Child & Health (growth abnormalities) Flashcards
A child shows normal growth if..
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
T or F: Babies should be weighed without clothes or nappy
True
How are children older than 2 years weighed?
In vests and pants, but no footwear
No dolls in hands
Only _________ scales in _____ setting should be used when weighing children
Only class III clinical electronic scales in metric setting should be used when weighing children
How is head circumference measured?
Using a narrow plastic or disposable paper tape
Head circumference should be measured where the circumference is at its..
Widest
When is length measured? What is being used to measure length?
Before 2 years of age with length board/mat
T or F: Length is measured with nappies but no footwear
False. Without nappies or footwear
When is height measured? What is being used to measure height?
Height should be measured from 2 years using rigid rule with T piece, or stadiometer
T or F: When plotting the chart, use points and do not join dots
True
What is the most common error of plotting mistakes?
Age errors - use calendar or age wheel to calculate age (age in week for first 6-12 months, calendar months thereafter)
A child is ‘on the X centile’ if the point is exactly on the….
Centile line or within 1/4 of a space of the centile line, otherwise child is ‘between centile X and Y’
What is a centile space?
Distance between two centile lines
Falls and rises in plotting should be expressed as…
Multiples of centile spaces (e.g. a fall through 2 1/2 centile spaces
Onset of female puberty is indicated by..
Development of breast buds
Onset of male puberty is indicated by…
Increase in testicular volume
What is the average age of girls and boys entering puberty?
Girls: 11 years
Boys: 6 months later
What are gonadotrophins?
FSH and LH
Which tool is used for staging puberty?
Tanner staging
What is true central precocious puberty?
Normal pubertal development occurring abnormally early - <8 years for girls, <9 years for boys
T or F: True central precocious puberty more common in girls than boys
True
What is pubertal delay?
Absence of secondary sexual development in a girl age 13 or boy age 14
T or F: Pubertal delay is more common in girls than boys
False. More common in boys than girls
Average height difference between adult men and women is ________
12.5-14 cm
Why is there a different in average height between men and women?
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
What information would you collect when taking a history of a suspected growth abnormality?
ICE
Birth
PMH
Pubertal symptoms
FH - parental heights, parental puberty, mid-parental height
What would you examine when suspecting a growth abnormality?
Height, weight, height velocity
Signs suggestive of pathology
Pubertal status
Which tests would you carry out when suspecting a growth abnormality?
Bloods – gonadotrophins, growth factors, testosterone/oestradiol, thyroid, karyotype, other pathology
Bone age
Dynamic function tests
MRI brain, USS uterus
Define short stature
Less than 2nd centile or > 2SDs below mid-parental height
What are the causes of short stature?
Genetic short stature
Constitutional growth delay
Dysmorphic syndromes
Endocrine disorders
Chronic diseases
Psychosocial deprivation
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
Pubertal assessment
Mid-parental centile
A female/male patient is considered in puberty or completing puberty if..
They are BELOW the 0.4th centile and should be referred for further investigation.
If a female/male patient is pre-pubertal, then they are..
Generally growing normally but should be compared to their mid-parental centile
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..
Puberty is delayed and further assessment is indicated
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
Pubertal assessment
Mid-parental centile
