BIOLOGY 2D03 Lecture Notes - Lecture 5: Primary Biliary Cirrhosis, Biliary Atresia, Chronic Respiratory Disease
19 Jun 2018
School
Department
Course
Professor
o Incorrect preparation of formula feed
o Lack of regular feeding time
o Infant difficult to feed – resists feeding/ disinterested
o Conflict over feeding e.g. messy and throwing food around – leads to early
termination of dinner times
o Problems with money – budgeting, shopping, cooking food
Psychosocial deprivation:
o Poor maternal-infant interaction
o Maternal depression
o Poor maternal education
Neglect or child abuse
Organic (5%):
Inadequate intake
o Impaired suck/ swallow e.g. cleft palate, impaired oromotor coordination
such as in cerebral palsy
o Chroi disease iduig aoreia e.g. roh’s, hroi real failure
Inadequate retention
o Pyloric stenosis, severe GORD
Malabsorption
o Coeliac disease, CF, cows milk protein intolerance, cholestatic liver disease
(e.g. biliary atresia), short gut syndrome post NEC (necrotising enterocolitis)
Failure to utilise nutrients
o Chroosoal disorders e.g. Dow’s, IUGR/ etree preaturit, ogeital
infection, metabolic disorders e.g. congenital hypothyroidism, storage
disorders
Increased requirements
o Thyrotoxicosis, CF, malignancy, chronic infection e.g. HIV, congenital heart
disease, renal failure
Examination
Nutritional assessment:
o Plot height, weight and head circumference on growth chart
o Triceps caliper to measure subcut fat (hard in infants)
o Mid upper arm is best measure of subcut fat in children from 6 months to 6
years as it is independent of age
Top to toe examination looking for: dysmorphic features, signs of malabsorption
(distended abdomen, thin buttocks, misery), chronic respiratory disease (chest
deformity, clubbing) etc
Investigations
Collateral history from the health visitor
JWH, JM, AJS
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Document Summary
Incorrect preparation of formula feed: lack of regular feeding time. Infant difficult to feed resists feeding/ disinterested: conflict over feeding e. g. messy and throwing food around leads to early termination of dinner times, problems with money budgeting, shopping, cooking food. Psychosocial deprivation: poor maternal-infant interaction, maternal depression, poor maternal education. Impaired suck/ swallow e. g. cleft palate, impaired oromotor coordination such as in cerebral palsy: chro(cid:374)i(cid:272) disease i(cid:374)du(cid:272)i(cid:374)g a(cid:374)ore(cid:454)ia e. g. (cid:272)roh(cid:374)"s, (cid:272)hro(cid:374)i(cid:272) re(cid:374)al failure. Malabsorption: coeliac disease, cf, cows milk protein intolerance, cholestatic liver disease (e. g. biliary atresia), short gut syndrome post nec (necrotising enterocolitis) Failure to utilise nutrients: chro(cid:373)oso(cid:373)al disorders e. g. dow(cid:374)"s, iugr/ e(cid:454)tre(cid:373)e pre(cid:373)aturit(cid:455), (cid:272)o(cid:374)ge(cid:374)ital infection, metabolic disorders e. g. congenital hypothyroidism, storage disorders. Increased requirements: thyrotoxicosis, cf, malignancy, chronic infection e. g. hiv, congenital heart disease, renal failure. Top to toe examination looking for: dysmorphic features, signs of malabsorption (distended abdomen, thin buttocks, misery), chronic respiratory disease (chest deformity, clubbing) etc.
