endocrine and diabetes Flashcards
factors influencing height
age sex race nutrition parental heights puberty skeletal maturity general health chronic disease specific growth disorders socio-economic status emotional well-being
assessment tools for child development
- height/ length/ weight
- growth charts and plotting
- MPH and target centiles
- growth velocity
- bone age
- pubertal assessment
growth disorders - indications for referral
- extreme short or tall stature
- height below target height
- abnormal height velocity
- history of chronic disease
- obvious dysmorphic syndrome
- early/ late puberty
pathological causes of short stature
- undernutrition
- chronic illness (JCA, IBD, coeliac)
- iatrogenic (steroids)
- psychological and social
- hormonal (GHD, hypothyroidism)
- syndromes (turners)
investigations into short stature
- FBC and ferritin
- U&E, LFT, Ca, CRP
- coeliac serology and IgA
- IGF-1, TFT, prolactin, cortisol
- karyotype
coeliac investigations paeds
- FBC
- ferritin
- coeliac serology
- IgA
what factors are included in Tanner method of staging puberty - female
- breast development
- genital development
- pubic hair
- axillary hair
define early puberty boys
<9
define delayed puberty boys
> 14
define early puberty girls
<8
define delayed puberty girls
> 13
Constitutional delay of growth and puberty
temporary delay in the skeletal growth and thus height of a child with no physical abnormalities causing the delay
causes of early breast development (hypothalamic activation)
- infantile thelarche
- thelarche varient
- central precocious puberty
causes of early secondary sexual characteristics
- exaggerated adrenarche
- precocious pseudopuberty (e.g. congenital adrenal hyperplasia)
causes of precocious pseudopuberty
- abnormal sex steroid hormone secretion
- gonadotrophin indépendant
need to exclude congenital adrenal hyperplasia
