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Endocrinology > Growth > Flashcards

Growth Flashcards

1
Q

What are the cellular processes to increase size?

A

Hyperplasia – increase cell number
Hypertrophy – increase cell size
Accretion – increase intercellular substance

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2
Q

True or false: lymphoid tissue doubles the amount seen in adult?

A

True

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3
Q

T or F: most of the neural tissue growth takes place in adulthood?

A

False: childhood

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4
Q

T or F: fetal growth rate is the fastest than any other periods in a human lifetime?

A

True

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5
Q

What is the childhood rate of height growth per year?

A

6 cm

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6
Q

Why are females on average shorter than males?

A

Pubertal linear velocities:

  • occur earlier
  • have a lower magnitude
  • shorter duration of pubertal growth
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7
Q

True or False: puberty contributes most to the final adult height?

A

False: infantile and childhood (puberty 10-15%)

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8
Q

What happens to arm span in relation to height throughout lifespan?

A

pre-puberty: arm span less than height

post-puberty: more than height

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9
Q

At approximately what age does the upper segment to lower is lower?

A

from age 7 and beyond

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10
Q

If the upper to lower segment ratio is higher than 1 for a 7 yrs old or older, what would this mean?

A

genetic syndrome

bone dysplagia

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11
Q

What two types of growth charts are used for 2 yrs or less?

A

head-circumference-for-age

weight-for-length

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12
Q

WHO growth charts are made from what?

A

WHO :
growth standards
growth reference

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13
Q

What age dictates at which percentile rate a child will grow?

A

2 years of age (continue at the same growth channel until puberty and should not deviate from growth channel)

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14
Q

What color is bone and cartilage on x-ray?

A

bone - white

cartilage - black

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15
Q

What is the end of the bone called?

A

epiphysis

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16
Q

True or false: the growth plate produces the metaphysis

A

False: it is the epiphysis

17
Q

What is the material that makes up the growth plate prior to adulthood?

A

cartilage

18
Q

True or False: Maturation of growth can be reflected in bone age

A

True

19
Q

What does bone represent and reflect?

A
  • represents secondary ossification

- reflects physiologic growth and maturity

20
Q

What are the broad determinants of growth?

A
  • genetics
  • nutrition
  • illness/health status (chronic anemia)
  • environment (sleep, exercise, seasonality, psychological)
  • hormones (proliferation and differentiation of chondrocytes) - insulin, GF, IGF-1, thyroid, estrogen
  • -> glucocorticoids stunts growth
21
Q

What is failure to thrive?

A

Body weight or rate of weight gain much less than expected compared to children of similar age and sex
- usually thin for their length (length and head circum. less affected than length)

22
Q

What are causes of failure to thrive?

A
  • inadequate intake (usually cause of very young)
  • inability to use
  • excessive utilization of energy
23
Q

What is short stature?

A

Lower than 3rd% (-2 SD) for age and sex

24
Q

When is short stature pathological?

A

Linear velocity lower than -2 SD for age
Crossing down more than 2 major growth channel lines
Projected height is lower than -2 SD for mid-parental target height

25
Q

What are causes of short stature?

A

Improper Growth Measurements

Normal variants:
Familial short stature (FSS)
Constitutional delay of growth and puberty (CDGP)

Pathologic causes:
Endocrinopathy (ie. hypothyroidism, growth hormone deficiencies, glucocorticoid excess ie. cushings)
Systemic Illness or Subclinical Illness (or meds)
Genetic Syndrome
Bony Dysplasias
Intrauterine Growth Retardation (IUGR) (ie. less than 10 percentile that do not catch up by 2 yrs)
Psychosocial deprivation (Kaspar Hauser syndrome)

26
Q

What is the difference between FSS and CDGP?

A 
for FSS:
Parents are short
Puberty is not delayed
Typically no bone age delay
Height-for-age trajectory approximates the mid-parental target height (height-for-bone age in CDGP)
27
Q

T or F: for endocrinopathies both weight and height velocities slow down?

A

False - only height, weight should be unaffected for then most part (unlike systemic disorders)

28
Q

What is tall stature and when is it pathological?

A

Higher than 97th% (+2 SD) for age and sex.

Is potentially pathologic if:
Linear velocity higher than +2 SD for age (crossing up percentiles)
Projected height is higher than +2 SD for mid-parental target height

29
Q

Causes of Tall Stature:

A

Normal Variants:
Familial Tall Stature
Constitutional

Obesity

Pathologic causes:
Endocrinopathy
Precocious Puberty
GH excess (rare)
Hyperthyroidism
Genetic syndromes
Marfan syndrome
Sotos syndrome
30
Q

True or False: bone age is greater than chronological age for precocious puberty

A

True

Endocrinology (16 decks)

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