Evaluation of Worrisome Growth Flashcards
What parameters define worrisome growth for height?
2nd percentile (roughly 2 SD below average for age and gender) or 3.5 inches shorter than mid-parental height
Kids usually grow about ________ cm in the first year of life.
25
From year one to four, kids grow about ______ cm/year.
10
Arguably the most important metric in evaluating a child’s growth is _____________.
a history of past points; for instance, you could have a kid who’s at the 2nd percentile, but that is less worrisome if he or she has been at the 2nd percentile for their entire life (as opposed to if they were at the 15th percentile during their last visit)
Delayed bone ages predict _____________.
greater eventual height
How can bone age help in the evaluation of growth?
Bone age that is younger than actual age is indicative of future growth, while bone age older than actual age predicts less future growth.
When does the fall in growth in familial short stature occur?
Usually between 6 months and 18 months; decreases in growth after “the first couple years of life” is worrisome for other causes of short stature
Constitutional growth delay is familiarly called _____________.
being a late bloomer –falling off the growth curve before 2-3 years of age, then paralleling it until puberty when some height is then regained
Constitutional growth delay is a ____________ trait.
polygenic (60% - 80% will have a family member with short stature)
The term “failure to thrive” should only be used for _-_______________.
kids younger than 2 years
What is nutritional growth retardation?
Linear growth stunting from poor weight gain in children over 2 years
Hormonal causes of worrisome growth generally affect ____________.
height (not weight)
Many features of ____________ that are present in adults are not present in kids. Often the only sign is poor growth.
hypothyroidism
Congenital growth hormone deficiency results in _________________.
- holoprosencephaly
- cleft lip
- septo-optic dysplasia
- optic nerve hypoplasia
- empty sella syndrome
_____________ can present on a spectrum, with a range of severity.
Growth hormone deficiency
What can cause acquired growth hormone deficiency?
Trauma Infection Hypophysitis Neoplasm Radiation
Face immature for age, increased truncal fat, and prominent frontal bossing are suggestive of ____________________.
growth hormone deficiency
Why is it important to pay attention to a child’s growth?
Because deficient growth may be the first sign of an underlying illness and a missed diagnosis may result in permanently limited growth
What percent of kids will fall within 3.5 inches of the mid-parental height prediction?
97%
What should be offered to parents of children with constitutional growth delay?
Generally just reassurance, but you can give testosterone to boys or estrogen to girls to delay puberty (so that the bones can continue to grow)
The most common cause of failure to thrive is ________________.
psychosocial factors
What defines failure to thrive?
Falling across two major percentile lines before age two or falling to less than 3rd percentile before age two
What two things stimulate growth hormone?
Clonidine and arginine
What is Noonan syndrome?
Abnormal post-GH-receptor signaling
What is true of kids born SGA?
Most catch up before age two
GH is FDA-approved for SGA kids who have ______________.
not caught up to normal by age two
Giving GH to those who are not GH deficient ______________.
does not produce dramatic results
Side effects of GH include _______________.
SCFE, pseudotumor cerebri, and unknown long-term risks
