Growth

Question 1

What does standard deviation measure?

Answer 1

Measure of variability

Question 2

What is the z score?

Answer 2

This is the standard deviation score - it is the number of standard deviations that a child is away from the mean.

Question 3

What percentage of people are within one standard deviation from the mean?

Answer 3

68%

Question 4

What percentage of people are within 2 standard deviations of the mean?

Answer 4

95%

Question 5

How far apart are the centile lines spaced on a growth chart?

Answer 5

2/3 of a standard deviation - this gives a practicle sequence to the lines

Question 6

What factors will demonstrate if a child has normal growth?

Answer 6

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

Question 7

What is the average age for a girl to enter puberty?

Answer 7

11 years

Question 8

What is the average age for a boy to enter puberty?

Answer 8

11.5 years

Question 9

What are the gonadotrophins?

Answer 9

LH and FSH

Question 10

What are the signs of puberty in poys?

Answer 10

Testicular volume >4ml
Size of genetalia
Presence of genital hair

Question 11

What are the signs of puberty in girls?

Answer 11

Breast development

Presence of pubic hair

Question 12

Puberty below which age is considered precocious?

Answer 12

<8 in females

<9 in males

Question 13

Puberty above which age is considered delayed?

Answer 13

> 13 in females

>14 in males

Question 14

What are the reasons for the height difference between men and women?

Answer 14

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

Question 15

What is mid-parental height?

Answer 15

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

Question 16

What tests can we do if we suspect a growth problem?

Answer 16

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

Question 17

What is the purpose of a bone age scan?

Answer 17

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

Question 18

What is genetic short stature?

Answer 18

The parents are short .˙. the child is short

Question 19

What is constitutional growth delay?

Answer 19

Bone age is delayed
This is a diagnosis of exclusion
We don’t know the cause

Question 20

What are dysmorphic syndromes?

Answer 20

Conditions such as downs syndrome and turners syndrome

These make a child grow differently and have their own specific growth charts

Question 21

Why may psychosocial impact have an impact on growth?

Answer 21

This is multifactorial. Children with poor nutrition or if they are unloved do not grow as well

Question 22

Why may psychosocial impact have an impact on growth?

Answer 22

This is multifactorial. Children with poor nutrition or if they are unloved do not grow as well