Child & Health (growth abnormalities)

Question 1

A child shows normal growth if..

Answer 1

Their measurements are within the normal range compared with children of their age

Their rate of growth is within the normal range compared with children of their age

Question 2

T or F: Babies should be weighed without clothes or nappy

Answer 2

True

Question 3

How are children older than 2 years weighed?

Answer 3

In vests and pants, but no footwear
No dolls in hands

Question 4

Only _________ scales in _____ setting should be used when weighing children

Answer 4

Only class III clinical electronic scales in metric setting should be used when weighing children

Question 5

How is head circumference measured?

Answer 5

Using a narrow plastic or disposable paper tape

Question 6

Head circumference should be measured where the circumference is at its..

Answer 6

Widest

Question 7

When is length measured? What is being used to measure length?

Answer 7

Before 2 years of age with length board/mat

Question 8

T or F: Length is measured with nappies but no footwear

Answer 8

False. Without nappies or footwear

Question 9

When is height measured? What is being used to measure height?

Answer 9

Height should be measured from 2 years using rigid rule with T piece, or stadiometer

Question 10

T or F: When plotting the chart, use points and do not join dots

Answer 10

True

Question 11

What is the most common error of plotting mistakes?

Answer 11

Age errors - use calendar or age wheel to calculate age (age in week for first 6-12 months, calendar months thereafter)

Question 12

A child is ‘on the X centile’ if the point is exactly on the….

Answer 12

Centile line or within 1/4 of a space of the centile line, otherwise child is ‘between centile X and Y’

Question 13

What is a centile space?

Answer 13

Distance between two centile lines

Question 14

Falls and rises in plotting should be expressed as…

Answer 14

Multiples of centile spaces (e.g. a fall through 2 1/2 centile spaces

Question 15

Onset of female puberty is indicated by..

Answer 15

Development of breast buds

Question 16

Onset of male puberty is indicated by…

Answer 16

Increase in testicular volume

Question 17

What is the average age of girls and boys entering puberty?

Answer 17

Girls: 11 years
Boys: 6 months later

Question 18

What are gonadotrophins?

Answer 18

FSH and LH

Question 19

Which tool is used for staging puberty?

Answer 19

Tanner staging

Question 20

What is true central precocious puberty?

Answer 20

Normal pubertal development occurring abnormally early - <8 years for girls, <9 years for boys

Question 21

T or F: True central precocious puberty more common in girls than boys

Answer 21

True

Question 22

What is pubertal delay?

Answer 22

Absence of secondary sexual development in a girl age 13 or boy age 14

Question 23

T or F: Pubertal delay is more common in girls than boys

Answer 23

False. More common in boys than girls

Question 24

Average height difference between adult men and women is ________

Answer 24

12.5-14 cm

Question 25

Why is there a different in average height between men and women?

Answer 25

Boys have delayed PHV (peak height velocity)
Boys PHV (14 years) is greater than in girls (12 years) due to testosterone
Boys are taller pre-puberty

Question 26

What information would you collect when taking a history of a suspected growth abnormality?

Answer 26

ICE
Birth
PMH
Pubertal symptoms
FH - parental heights, parental puberty, mid-parental height

Question 27

What would you examine when suspecting a growth abnormality?

Answer 27

Height, weight, height velocity
Signs suggestive of pathology
Pubertal status

Question 28

Which tests would you carry out when suspecting a growth abnormality?

Answer 28

Bloods – gonadotrophins, growth factors, testosterone/oestradiol, thyroid, karyotype, other pathology
Bone age
Dynamic function tests
MRI brain, USS uterus

Question 29

Define short stature

Answer 29

Less than 2nd centile or > 2SDs below mid-parental height

Question 30

What are the causes of short stature?

Answer 30

Genetic short stature
Constitutional growth delay
Dysmorphic syndromes
Endocrine disorders
Chronic diseases
Psychosocial deprivation

Question 31

If a female patient is between 8-13 years old and is plotting within the shaded area of the chart for their height centile, ____________ and __________ is assessed

Answer 31

Pubertal assessment
Mid-parental centile

Question 32

A female/male patient is considered in puberty or completing puberty if..

Answer 32

They are BELOW the 0.4th centile and should be referred for further investigation.

Question 33

If a female/male patient is pre-pubertal, then they are..

Answer 33

Generally growing normally but should be compared to their mid-parental centile

Question 34

If there are no signs of puberty by 13 years of age in a female patients or 14 years of age in male patients, then..

Answer 34

Puberty is delayed and further assessment is indicated

Question 35

If a male patient is between 9-14 years old and is plotting within the shaded area of the chart for their height centile, ____________ and __________ is assessed

Answer 35

Pubertal assessment
Mid-parental centile