Paeds Vivas · clinical-assessment-and-reasoning
Failure to thrive and faltering growth: diagnostic approach — viva
Branching structured oral on faltering growth diagnostic approach.
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Target exams
RACP DCEMRCPCH Clinical
Prompt
A plotted growth chart shows a 7-month-old whose weight has crossed from the 50th to below the 2nd centile over four months. You are the paediatric registrar in clinic.
Opening (must-hit)
“I will re-measure and re-plot on the correct chart, assess stability, then build a mechanism-based differential while I support intake and keep safeguarding in view.” [1] [2]
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References7Show ledgerHide ledger
- [1]Homan GJ Failure to Thrive: A Practical Guide Am Fam Physician, 2016.PMID 27548594
- [2]Gonzalez-Viana E Faltering growth in children: summary of NICE guidance BMJ, 2017.PMID 28963099
- [3]Shields B Weight faltering and failure to thrive in infancy and early childhood BMJ, 2012.PMID 23014901
- [4]Harper NS Neglect: failure to thrive and obesity Pediatr Clin North Am, 2014.PMID 25242707
- [5]da Silva JSV ASPEN Consensus Recommendations for Refeeding Syndrome Nutr Clin Pract, 2020.PMID 32115791
- [6]Mills E Association between caregiver concern for clinical deterioration and critical illness in children presenting to hospital: a prospective cohort study Lancet Child Adolesc Health, 2025.PMID 40451224
- [7]Burvenich R Effectiveness of safety-netting approaches for acutely ill children: a network meta-analysis Br J Gen Pract, 2025.PMID 39117428