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Pediatrics > Growth > Flashcards

Growth Flashcards

1
Q

Embryonic stage:

A

The first 8 weeks.

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2
Q

Fetal stage:

A

9th to the 40th weeks

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3
Q

Includes maximum rate of growth

A

Fetal stage:

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4
Q

Factors affecting fetal stage

A

Maternal and placental health and fetal insulin.

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5
Q

Neonates stage

A

first 4 weeks of life (28 days of life)

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6
Q

first 4 weeks of life (28 days of life)

A

neonates stage

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7
Q

Infancy stage

A

from one month to 2 years

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8
Q

Factors affecting the infacy stage

A

Nutrition, good health, thyroid hormone, happiness

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9
Q

factors affecting childhood

A

genes, growth hormone, thyroid hormone,
nutrition, good health and happiness,

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10
Q

Factors affecting Adolescence

A

Testosterone/Estrogen, growth hormone

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11
Q

Factors affecting physical growth

A
  1. Race:
  2. Family genes: Height and body frame are inherited from parents
  3. Sex: Girls grow faster from the 7th month to 4 years and start puberty at a younger age.
  4. Chromosomal disorders: (as Down syndrome): usually show retarded growth.
  5. Socioeconomic factors: Poor housing and hygiene and poor health
    can delay growth.
  6. Nutritional status: Under nutrition delays growth while over nutrition can lead to obesity.
  7. Chronic illness: Renal, liver, chest diseases, cardiac and GIT.
  8. Developmental anomalies: as cleft palate, pyloric stenosis and renal anomalies.
  9. Chronic infection: e.g. Tuberculosis and brucellosis.
  10. Endocrinal factors: Growth hormone, Thyroid hormone, androgens, adrenal cortisol, excess steroids

4 مليش دعوه بيهم
4 امراض
2 nutrition

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12
Q

Growth hormone: deficiency causes

A

proportionate — short stature, normal mentality and characteristic features

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13
Q

Thyroid hormone deficiency causes……

A

disproportionate short stature, mental retardation and coarse face in infants and children with congenital hypothyroidism (Cretinism).

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14
Q

acquired hypothyrodism causes

A

Proportionate short stature in children

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15
Q

effect of androgen on physical activity

A

Excess androgens cause tall stature as a child but proportionate short stature later as an adult.

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16
Q

Adrenal cortisol: deficiency causes

A

failure to thrive and asthenia

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17
Q

Excess steroids whether endogenous or exogenous causes

A

short stature with characteristic obesity (Cushing syndrome).

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18
Q

normal birth weight

A

3 Kg (Normal from 2.5 to 4 Kg).

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19
Q

W at 4 months

A

6 Kg

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20
Q

W at 8 moths

A

8

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21
Q

W at 12 months

A

9 Kg

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22
Q

W at 2 years

A

12 Kg

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23
Q

W at 6 years

A

20Kg

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24
Q

w at 10 years

A

30 Kg

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25
Q

Length at Birth

A

50 cm

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26
Q

length at 1 year

A

75 cm

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27
Q

length at 4 years

A

100 cm

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28
Q

Head circumference at birth

A

35 cm

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29
Q

Head circumference 1 year

A

47 cm

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30
Q

Head circumference 12 years

A

53 cm

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31
Q

Anterior Fontanelle at birth

A

3 fingers

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32
Q

Anterior Fontanelle 6 months

A

2 fingers

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33
Q

Anterior Fontanelle 1 year

A

1 finger

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34
Q

Anterior Fontanelle closed at

A

1.5 years

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35
Q

motor dev

A

3m: head support
6m: sits without support
9m: crawling
12m: walks

36
Q

head support

A

3m

37
Q

sits without support

A

6m

38
Q

crawling

A

9 month

39
Q

walks unsteady

A

12

40
Q

rolling over

A

8 months

41
Q

pushing with feet

A

4 months

42
Q

walks steady

A

15 months

43
Q

stands

A

11 months

44
Q

turn head from side to side

A

at birth

45
Q

Ascends stairs in an adult manner

A

3 years

46
Q

can pedal tricycle

A

3 years

47
Q

Descends stairs in an adult manner

A

4 years

48
Q

Can hop on one feet

A

5 years

49
Q

Ascends stairs in a child manner

A

18 m

50
Q

runs stiffly

A

18m

51
Q

Descends stairs in a child manner

A

2 years

52
Q

runs well

A

2 years

53
Q

palmer grasp

A

6 months

54
Q

transfer objects

A

7 months

55
Q

Immature pincer grasp

A

10 months

56
Q

mature pincer grasp

A

12 months

57
Q

tower of 3
tower of 6
tower of 8

A

18 mon
2 years
2.5 years

58
Q

Follows moving objects or light

A

1 month

59
Q

Smiles on social contact

A

2 months

60
Q

Recognizes his mother

A

4 months

61
Q

draw a shape and its age

A

line 2 years
cicrle 3 years
square 4 years
triangle 5 years

62
Q

Follows moving objects or light

A

1 month

63
Q

Laughs and prefers social contact

A

6 months

64
Q

babbling

A

8 months

65
Q

Responds to own name

A

9 months

66
Q

Says Mama, Dada

A

9 months

67
Q

Waves bye — bye

A

12 months

68
Q

Says only 2-3 words

A

1 year

68
Q

Says about 10 words

A

1.5 years

69
Q

Knows about 100 words

A

2 years

70
Q

Shows 2 parts of the body

A

1.5 years

71
Q

says 3 words sentence (telegraphic)

A

2 yyears

72
Q

Gives full name, age and sex

A

3 years

72
Q

tells story — counts up to 10

A

4 years

73
Q

Clear and fluent speech

A

5 years

74
Q

Can draw a man with all features

A

6 years

75
Q

enumerate causes of short stature

A

Normal Variants:
1. Familial (genetic) short stature
2. Constitutional delay of growth and puberty

Pathological Variants:
1. Genetic and chromosomal disorders
= Down syndrome.
= Turner syndrome
= Mucopolysaccharidosis.
= Skeletal dysplasia: Achonroplasia
= Russel Silver syndrome.

