Case presentations and growth hormone axis [027] Flashcards
2- A five year old boy is coming for routine annual checkup. His weight is 28kg and height 106cm.
Assess the growth (weight, height, BMI) of this boy
Answer: The boy’s weight is above the 97 th centile, the height is between the 25th and 50 th and his BMI is high (24.9) which is above the 97 th centile, this indicates that he is morbid obese for age (obese is diagnosed when BMI is between the 85th and 95 th centiles and morbid obese is diagnosed when BMI is above the 95th centile).
z-score: Weight : > +3 SDS , height: - 1 SDS
BMI: 24.9 : > +3 SDS
3- A mother is coming for scheduled vaccination of her two month old baby girl.
After assessing the child, it was found that her weight is 4kg. Assess the centile of her weight. Explain to the mother what does it mean?
Answer: her weight is on the 25 th centile which is normal. This means that 25% of 2 month old infants are below 4 Kg and 75% are above it.
z-score: weight : -2 SDS
- A sixteen year old girl comes to the nutrition department accompanied by her mother. The mother states that her daughter is not eating well lately. Her height is 1.65meter and weight is 47kg. Assess the growth (weight, height, BMI) of this girl.
Her height is normal since she is between the 75 th and 90th centile range. Her weight for age is on the 10 th centile so she has normal weight, but as per her BMI= 17.26, she is underweight.
z-score height: between 0 and +1 SDS
BMI; 17.2: between -1 and -2 SDS
5- A mother brought her eight month old girl to the outpatient clinic. She told the doctor that she feels that her daughter head is large for girls in her age. You measured the head circumference and it was 43 cm.
Is the mother‘s concern justified? Explain to the mother your findings.
Answer: her head circumference is on the 50 th centile (normal) and this means it is the median and 50% of infants that age have head circumference are below that and 50% are above that value.
z-score: HC is between 0 and -1 SDS
A twelve year old boy presents to you in the clinic. His height is 157cm. His mother claims that all family members on both sides of the parents are tall. When his older brother was his age, he was much taller. His mother height is 165cm and the father height is 170cm.
After consultation with you, she also asks if he is within his parents’ height. Calculate his target centile range and comment if he is within that range.
Answer: His height is on the 75 th centile which is normal
Mean parental height= maternal height + paternal height /2 ± 7 (plus for boy and minus for a girl) =(165+170)/2+ 7=174 cm
Target centile range= Mean parental height ± 12 = (= 174-12= 162 and 174+12=186
The target centile range is between 162-186cm which is between the 5 th and 90th centile. Since he is within his parents’ range (he his 75 th centile), so you should reassure his parents.
