Growth and Development Flashcards
What are the 5 determinants of growth?
1) Parental phenotype and genotype
2) Hormones
3) Nutrition
4) Psychosocial deprivation
5) Pregnancy factors
When is the growth velocity the fastest?
In utero and in infancy
When does growth end?
When the epiphyses fuse
What is hypochondroplasia?
Developmental disorder causing shorter limbs
What is the main factor driving infant growth?
Nutrition
What are some DD for short stature?
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
Name the scale that is used to describe physical development based on external sex characteristics.
Tanner Scale
What factors see an increase in final height?
Androgen/oestrogen deficiency.
GH excess.
Marfan’s.
Klinefelter’s
What is adrenarche, thelarche and pubarche?
Adrenarche: Development of adrenal gland –> Produce androgens –> Body odour/mild acne
Thelarche: Development of breasts
Pubarche: Development of pubertal hair
What is delayed puberty?
Absence of secondary sexual characteristics by 14-16
What causes male delayed puberty?
Constitutional delay - runs in the family.
What can cause female delayed puberty?
Turner’s Syndrome 45X
What is the first sign of puberty in boys?
First ejaculation and testicular size >3ml.
What are 3 potential consequences of delayed puberty?
1) Reproduction defects
2) Psychological problems
3) Reduced bone mass
How might you investigate delayed puberty?
FBC, U+E, TFT’s, LH/FSH, karyotyping.
Define precocious puberty.
Onset of secondary sexual characteristics before 8/9
What must you rule out as a cause of precocious puberty in boys?
Brain tumour
How would you treat precocious puberty?
GnRH super-agonists can be given to suppress pulsatility of GnRH secretion.
What is hypergonadotropic hypogonadism?
Primary gonadal failure e.g. testes/ovarian failure.
What is the affect of hypergonadotropic hypogonadism on the following:
a) FSH/LH.
b) Oestrogen/testosterone.
a) High FSH/LH.
b) Low oestrogen/testosterone.
Name 2 diseases that are examples of hypergonadotropic hypogonadism.
- Turner syndrome (45X0).
- Klinefelter syndrome (47XXY).
What is hypogonadotropic hypogonadism?
Secondary gonadal failure e.g. hypopituitary or hypothalamic problem.
