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Year 3 Paediatrics > 11. Growth and Endocrine Conditions > Flashcards

11. Growth and Endocrine Conditions Flashcards

1
Q

What factors influence height?

A 
Age
Sex
Race
Nutrition
Parental heights
Puberty
General health
Growth disorders
Emotional well being
Social-economic status
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2
Q

What are the three phases of child growth?

A

Infantile-10/15cm per year
Childhood - 5/7cm per year
Pubertal- girls 11-15, boys 14-18

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3
Q

How d you measure a babies height up to 2 years of age?

A

Put them in between a plate. Measure length, I.e. baby is lying down

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4
Q

What other measurements do we do in under 2’s

A

Head circumference

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5
Q

How do you measure a child 2 years and shoves height?

A

Height stand- shoes and socks off stand up straight

Sitting height- May indicate body disproportions

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6
Q

What special growth charts can be used?

A

Condition specific growth charts for those with disabilities

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7
Q

What simple tools can be used to assess if growth is on track?

A

Chart parental height and work out child’s estimated height

Bone age- radiograph interpretated by radiographer

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8
Q

What would you like to assess on history and examination?

A 
Birth weight and gestation
PMH
FH/SH/ schooling
Systematic enquiry 
Dysmorphic features
Systemic examination including pubertal assessment
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9
Q

In summary what are the assessment tools you use

A 
Height/length/head circumference 
Growth charts and plotting
MPH and target centiles
Growth velocity
Bone age
Pubertal assessment
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10
Q

What are some indications for referral to the growth clinic?

A 
Extremely short or tall stature
Height be,low tartget height
Abnormal height velocity
History of chronic disease
Obvious dysmorphic syndromes
Early/late puberty
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11
Q

What are the common categories of short statures?

A

Familial- runs in the family, completely normal

Constitutional- short fro now but will catch up later on

SGA/IUGR- interested at these ones- if they don’t catch up, further investigate

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12
Q

What are the pathological causes of short stature?

A 
Undernitrition
Chronic illness (JCA, IBD, coeliac)
Iatrogenic (steroids)
Psychological and social
Hormonal (GHD, hypothyroidism)
Syndromes (turner, P-W)
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13
Q

Why would you do a FBC and ferritin Test in a child with small stature!

A

General health

Coeliacs

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14
Q

LFT’s, U&E’s

A

Renal and liver disease

Calcium metabolism problem?

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15
Q

Coeliac serology

A

Coeliac

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16
Q

IGF-1

A

Hormonal disorders

17
Q

Karyotyoe

A

Turner’s syndrome

18
Q

What is an IGF-1 Test?

A

A growth hormone stimulation test aimed to see if arginine and insulin affect growth

19
Q

What is. Typical presentation of thyroid deficiency in children?

A

Gained weight and lost height

20
Q

What are the presentations of turners syndrome?

A

Webber neck, wide carrying angle,

Do a karotype test to confirm

21
Q

What is pari vili syndrome

A

Picked up at birth

22
Q

What is noonans syndrome ?

A

Genetic disorder of childhood, come dine with me

23
Q

What is achondroplasia

A

Diagnosed antenatal your just after birth
Short legs, long limbs
No treatments apart from leg lengthening when older

24
Q

How do assess puberty?

A 
Use tanners method:
B breasts 1-5
G genitalia 1-5
PH pubic hair 1-5
AH axillary hair 1-3 
T  testicles 2-20ml (oligometer) 
SO- e.g. stat,ent as B3 PH3 or G2 PH2 6/6
25
Q

What are the various stages of tanners?

A 
1
2- important one 
3
4
5- fully grown
26
Q

What are the relationships between growth and changes in puberty in males

A

Testicular growth
Penile growth
Advanced changes of puberty (testicular 10-12ml)
Facial hair and shaving (comes at the end of puberty)

27
Q

What happens to girls between growth and puberty

A

Breast budding
Early breast development
Menarche

28
Q

What is constituational delay of growth and puberty?

A

Boys mainly
FH in dad or brothers
Bone age delay
Need to exclude organic diseases

29
Q

What is normal pubertal age range?

A

8-13- girls

9-14- boys

30
Q

How does hypothyroidism present in children?

A

Congenital presents in 2 week blood spot
Lack of height gain
Pubertal delay
Poor school performance

31
Q

When you have a fat child what do you consider?

A

Height- obese and tall is relatively okay but obese and small is not good

32
Q

What are the presenting symptoms of diabetes in children?

A

Weight loss
Tiredness
Increased thirst
Polyuria

33
Q

What are the immediate things you do for kids with diabetes?

A

Test! If blood glucose is over 11mmol/l admit

34
Q

How do children under 5 present with diabetes?

A 
Heavier than usual nappies 
Blurred vision
Candidiasis 
Constipation 
Recurring skin infection
Irritability behaviour change
35
Q

What are the symptoms of DKA?

A

Nausea and vomiting

Abdominal pain

Ketotic breath

Drowsiness

Rapid deep sighing respiration

Year 3 Paediatrics (42 decks)

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