Growth and Development

Question 1

What are the 5 determinants of growth?

Answer 1

1) Parental phenotype and genotype
2) Hormones
3) Nutrition
4) Psychosocial deprivation
5) Pregnancy factors

Question 2

When is the growth velocity the fastest?

Answer 2

In utero and in infancy

Question 3

When does growth end?

Answer 3

When the epiphyses fuse

Question 4

What is hypochondroplasia?

Answer 4

Developmental disorder causing shorter limbs

Question 5

What is the main factor driving infant growth?

Answer 5

Nutrition

Question 6

What are some DD for short stature?

Answer 6

1) Idiopathic
2) Delayed puberty
3) Constitutional delay
4) Slow maturation
5) Environmental
6) Nutrition
7) Skeletal disease
8) Physical disease e.g. Coeliac, IBD, CHD
9) Endocrine pathology
10) Turner’s syndrome

Question 7

Name the scale that is used to describe physical development based on external sex characteristics.

Answer 7

Tanner Scale

Question 8

What factors see an increase in final height?

Answer 8

Androgen/oestrogen deficiency.
GH excess.
Marfan’s.
Klinefelter’s

Question 9

What is adrenarche, thelarche and pubarche?

Answer 9

Adrenarche: Development of adrenal gland –> Produce androgens –> Body odour/mild acne
Thelarche: Development of breasts
Pubarche: Development of pubertal hair

Question 10

What is delayed puberty?

Answer 10

Absence of secondary sexual characteristics by 14-16

Question 11

What causes male delayed puberty?

Answer 11

Constitutional delay - runs in the family.

Question 12

What can cause female delayed puberty?

Answer 12

Turner’s Syndrome 45X

Question 13

What is the first sign of puberty in boys?

Answer 13

First ejaculation and testicular size >3ml.

Question 14

What are 3 potential consequences of delayed puberty?

Answer 14

1) Reproduction defects
2) Psychological problems
3) Reduced bone mass

Question 15

How might you investigate delayed puberty?

Answer 15

FBC, U+E, TFT’s, LH/FSH, karyotyping.

Question 16

Define precocious puberty.

Answer 16

Onset of secondary sexual characteristics before 8/9

Question 17

What must you rule out as a cause of precocious puberty in boys?

Answer 17

Brain tumour

Question 18

How would you treat precocious puberty?

Answer 18

GnRH super-agonists can be given to suppress pulsatility of GnRH secretion.

Question 19

What is hypergonadotropic hypogonadism?

Answer 19

Primary gonadal failure e.g. testes/ovarian failure.

Question 20

What is the affect of hypergonadotropic hypogonadism on the following:
a) FSH/LH.
b) Oestrogen/testosterone.

Answer 20

a) High FSH/LH.
b) Low oestrogen/testosterone.

Question 21

Name 2 diseases that are examples of hypergonadotropic hypogonadism.

Answer 21

1. Turner syndrome (45X0).
2. Klinefelter syndrome (47XXY).

Question 22

What is hypogonadotropic hypogonadism?

Answer 22

Secondary gonadal failure e.g. hypopituitary or hypothalamic problem.