6 - childhood growth Flashcards

1
Q

difference between cumulative height and height velocity

A

cumulative height = how tall the child is now as a total of all the growth they’ve done from conception

height velocity = how fast a child is growing per year

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2
Q

what constitutes normal growth

A

growing along a centile - can have short children from tall parents but as long as they continue growing along their centile e.g. 25th (25% of children shorter than 25th centile) its fine

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3
Q

hormonal control of growth (axis and also factors/hormones at different ages)

A

factors e.g. age, nutrition, health, puberty in to the hypothalamus and affect release of GnRH (+) and SS (-)

these act on the pituitary.
Pituitary release GH in pulses (mainly overnight)

GH causes growth
also acts on liver, bones and muscles –> release IGF-1 –> growth

Infancy - nutritionally dependent before 1year
9-12 months - influence of GH
childhood - nutrition less impact
puberty - sex steroids and GH – pubertal growth spurt and epiphyseal growth plates fuse

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4
Q

factors that influence childhood growth

A
events before birth e.g. poor foetal growth, low BW, prematurity
genetics e.g. inherited growth disorders
Malnutrition
Malabsorption
Randomness
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5
Q

what is abnormal growth

causes of short stature

A

a child who falls significantly in their centile position

  • malnutrition
  • genetic illness - achondroplasia (short leg length - use standing height vs sitting height); Turner’s; Down syndrome
  • chronic disease e.g. asthma, sickle cell disease, chronic arthritis, IBD, CF, renal failure, congenital HD
  • endocrine causes e.g. low GH, thyroid hormone, steroid excess
  • psychological stress and neglect (effect pulsatility of GH)
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6
Q

causes of tall stature

A
  • Marfan and Soto syndrome
  • tall parents
  • GH hormone excess from pituitary tumour
  • precocious puberty (early growth spurt)
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7
Q

how obesity is measured in children

complications

A

having a BMI centile position above 85th centile

T2DM
orthopaedic problems
PCOS
CVS risk
Cancer
Psychological
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8
Q

Possible genetic factors in obesity (polygenic and monogenic)

A

polygenic = highly heritable that — FTO gene can affect behaviour and appetite - more likely to gain weight

monogenic = rare — leptin deficiency, leptin R deficiency, POMC deficiency, MC4R deficiency

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