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Block 3 Week 7 > Eckert Endocrine Growth > Flashcards

Eckert Endocrine Growth Flashcards

1
Q

If you go into liver failure will you grow? whY?

A

no

you need IGF-1 and IGF-BPI to grow which is made in the liver

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2
Q

The direct effect of GH is negligible compared to IGF-1. T or F

A

T

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3
Q

In a prenatal child, what makes you grow the most?

A

IGF-I and nutrition/maternal factors

GH and T4 have minor effects

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4
Q

How much does a prenatal child grow a week?

A

1.2-2.5 cm/week with peak at midgestation

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5
Q

How much does an infant and toddler grow per year and what affects the growth the most?

A

15-25cm

nutrition and GH/T4

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6
Q

Between what years is rechanneling common?

A

Between birth and 3 years

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7
Q

What affects the growth the most in childhood?

How much does a child grow in a year?

A

Hormones, genetics, and nutrition

5-7 cm a year

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8
Q

What affects growth the most during puberty?

How much does a child grow in a year?

A

hormones

up to 15 cm/year

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9
Q

When you measure a baby how do you do it?

A

measure length in less than 2 year olds,

measure height after 2 year olds

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10
Q

How do you know a baby is growing irregularly?

A

if it is growing more than 2 SDs in variation from normal growth velocity

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11
Q

What hormones are involved in normal growth?

A

growth hormones, thyroid hormones, cortisol, pubertal hormones

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12
Q

What are factors involved in normal growth?

A 
hormones
nutrition
GI abnormalities
Genetics
Environment
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13
Q 
What are these important for:
FAS, drug exposure
ADD and meds
Steroids – inhaled and oral
“Stress”
A

environmental factors influencing normal growth

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14
Q

Not getting enough calories or getting the wrong calories can stunt growth, so can (blank) due to stress.

A

psychosocial dwarfism

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15
Q

Usually height is determined by genetics of (blank)

A

Same sex parent

I.e. tall dad, tall son

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16
Q

how do you predict height of males and females?

Is this a good predictor of height?

A

Females-> take Moms heigh + (fathers height-13)/2
Males-> take moms height add 13 plus dads height/2
Plot MPH in percentile
Yes

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17
Q

On a growth chart, if weight is more affected than height then what is the problem?

A

Problems with GI, nutrition, renal, metabolic, CF

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18
Q

On a growth chart, if height is more affected then weight then what is the problem?

A

Problem with endocrine/syndromic, renal, metabolic

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19
Q

What do growth charts tell you?

A

height, weight, and OFC (occipital frontal circumference)

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20
Q

Is head growth (OFC) affected by hormone deficiencies?

What is it most affected by?

A

no surprisingly

neurologic/genetic (most likely not endocrine)

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21
Q

When should you start evaluating growth by bone age and what is this useful for?

A

not until 3 years

helpful for determining height potential

22
Q

How many times should you take a height measurement?

A

3 times and then average

23
Q

If someone is small but growth velocity is normal for prepuberty and bone age combined with height yield a normal predicted height but the bone age is 2 years behind then the problem is most likely (blank)

A

constitutional delay of growth and puberty

24
Q

Is consititutional delay more common in males or females?

A

males

25
Q

Describe constitutional delay of growth and puberty

A 
relative short stature
normal predictive value
normal growth velocity (pre-pubertal)
delayed puberty (after 14 years)
Bone age is 2 years behind or more
i.e growing normally then flat line=delay of growth
26
Q

What are some things that can cause short stature?

A

medications (ADD, steroids)
Gi issues (celiac, nutrtition, IBD)
Hypothyroidism, pituitary problems, adrenal problems, kallman syndrome

27
Q

What syndromes can lead to short stature?

