Clinical Flashcards
What are the most common reasons for large and small fetal birthweight?
Maternal diabetes is the most common cause of larger birth weight; although severe DM will lead to small birth weight. Above 90th percentile
Worldwide maternal malnutrition is the leading cause of small infants. GH resistance (laron syndrome), and insulin resistance also contribute to small birth weights. below the 5th percentile
How do you simply distinguish between familial short statute and constitutional delay on a growth chart?
FSS- small the whole time but they follow their curve and end up short like their parents.
CD- Below the curve on the chart, but then have a late growth spurt and end up at normal height.
Although precocious puberty may sound cool to a kid wanting breasts or facial hair what are the downsides?
Puberty triggers closure of the epiphyseal plates and prematurely stops growth.
How do you test for bone age?
Usually a scan of the left hand and examination of the epiphyseal plate.
Why are the criteria for short or tall stature below the 5th and above the 95th percentiles respectively?
This represents 2 SD in either direction as abnormal.
Pathologic short stature requires what criteria?
Height greater than 3.5 SD below the mean for chronologic age or greater than 2 SD for their target height based on parental height, and 2 SD for growth rate.
What are some common endocrine etiologies for short stature?
GH deficient, hypothyroid, cushings disease
When someone has familial short or tall statue what do you expect of their bone age? What about Constitutional ?
Normal for familial-their normal is just slower or faster than average
young, or advanced bone age for constitutional-growth is slower or faster but it will normalize
What are some non GH reasons for tall statue in youth?
Hyperthyroid, CAH, Precocious puberty
