Abnormal peds growth Flashcards
T or F: normal growth is pulsatile
true
T or F: normal growth is seasonal
true
normal portionality for weight-to-height
2.3rd-97.7th percentile
body proportion (US/LS) is higher or lower in turners?
incr (longer US, shorter LS)
body proportion (US/LS) is higher or lower in marfan?
decr
FTT is based on decreased velocity of Weight or Length
WEIGHT
FTT is defined by (2)
- weight under 2nd percentile
2. decr velocity of weight gain
how to determine if a child’s growth is abnormally rapid
height-for-age curve deviated upwards across 2 major height % curves
what can you evaluate if there is evidence of accelerated growth
bone age
advanced bone age is ____% above chronological age
20%
most common overgrowth in infancy is
maternal diabetes
macrocephaly, frontal bossing, hypertelorism, intellectual disability, large at birth, advanced bone age, IFG1 normal
cerebral gigantism (sotos syndrome)
advanced bone age, rapid growth then slows, macrosomia, visceromegaly, macroglossia, omphalocele, hypoglycemia, hyperinsulinism, renal issues
beckwith-wiedemann syndrome
most common cause of tall state
familial tall stature
precocious puberty is more common in girls or boys
girls
types of precocious puberty
Central GDPP
peripheral GDIP
those with precocious puberty have ___bone age, ___epihpyseal closure
advanced bone age, early epiphyseal closure
most reliable measurement of growth hormone excess
IGFBP-3
long legs, reduced UL segment ratio, low sitting height (eunuchoid proportions)
sex hormone deficiency
mutation of ACTH receptor is primary or secondary adrenal insufficiency
primary adrenal insufficiency (high ACTH, low cortisol)
tall, obese, early onset puberty, low GH but normal IGF
exogenous obesity
what is the most common monogenic cause of human obesity?
melanocortin 4 receptor (MC4R)
hyperphagia, hyperinsulinemia, obese kid, preserved reproductive fxn
MC4R mutation
47XXY, long legs, short trunk, small testes, gynecomastia, learning disabled, bone age normal/delayed
klinefelter
how to tx klinefelter
testosterone
delayed motor/ language development, large teeth, tremor, ADHD, autism
47 XYY syndrome
lens subluxated upward
marfan
lens subluxated downward
homocystinuria
does marfans or homocysteinuria have risk for thrombotic events?
homocysteinuria
does marfans or homocysteinuria have risk for intellectual disability?
homocysteinuria
tall, AD, dysregulated GH, precocious pubterty, cafe au lait spots, hamartomas, gliomas
von recklinghausen disease (NF1)
madelung deformity of the forearm
turner syndrome
if you see a girl with short stature, what should be in your differential?
turner syndrome
obesity, severe hyperphagia, developmental delay, hypogonadism
prader-willi
how to tx prader-wili
GH
hypertelorism, downward slanting eyes, low ears, pectus excavatum, webbed neck, intellectual disability
noonan syndrome
how to tx noonan syndrome
GH
short trunk dwarfism, mostly affects spine
spondyloepiphyseal dysplasia
