CSP Growth & Development in Pediatrics 3 — Questions and Answers
Question 1: Which growth chart is recommended for monitoring growth in children ages 2–20 years in the United States?
- WHO Child Growth Standards (2006)
- Fenton preterm growth chart
- CDC 2000 Growth Charts (Correct answer)
- INTERGROWTH-21st standards
Correct answer: CDC 2000 Growth Charts
The CDC 2000 Growth Charts are recommended for children aged 2–20 years in the US, while the WHO standards are preferred for children 0–2 years of age.
Question 2: A premature infant born at 28 weeks gestation is now 6 months chronological age. What corrected age should be used when plotting growth on a standard growth chart?
- 3 months corrected age (Correct answer)
- 4 months corrected age
- 6 months corrected age
- No correction needed after 3 months chronological age
Correct answer: 3 months corrected age
Corrected age = chronological age minus weeks of prematurity (in months): 6 months − 3 months (12 weeks early) = 3 months corrected age; age correction is recommended until 24–36 months.
Question 3: What is the approximate expected daily weight gain for a healthy term newborn during the first 3 months of life?
- 10–15 g/day
- 20–30 g/day (Correct answer)
- 40–50 g/day
- 60–70 g/day
Correct answer: 20–30 g/day
Healthy term infants typically gain 20–30 grams per day (about 150–200 g/week) during the first 3 months, which is a key benchmark for assessing adequate nutrition and growth.
Question 4: In evaluating a child with short stature, an advanced bone age compared to chronological age is most suggestive of which condition?
- Growth hormone deficiency
- Constitutional growth delay
- Hypothyroidism
- Precocious puberty (Correct answer)
Correct answer: Precocious puberty
Advanced bone age relative to chronological age is characteristic of precocious puberty, as sex steroids accelerate skeletal maturation and epiphyseal development.
Question 5: Which of the following developmental milestones is typically achieved by a healthy 12-month-old infant?
- Walking independently without support
- Speaking 50 words
- Pincer grasp with index finger and thumb (Correct answer)
- Drawing a circle
Correct answer: Pincer grasp with index finger and thumb
Pincer grasp (fine motor coordination with index finger and thumb) is typically achieved by 9–12 months; independent walking usually develops by 12–15 months and 50 words by approximately 24 months.
Question 6: A child's length-for-age z-score is −2.5 and weight-for-length z-score is −0.5. Which nutrition classification best describes this child?
- Acute malnutrition (wasting)
- Chronic malnutrition (stunting) (Correct answer)
- Underweight only
- Both wasting and stunting
Correct answer: Chronic malnutrition (stunting)
Stunting is defined by low length/height-for-age (z-score < −2), reflecting chronic inadequate nutrition, while normal weight-for-length indicates no current acute wasting.
Question 7: Which endocrine hormone has the greatest direct anabolic effect on linear bone growth during childhood?
- Cortisol
- Insulin-like growth factor-1 (IGF-1) (Correct answer)
- Thyroid-stimulating hormone (TSH)
- Glucagon
Correct answer: Insulin-like growth factor-1 (IGF-1)
IGF-1, produced primarily in the liver in response to growth hormone, directly stimulates chondrocyte proliferation at the epiphyseal growth plate, making it the primary mediator of linear bone growth.
CSP Growth & Development in Pediatrics 3
Which growth chart is recommended for monitoring growth in children ages 2–20 years in the United States?