Abnormal Growth

Question 1

what are centile lines

Answer 1

cross sections of the normal growth curve - spaced 2/3 of a SD apart

Question 2

what is the first growth phase dependent upon

Answer 2

nutrition

Question 3

what is the second growth phase based on

Answer 3

growth hormone

Question 4

what is the third growth phase based on

Answer 4

sex steroid

Question 5

what makes a child’s growth normal

Answer 5

if their measurement is within normal rage for their age

if their rate of growth is within normal range for their age

Question 6

what is a reassuring sign for paediatricians

Answer 6

child growing normally

Question 7

what way have growth charts shifted in the last 30 years

Answer 7

to the right
graph has longer tail

due to increasing severe obesity and an upward trend in height

Question 8

how should babies be measured

Answer 8

without any clothes or nappy
with a proper length board or mat
requires 2 measures

Question 9

what measurements are taken for children

Answer 9

head circumference
weight
height

Question 10

what does it mean if the child’s height is ‘on the centile x’

Answer 10

the point is on the x line or within 1/4 of a space of the x line

Question 11

what is the average ages for girls and boys to enter puberty

Answer 11

girls - 11

boys - 6 months later on average

Question 12

what is the normal reference ranges for entering puberty for girls and boys

Answer 12

anything older than 8 for girls and 9 for boys

Question 13

what are the gonadotrophic hormones

Answer 13

FSH and LH

Question 14

what is the first sign boys have entered puberty

Answer 14

testicular volume >4ml

Question 15

how is female puberty staged

Answer 15

in terms of when breasts, body hair and periods develop

Thelarche - breast budding
Adrenarche - body hair and odour
Menarche -periods start

Question 16

how long after thelarche does menarche tend to occur

Answer 16

2 years 
(range 1-5)

Question 17

what is the average height difference between men and women

Answer 17

12.5-14cm

Question 18

when do boys have their growth spurt

Answer 18

average age 14

Question 19

when do girls have their growth spurt

Answer 19

average 12

Question 20

what to ask in a history for growth problems

Answer 20

ICE- see if child/parents are worried about height
Birth history - could be due to a placental insufficiency but child will catch up
PMH
Pubertal symptoms
FH
-parental heights
-parental puberty

Question 21

what are some examinations for growth problems

Answer 21

height, weight, height velocity
signs suggestive of pathology
Pubertal status

Question 22

growth problem investigations

Answer 22

bloods
-gonadotrophins, GH, testosterone/oestrogen, thyroid, karyotype
bone age
dynamic function tests
MRI brain
USS uterus - see if theres endometrial thickening

Question 23

Causes of short stature

Answer 23

Genetic short stature 
Constitutional growth delay (late maturation occurring around puberty) 
Dysmorphic syndromes 
Endocrine disorders 
Chronic disease 
Psychosocial deprivation

Question 24

why does growth matter

Answer 24

it’s a marker of health

abnormal growth may be indicative or other pathology

Question 25

what are some consequences of abnormal growth

Answer 25

psychosocial aspect
-altered confidence

socioeconomic status
-earn less than taller people