[CLMD] Pediatric Endocrine

Question 1

For growth curves, what do you need to remember to take accurate measurements?

Answer 1

At certain ages, the criteria for measuring turns from

Supine to Standing

*Remember to check this on your growth curves!!!

Question 2

What are the BMI values for:

Underweight

Normal

Overweight

Obese

Answer 2

BMI < 18.5 = Underweight

BMI 18.5-24.5 = Normal

BMI 25-29.9 = Overweight

BMI > or equal to 30 = Obese

Question 3

What is the best rule to follow for school age children for appropirate growth pattern?

Answer 3

6 years old to puberty

At least 5cm/year (2inches)

Question 4

When growth parameters are affected

What should you think of when weight falls off the curve?

Answer 4

Most likely NUTRITION

• Not enough in (emesis, no food)
• Not enough absorbed (mal-absorptive conditions)
• Higher than average caloric requirements

Question 5

When growth parameters are affected

What should you think of when length falls off the curve?

Answer 5

Think ENDOCRINE

• GH deficiency
• Hypothyroidism
• Cushing’s syndrome

Question 6

When growth parameters are affected

What should you think of when head circumference falls off the curve?

Answer 6

Primary failure of the brain to grow

Severe craniosynostosis

Question 7

What does bone age estimate?

Answer 7

Rough estimate of a child’s skeletal maturation by assessing the ossification of the epiphyseal centers

Helps estimate a child’s GROWTH POTENTIAL

Question 8

When is bone age considered delayed?

Answer 8

2 standard deviations below the chonologic age

Question 9

What is the best way to determine abnormal growth in a pediatric patient?

Answer 9

HISTORY AND PHYSICAL

Question 10

When does a catch-down growth pattern typically occur?

Answer 10

First 18 months of life

Often occurs as more table food is introduced

Question 11

What makes a growth curve more meaningful?

Answer 11

MORE POINTS ON IT

Question 12

When measuring length for a growth curve in a child that is less than 36 months of age, how do you measure them?

Answer 12

Supine

Question 13

When measuring length for a growth curve in a child that is older than 24 months, how do you measure them?

Answer 13

Standing up (stature)

Question 14

What is defined as short stature?

Answer 14

Height is 2 standard deviations below mean height for age and sex (<3%ile)

OR

Height is more than 2 standard deviations below the mid-parental height

Question 15

What is the most important initial work up value for assessing short stature?

Answer 15

IGF and IGFBP-3 levels

Question 16

What labs should you check for turner syndrome?

Answer 16

With delayed puberty/short stature in females…

ALWAYS CHECK A KARYOTYPE

Question 17

What are the standards for previvious puberty in girls? boys?

Answer 17

Girls = 8 y/o

Boys = 9 y/o

Question 18

What is the definition of prevocious puberty?

Answer 18

Full activation of the HPG axis before the age of 8 in girls and 9 in boys

Question 19

When should you consider precocious puberty in girls?

Answer 19

• Progessive breast development
• Crossing major percentile lines upward on the linear growth chart

Question 20

When should you consider precocious puberty in boys?

Answer 20

• Evidence of both testicular and penile enlargement
• Crossing major percentile lines upward on linear growth chart