Archie's Double Digest 150 (May 2004) by Sid Jacobson, Richard H. Goldwater, Victor Gorelick, Nelson

By Sid Jacobson, Richard H. Goldwater, Victor Gorelick, Nelson Ribiero

Archie's Double Digest #150 - might 2004

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Extra resources for Archie's Double Digest 150 (May 2004)

Sample text

Provide healthy meals and snacks. Ⅲ Keep matches and guns out of children’s reach. Ⅲ Use seat belt always. 11 to 21 Years Ⅲ Continue to support a healthy diet and exercise. Ⅲ Wear appropriate protective sports gear. Ⅲ Counsel on safe sex and avoiding alcohol and drugs. Ⅲ Promote a healthy social life. Ⅲ Ask about mood or eating disorders (see below). SCREENING Metabolic screening may vary from region to region. Metabolic Screening In the first month of life the neonate should receive screening for various metabolic disorders including hypothyroidism, phenylketonuria (PKU), sickle cell disease, and adrenal cortex abnormalities.

Lack of weight gain after adequate caloric feedings is characteristic of nonorganic failure to thrive. 37 Ⅲ Organic versus nonorganic FTT is best distinguished by a detailed history and physical exam. Screening tests for common causes include complete blood count (CBC), electrolytes, blood urea nitrogen (BUN), creatinine, and albumin. TREATMENT Ⅲ If a nonorganic cause is suspected or the child is severely malnourished, hospitalization may be required. Ⅲ If organic, treat the cause. PROGNOSIS FTT during the first year of life has a poor outcome due to the rapid growth of the brain during the first 6 months.

Lissencephaly) IMPACT A small brain predisposes to cognitive/motor delay and seizures. Weight is affected first in FTT, followed by height and head circumference. Psychosocial reasons account for most cases of FTT in the United States. Macrocephaly DEFINITION Head circumference > 3 standard deviations above the mean. ETIOLOGY Ⅲ Familial in 50% of cases Ⅲ Hydrocephalus Ⅲ Other causes: Large brain (megalencephaly), cranioskeletal dysplasia, Sotos syndrome Failure to Thrive (FTT) DEFINITION FTT is defined as a weight below the third percentile or a fall off the growth chart by two percentiles.

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