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1 Paediatrics > Endocrinology and growth > Flashcards

Endocrinology and growth Flashcards

1
Q

What are the three phases of normal growth and puberty?

A

Infantile phase
Childhood
Puberty

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2
Q

At what age does the childhood phase begin and end?

A

from 2 years until adolescent growth spurt

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3
Q

When is the average peak of growth spurt in girls?

A

12

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4
Q

When is the average peak of growth spurt in boys?

A

14

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5
Q

Which phase is thyroxine and GH dependent?

A

Childhood phase (infantile phase is non dependent on these)

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6
Q

Which hormone stimulates growth hormone?

A

Oestrogen (Aromatised from testosterone)

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7
Q

Does oestrogen stimulate GH in both sexes?

A

yes!!

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8
Q

Which hormone stimulates the fusion of epiphyses?

A

oestrogen

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9
Q

List three causes of short stature

A

NIDSCED
Normal genetic short stature
Intrauterine growth retardation (alcohol)
Dysmorphic syndrome (down’s, turner’s)
Skeletal dysplasias- achondroplasia
Chronic systemic disease (IBD, CF, sever asthma, CKD)
Endocrine disorder
Dire social circumstances (psycholoigcal)
+Constitutional delay (looks young and short for age)

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10
Q

How can causes of failure to thrive/weight faltering be divided?

A

organic and non-organic

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11
Q

Name a non-organic cause of failure to thrive

A

nutritional, pyschological

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12
Q

Name two causes of weight faltering

A

malabsorption (coeliac disease)
cardiac
resp
renal insufficiencies

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13
Q

What is the cause of growth failure?

A

GH deficiency

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14
Q

Early puberty is most commonly associated with which sex?

A

females

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15
Q

Delayed puberty is most commonly associated with which sex?

A

males

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16
Q

Which tumour can cause GH deficiency?

A

craniopharyngioma

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17
Q

Name a syndrome that causes delayed puberty

A

Kallman’s syndrome

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18
Q

Name one cause of primary ovarian failure

A

Turner’s and total body irradiation (prior to bone marrow transplant for leukaemia)

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19
Q

Name two causes of primary testicular failure?

A

klinefelter’s syndrome, after TB infection, following surgery for cryptorchidism (undescended testes)

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20
Q

What are the levels of FSH and LH in primary gonadal failure?

A

elevated

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21
Q

What is the most common cause of hyperthyroidism in childhood and adolescence?

A

grave’s disease

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22
Q

Is grave’s disease more common in children or adults?

A

rare in children however more severe

23
Q

Name one congenital cause of hypothyroisidm?

A

thyroid dysgenesis

24
Q

Name one acquired cause of hypothyroidism?

A

hashimoto’s thyroiditis

25
Q

What is the most common cause of acquired central insufficiency?

A

exogenous steroids

26
Q

Name four hormones synthesized in the anterior pituitary

A 
LH, FSH
TSH
ACTH
GH
Prolactin
27
Q

List two hormones stored by the posterior pituitary gland

A

ADH and oxytocin

produced in the hypothalamus but stored in pituitary

28
Q

Name three axis in endocrine system

A

thyroid, gonadal, growth hormone,adrenal, and posterior pituitary axis

29
Q

What is the most common cause of polyuria and polydipsia in preschool children?

A

habit drinking

30
Q

What is the cause of congenital diabetes insipidus?

A

deficient ADH

31
Q

What is a cause of acquired diabetes insipidus?

A

tumour- craniopharygioma

32
Q

Name autoimmune cause of poor growth?

A

hypothyroidism

33
Q

What is the effect of deficiency in T4 on growth and puberty?

A

stunts growth but doesn’t delay puberty

34
Q

Two investigations in patient with poor growth?

A 
thyroxine test
hand XR (growth potential)
35
Q

Aside from height and weight, what else is important to plot?

A

mid-parental height

36
Q

Is BMI stable in children?

A

no

37
Q

What is the first sign of puberty in girls and boys?

A 
breast enlargement
Testicular changes
(if GP patient says child is more sweaty and has acne, this does not indicate puberty)
38
Q

Which investigation must always be conducted in girls if concern for short stature?

A

karyotype- Turner’s syndrome= cause of short stature

39
Q

What is Tanner staging?

A

scale of physical development in children, adolescents and adults. The scale defines physical measurements of development based on external primary and secondary sex characteristics, such as the size of the breasts, genitals, testicular volume and development of pubic hair

40
Q

List three factors that influence childhood growth

A

Fetal- uterine environment
Infant- nutrition and thyroid hormones
Childhood- GH and thyroid hormone
Pubertal- testosterone and oestrogen

41
Q

Baby is born premature at 34 weeks. What is the gestational correction?

A

40-34= 6 weeks

42
Q

For how long do you continue to use the corrected gestational age on growth charts?

A

32-36 weeks for 1 year

<32 weeks for 2 years

43
Q

What is the normal weight loss in newborns?

A

<10% in the first 3-4 days

44
Q

At what point should newborn regain birthweight?

A

by 3 weeks

45
Q

Why do babies lose weight when they are born?

A

water loss

46
Q

How is faltering weight defined

A

2 or more centile spaces and birthweight between 9th and 91st centiles

47
Q

List three differential diagnoses for faltering weight

A
  1. Poor oral intake- (cleft palate, poor suck, CNS disorder)
  2. Malabsorption (CF, IBD)
  3. Increased metabolic state (cardiac failure, hyperthryoidism, malignancy, renal failure)
  4. Metabolic diseases
  5. Prenatal- maternal nutrition, smoking, toxins
  6. Non-organic: food aversion, family mental health, neglect…
48
Q

List three investigations for faltering weight

A

FBC, U+Es, CRP, anti-TTG (>9 months), TFT, ferritin, iron studies, urine MC&S

weight, height, OFHC
Feeding history
full developmental/clinical assessment

49
Q

Three differential diagnoses for macrocephaly?

A 
Hydrocephalus 
Raised intracranial blood volume
Megancephaly
Thickening of skull
Mass lesions
50
Q

What causes hydrocephalus?

A

increased CSF

51
Q

What can cause increased intracranial blood volume?

A

haemorrhage

arteriovenous malformation

52
Q

What can causes megancephaly?

A

=enlargement of brain parenchyma

NF1

53
Q

What can cause thickening of the skull?

A

bone marrow hyperplasia e.g. thalassemia major

primary bone disorders

54
Q

List two mass lesions that can cause macrocephaly?

A

intracranial cyst
tumour
abscess

1 Paediatrics (19 decks)

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