  1. Endocrinal causes:
    = Growth hormone deficiency
    Panhypopituitarism e.g. craniopharngioma
    Isolated growth hormone deficiency.
    Insulin growth factor 1(IGF1) deficiency (Laron syndrome)
    = Hypothyroidism : congenital /autoimmune thyroiditis
    =Hypoparathyroidism Cushing
    =Hypogonadism
    = Adrenal hormones
    -Cushing syndrome.
    -Adrenal insufficiency.
    -Corticosteroid therapy
    1. Severe systemic diseases in infancy and childhood
      = Chronic diseases (chronic kidney disease - cystic fibrosis - liver cell failure
      malabsorption- hemolytic anemia).
      = Chronic infections: Tuberculosis-bilharziasis.
  3. Nutritional starvation (malnutrition)
    1. Social short stature
      = Psychological deprivation: disturbed child-mother or family relation reduces growth hormone release
76
Q

genetic and chromosomal disoders causing short stature

A

= Down syndrome.
= Turner syndrome
= Mucopolysaccharidosis.
= Skeletal dysplasia: Achonroplasia
= Russel Silver syndrome.

77
Q

Endocrinal causes of short stature

A
  1. Endocrinal causes:
    = Growth hormone deficiency
    Panhypopituitarism e.g. craniopharngioma
    Isolated growth hormone deficiency.
    Insulin growth factor 1(IGF1) deficiency (Laron syndrome)
    = Hypothyroidism : congenital /autoimmune thyroiditis
    =Hypoparathyroidism Cushing
    =Hypogonadism
    = Adrenal hormones
    -Cushing syndrome.
    -Adrenal insufficiency.
    -Corticosteroid therapy
78
Q

Investigations for short stature

A
  1. Bone age assessment: x-ray of the left hand and wrist will diagnose the normal variant (familial/constitutional)
  2. Karyotyping in short females to exclude Turner syndrome (45 XO).
    1. Anti-tissue transglutaminase (positive in case of Celiac disease).
  4. Skeletal survey if skeletal dysplasia is suspected (e.g. Achondroplasia). Rickets also should not be missed as a cause.
  5. If bone age is markedly delayed: Endocrinal assessment is warranted including: Thyroid profile - Growth hormone stimulation tests - Steroids and ACTH if clinically suspected.
  6. If pituitary hormonal deficiency is diagnosed (Isolated GH deficiency or
    Panhypopituitarism): MRI to detect craniopharyngioma or brain anomalies.
    liver cell function and kidney cell function
    CBC
    tuberculin for tuberculosis
78
Q

list the causes of the macrocephaly

A
  1. Cranial causes
    Familial large head.
    Chronic hemolytic anemia.
    Rickets.
    Achonroplasia and mucopolysaccharidosis
  2. Intracranial (increased intracranial tension)
    Hydrocephalus.
    Subdural hematoma and Subdural effusion.
    Brain tumors.
    Neurofibromatosis
    Cerebral gigantism (Sotos syndrome)
    CNS storage disease e.g. mucopolysaccharidosis (Hurler’s syndrom
79
Q

Etiology of microcephaly

A

A. True microcephaly
Primary (genetic)
1. Familial ( autosomal recessive)
2. Autosomal dominant
3. Syndromes (Down: trisomy 21) — (Edwards: trisomy 18)-( Cri du chat:5p)
Secondary (non- genetic or acquired)

  1. Prenatal causes
    Congenital infections e.g. Cytomegalovirus, Rubella
    Irradiation
    Drugs e.g. — fetal alcohol syndrome.
  2. Perinatal causes
    Hypoxic ischemic injury.
    Intracranial hemorrhage.
  3. Post- natal causes
    Kernicterus
    CNS infections: meningitis -encephalitis.
    Intracranial hemorrhage.

B. Craniostenosis ( craniosynostosis)

80
Q

carnial causes of macrocephaly

A
  1. familial large head
  2. chronic hemolytic disease
  3. Rickets
  4. Anchodroplasia and mucopolysaccharidosis
81
Q

intracranial causes of macrocephaly

A

Hydrocephalus.
Subdural hematoma and Subdural effusion.
Brain tumors.
Neurofibromatosis
Cerebral gigantism (Sotos syndrome)
CNS storage disease e.g. mucopolysaccharidosis (Hurler’s syndrome)

82
Q

Causes of the precocoious pubery

A
  1. Normal variant
    Premature thelarche in girls
    Gynecomastia in boys
    Premature adrenarche (premature pubarche)
  2. True precocious puberty(
    Idiopathic(mainly in girls): the commonest
    Secondary (commoner in boys)
    Brain tumors- hydrocephalus.
    Trauma and radiotherapy.
  3. Pseudo precocious puberty
    Girls: ovarian tumors or excess Estrogen
    Boys: testicular tumors or excess androgens
83
Q

Definition of Precocious puberty

A

Onset of puberty before 8 years in girls or before 9 years in boys

Pediatrics (11 decks)

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