Growth Flashcards
What does standard deviation measure?
Measure of variability
What is the z score?
This is the standard deviation score - it is the number of standard deviations that a child is away from the mean.
What percentage of people are within one standard deviation from the mean?
68%
What percentage of people are within 2 standard deviations of the mean?
95%
How far apart are the centile lines spaced on a growth chart?
2/3 of a standard deviation - this gives a practicle sequence to the lines
What factors will demonstrate if a child has normal growth?
If their measurements are within the normal range compared with a child of their age
If their rate of growth is within a normal range when compared to a child of their age
What is the average age for a girl to enter puberty?
11 years
What is the average age for a boy to enter puberty?
11.5 years
What are the gonadotrophins?
LH and FSH
What are the signs of puberty in poys?
Testicular volume >4ml
Size of genetalia
Presence of genital hair
What are the signs of puberty in girls?
Breast development
Presence of pubic hair
Puberty below which age is considered precocious?
<8 in females
<9 in males
Puberty above which age is considered delayed?
> 13 in females
>14 in males
What are the reasons for the height difference between men and women?
Boys have delayed peak height velocity as their growth spurt occurs later in puberty.
The peak height velocity for boys is higher than that of girls
Boys are taller prepuberty
What is mid-parental height?
The mid-parental height is a child’s projected adult height based on the heights of the parents: in girls, the father’s height minus 13 cm (5 in) is averaged with the mother’s height; in boys, the mother’s height plus 13 cm is averaged with the father’s height
This is correctd for 90% of children
What tests can we do if we suspect a growth problem?
Bloods - gonadotrophins; growth factors; testosterone/oestradiol; thyroid function
Karyotyping
Bone Age
Dynamic Function Tests - e.g. to measure growth hormone
MRI brain scan
USS uterus
What is the purpose of a bone age scan?
This is performed of the non-dominant wrist can be useful for reassuring parents
e.g. children aged 10 who have a bone age of 7 still have 3 years of catch up growth on their peers .˙. they will catch up in time
What is genetic short stature?
The parents are short .˙. the child is short
What is constitutional growth delay?
Bone age is delayed
This is a diagnosis of exclusion
We don’t know the cause
What are dysmorphic syndromes?
Conditions such as downs syndrome and turners syndrome
These make a child grow differently and have their own specific growth charts
Why may psychosocial impact have an impact on growth?
This is multifactorial. Children with poor nutrition or if they are unloved do not grow as well
Why may psychosocial impact have an impact on growth?
This is multifactorial. Children with poor nutrition or if they are unloved do not grow as well
