously clear areas, tachypnea, retractions)
Activity (decreased, impaired exercise intolerance, increased absenteeism)
Sputum (becomes darker, thicker, and more abundant, forming plugs)

Cystic fibrosis: presenting signs CF PANCREAS:

Chronic cough and wheezing
Failure to thrive
Pancreatic insufficiency (symptoms of malabsorption like steatorrhea)
Alkalosis and hypotonic dehydration
Neonatal intestinal obstruction (meconium ileus)/ Nasal polyps
Clubbing of fingers/ Chest radiograph with characteristic changes
Rectal prolapse
Electrolyte elevation in sweat, salty skin
Absence or congenital atresia of vas deferens
Sputum with Staph or Pseudomonas (mucoid)

WAGR syndrome: components WAGR:

Wilm's tumor
Aniridia
Gential abnormalities
Mental retardation

Williams syndrome: features WILLIAMS:

Weight (low at birth, slow to gain)
Iris (stellate iris)
Long philtrum
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Large mouth
Increased Ca++
Aortic stenosis (and other stenoses)
Mental retardation
Swelling around eyes (periorbital puffiness)

Russell Silver syndrome: features ABCDEF:

Asymmetric limb (hemihypertrophy)
Bossing (frontal)
Clinodactyly/ Cafe au lait spots
Dwarf (short stature)
Excretion (GU malformation)
Face (triangular face, micrognathia)

Vacterl syndrome: components VACTERL:

Vertebral anomalies
Anorectal malformation
Cardiac anomaly
Tracheo-esophageal fistula
Exomphalos (aka omphalocele)
Renal anomalies
Limb anomalies

Ataxia-Telangiectasia (AT): common sign AT:

Absent
Thymus

Sturge-Weber syndrome: hallmark features Sturge-Weber:

1. Seizures
2. PortWine stain

Guthrie card: diseases identified with it GUTHRIE:

Galactosaemia

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Urine [maple syrup urine disease]
THyRoid [hypothyroidism]
Inborn Errors of metabolism [eg: PKU]

Guthrie card: diseases identified with it "Guthrie Cards Can Help Predict
Bad Metabolism":
Galactosaemia
Cystic fibrosis
Congenital adrenal hyperplasia
Hypothyroidism
Phenylketonuria
Biotidinase deficiency
Maple syrup urine disease

Thanks
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