A

turner, noonan, russel-silver, cushings syndrome, kallman syndrome

28
Q

If bone is different than actual age we can predict (blank)

A

hypothyroidism

29
Q

What are these for:
Bone Age***
CMP, CBC, TSH, fT4, IGF-1, IGF-BP-3,karyotype in girls, ESR, celiac panel (tTg IGA, total IgA), gonadotropins, estradiol/testosterone
If indicated ACTH, cortisol, salivary cortisol
If hormone deficiency present, MRI pituitary
GH stimulation testing - controversial

A

Growth evaluation

30
Q

If gonadotropins are high in females then what is most likely the cause?

A

turners syndrome

31
Q

Is cushings syndrome prevalent in children?

A

no it is rare

32
Q 
What does this cause:
Most common isolated deficiency
IGF-1, BP-3 low
Growth velocity slow
Bone age delay
Hypoglycemia, fatigue, slow mentation
A

growth hormone deficiency

33
Q

If you aren’t doing well nutritionally what will your IGF 1 and BP3 levels be like?

A

IGF1 will be low and your BP3 will be normal

34
Q

If you have growth hormone deficiency what will your IGF 1 and BP3 levels be like?

A

both will be low

35
Q

If an infant has hypoglycemia, then this is a sign they will have (blank)

A

growth hormone defiency

36
Q

When growth velocity is normal and bone age combined with height yield a normal predicted height, most likely is (blank)

A

constitutional delay of growth and puberty

37
Q

what can a single central incisor be indicative of in an infant?

A

GH deficiency

38
Q

What does this indicate:
Hx neonatal hypoglycemia, jaundice, microphallus
Poor growth, delayed puberty
Fatigue, constipation, polyuria, polydipsia
Developmental Delay
+/- Appetite, sleeping issues
Diabetes insipidus
May be associated with septo-optic dysplasia, midline defects, single central incisor
Low free T4 (nl TSH), adrenal function tests, osmolality, low IGF-1, BP-3

A

hypopituitarism

39
Q

If you have a short female, with some cardiac or kidney abnormalities, has hypothyroidism, celiacs, or diabetes, what should you think is the cause?

A

turner syndrome

40
Q

Why do people with turner syndromes often have problems?

A

because autoimmune disorders are higher in these populations than normal

41
Q

People with turner syndrome lack (blank) but you can give them some growth hormone to help with their lack of growth

A

estrogen

42
Q

What is this indicative of:
Short stature, macrocephaly, micrognathia (undersized jaw), asymmetric limbs, precocious puberty, scoliosis, Failure to thrive, hypoglycemia as infant.

A

Russell-Silver syndrome

43
Q

How do you treat Russell-Silver Syndrome?

A

with growth hormone, high calorie foods, and appetite stimulus

44
Q

What is this:
“male Turner” right sided cardiac defects, neck webbing, hypogonadism
This runs in the family

A

Noonas syndrome

45
Q

What is this:

Failure to thrive, hypotonia as infant, excessive weight gain after 1st year of life

A

Prader-Willi Syndrome

46
Q

What is this:
rare, can be caused by steroid use, short stature, rapid weight gain, buffalo hump, striae, hypertension, delayed puberty

A

Cushings syndrome

47
Q

How do you test for cushings syndrome?

A

salivary cortisol, AM cortisol, ACTH, 24 hours urine for free cortisol, dexamethasone suppression test

48
Q

What should you do if you have patients with any of these:
Unexplained neonatal hypoglycemia, jaundice, microphallus
Early signs of hypopituitarism, including GHD
Unexplained, abnormally slow or fast growth
Persistent growth velocity 95th% for age
Extreme short stature (>2.5 SD) (or extreme tall)
Growth pattern and prognosis at variance with family
Height projection differs significantly from MPH
Detection of abnormal body proportion

A

Refer them!

49
Q

Arm span should be within (blank) of your height, if it isnt, deenotes a growth problem

A

2 cm

50
Q

If someone has high stature what could the caues be?

A 
GH tumor
Marfans
Sotos syndrome
Klinefelters
hyperthryoidism
obesity
precocoious puberty
51
Q

If you have flat-lined height at a certain point but increasing weight, what does this indicate?

A

indicates obesity

Block 3 Week 7 (8 decks)

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