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20 Cards in this Set

  • Front
  • Back
1. Failure To Thrive (FTT)?
a. FTT is a physical sign, not a final diagnosis.
2. When is Failure To Thrive (FTT) suspected?
a. When growth is below the 1/3 to 1/5 percentile or crosses more than 2 major growth percentiles in a short time frame.
b. Usually seen in children younger than 5 yrs whose physical growth is significantly less than that of their peers.
3. Nonorganic (psychosocial) FTT?
a. Poor growth w/o a medical aetiology.
b. Nonorganic FTT often is related to poverty or poor caregiver-child interaction.
c. It constitutes 30-50% of FTT cases identified in tertiary care settings and nearly all cases in primary care settings.
4. Organic Failure To Thrive (FTT)?
a. Poor growth caused by an underlying medical condition.
5. Organic causes of FTT?
a. IBD
b. Renal disease
c. Congenital heart conditions.
6. Goals of H&P and lab tests for Failure To Thrive (FTT)?
a. To establish whether the child’s caregiver is supplying enough calories
b. Whether the child is consuming enough calories
c. Whether the child is able to use the calories for growth
7. Most important tools in an FTT evaluation?
a. History and physical.
b. A dietary hx can offer important clues to ID an aetiology.
8. Symptoms of Nonorganic FTT?
a. May demonstrate an occipital bald spot from lying in a bed and failure to attain appropriate developmental milestones resulting from lack of parenteral stimulation.
b. Maybe disinterested in their environment
c. May avoid eye contact, smiling, or vocalization
d. May not respond well to maternal attempts of comforting
9. Can there be improvement in FTT?
a. Yes, children w/some types of organic FTT (renal tubular acidosis) and most nonorganic FTT show “catch-up” in developmental milestones w/successful therapy.
10. What can give a good clue to maternal-child interaction and bonding issues or to physical problems, during an office visit (esp. of younger infants)?
a. If the clinician observes a feeding.
b. Physical problems seen may include cerebral palsy, oral motor or swallowing difficulties, velum cleft palate.
11. Tests for child w/failure to thrive and cystic fibrosis in the family?
a. Sweat chloride testing or genetic testing.
12. Tests for child w/failure to thrive and Loud, harsh, systolic murmur and bounding pulses?
1. Chest radiograph
2. ECG
3. Perhaps echo and cardio consult.
13. Tests for child w/failure to thrive and living in lower socioeconomic classes or cities w/high lead prevalence?
a. Lead level and CBC.
14. Tx and f/u for FTT?
a. Disease specific.
b. Pts w/nonorganic FTT are managed w/improved dietary intake, close follow-up, and attention to psychosocial issues.
15. Calorie requirement for healthy infants in the first year of life?
a. 120kcal/kg/d and
b. 100 k/cal/kg thereafter.
16. Calorie requirement for FTT children?
a. Require an additional 50-100%w to ensure adequate catch-up growth.
b. A mealtime routine is important.
17. What response to treatment supports the diagnosis of nonorganic FTT?
a. Rapid weight gain.
18. Next step in management of failure to thrive?
a. Gather more information, including birth, past medical, family, social, and developmental histories.
b. A dietary history is especially important.
19. Most likely diagnosis in Failure to thrive?
a. Most likely “nonorganic” in nature.
20. Next step in evaluation of FTT?
a. Limited screening laboratory testing to identify organic causes of FTT.
b. Dietary counseling
c. Frequent office visits to assess weight gain.