Child growth and development Flashcards
1
Q
Purpose of growth measurement
A
- poor growth in infancy is associated with high childhood morbidity and mortality
- best indicator of health
- identify disorders of growth
- assess obesity
- demonstration of normality of growth by age and stage of puberty
2
Q
Centile chart
A
Express variation within the population
- head circumference
- weight
- height/length
- leg length
- BMI
- growth velocity
- specialist charts
3
Q
Height centiles
A
Express how many people in the population are at a particular height at any age
4
Q
Height velocity calculation
A
(height now-height last visit)/(age now-age last visit)
- expressed in cm/year
- interval ~6 months
5
Q
Endocrine growth control
A
- GH-IGF-1 axis regulator of human linear growth
- GH single chain polypeptide
- Somatotroph cells of anterior pituitary gland
- pulsatile secretion (influenced by nutrition, sleep, exercise and stress)
6
Q
Antenatal phase
A
- most rapid phase of growth
- maternal health and placenta=important factors
7
Q
Infancy
A
- rapid initial growth (~23-25cm in first year)
- continuation of fetal growth
- nutritionally dependent
- 9-12 months GH influence
8
Q
Childhood
A
- post infancy to adolescence
- growth rates in boys and girls similar
- GH/IGF-1 axis drives growth
- nutrition less impact
9
Q
Stopping growth
A
- bones mature and epiphyses fuse at the end of puberty
- final part of growth occurs in spine and final epiphyses to fuse are in the pelvis
10
Q
Short stature causes
A
- genetic
- pubertal and growth delay
- IUGR/SGA
- dysmorphic syndromes
- endocrine disorders
- chronic paediatric disease
- psychosocial deprivation
11
Q
Abnormal growth despite normal hormones
A
SYNDROMES
- Turner syndrome
- Down syndrome
- Skeletal dysplasia
12
Q
Chronic paediatric diseases
A
- asthma
- sickle cell disease
- juvenile chronic arthritis
- cystic fibrosis
- renal failure
- congenital heart disease
- inflammatory bowel disease (Crohn’s and Coeliac)
13
Q
Causes of tall stature
A
- tall parents
- early puberty
- syndromes (eg: Marfans)
- GH excess
14
Q
Obesity complications
A
- T2DM
- orthopaedic problems
- polycystic ovarian disease
- cardiovascular risk
- psychological problems
- cancer
- respiratory difficulties
15
Q
Genetics of weight
A
- polygenic inheritance
- weight highly heritable trait (40-70%)
- monogenic obesity syndromes are rare
- Leptin deficiency
- Leptin receptor deficiency
- POMC deficiency
- PC-1 deficiency
- MC4R deficiency
