endo

Question 1

A 12 year old boy is reviewed in the paediatric endocrine clinic because of short stature. He otherwise well and examination is unremarkable. His growth chart is shown below.

What are the three phases of growth?

Answer 1

1. infantile phase; from conception to 2yrs
2. childhood phase; from 2yrs to adolescence
3. pubertal phase; from adolescence until final height

Question 2

What are the two main drivers of the childhood phase of growth?

Answer 2

growth hormone and thyroxine

Question 3

His father’s height is 175cm, his mother’s height is 155cm. What is his mid-parental height centile?

Answer 3

(remember to add the correction factor 12.5cm to mother’s height before averaging the two values and plotting on the growth chart)

Question 4

Is his height at 12yrs within the mid-parental target range?

Answer 4

no

Question 5

What does his growth chart show?

Answer 5

growth failure, reducing height velocity

Question 6

Growth failure due to growth hormone deficiency is rare. It may be congenital (& associated with midline defects such as absent septum pellucidum, Septo-optic dysplasia, holoprosencephaly, cleft palate, single central incisor) or acquired.

Name one cause of acquired growth hormone deficiency

Answer 6

1. craniopharyngioma
2. head injury
3. cranial radiotherapy