Clinical Growth and Development

Question 1

what is the tanner method of staging puberty?

Answer 1

B Breast development
G genital development
PH pubic hair
AH axillary hair
T testicles

Question 2

what is used to measure testicle growth?

Answer 2

prader orchidometer

Question 3

what are some non-modifiable factors influencing height?

Answer 3

> parental heights
> puberty
> race
> sex
> age
> skeletal maturity

Question 4

name some modifiable factors influencing growth

Answer 4

> emotional well being
nutrition
general health
socio-economic status

Question 5

true or false:

males have an earlier but smaller growth in height during puberty

Answer 5

false females do

Question 6

what is the earliest objective stage of puberty in boys?

Answer 6

onset of testicular growth

Question 7

what is the earliest objective stage of puberty in girls?

Answer 7

breast budding

Question 8

what would indicate referral was needed in abnormal growth and development?

Answer 8

> obvious dysmorphic syndrome
> extreme short/tall stature
> height below target
> abnormal height velocity
> history of chronic disease
> early/late puberty

Question 9

what can cause short stature?

Answer 9

> familial
> constitutional delay of growth
> pathological reasons
> psychosocial growth disturbance
> glucocorticoid excess

Question 10

what pathological reasons might there be for short stature?

Answer 10

> under nutrition
> chronic illness (coeliac)
> iatrogenic (steroids)
> psychological (and social)
> hormonal (hypothyroidism)
> syndromes (turner, noonans)

Question 11

what age would early puberty by in girls?

Answer 11

< 8yrs

Question 12

what age would late puberty be in girls?

Answer 12

> 13yrs

Question 13

what age would early puberty be in boys?

Answer 13

< 9 yrs

Question 14

what age would delayed puberty be in boys?

Answer 14

> 14yrs

Question 15

what can cause delayed puberty?

Answer 15

> cryptorchidism
> testicular irradiation
> gonadal dysgenesis
> chronic disease (asthma/crohn's)
> impaired HPG axis

Question 16

what can lead to impaired HPG axis?

Answer 16

> septo-optic dysplasia
kallmans syndrome
craniopharyngioma

Question 17

what can cause central precocious puberty?

Answer 17

boys:
> tumour

girls:
> idiopathic
> pituitary problems

Question 18

how may central precocious puberty present in girls?

Answer 18

> advanced bone age
growth spurt
breast development

Question 19

how may precocious puberty present in boys?

Answer 19

> testicular enlargement
advanced bone age
growth spurt

Question 20

how is central precocious puberty treated?

Answer 20

GnRH angonist

Question 21

what is precocious psuedopuberty?

Answer 21

> abnormal sex hormone secretion
gonadotropin independent
secondary sexual characteristics

Question 22

true or false:

obese and short is abnormal

Answer 22

true

Question 23

what syndromes can cause obesity?

Answer 23

> prader willi
Laurence moon biedl
pseudohypoparathyroidism
downs syndrome

Question 24

what endocrine problems can cause obesity?

Answer 24

> hypothyroidism
> GHD
> glucocorticoid excess
> hypothalamic lesion
> androgen excess
> insulinoma
> insulin resistance syndromes
> leptin deficiency

Question 25

what are the symptoms of diabetes in children?

Answer 25

> thirsty > thinner > tired > going to the toilet more frequently

Question 26

a child present with a history of thirst and tiredness. they have lost weight and have started wetting the bed again. what do you do?

Answer 26

> test their capillary blood glucose and do a urine dipstick | > if their [BG] <11mmol/l phone for an urgent same day appointment

Question 27

how may a child <5yrs present with diabetes?

Answer 27

``` > irritability > candidiasis > constipation > blurred vision > recurrent skin infection > behaviour change ```

Question 28

what at the symptoms of diabetic ketoacidosis?

Answer 28

``` > rapid deep respiration > sweet smelling breath > abdominal pain > nausea and vomiting > drowsiness > coma ```