Growth and Development Flashcards
What are some common measurement and assessment tools used to determine whether babies / children are developing normally?
- Height (standing and sitting)
- Length (babies)
- Head circumference (<2 years old)
- BMI
- Bone age
What are some important practices when taking measurements of children during development?
- Being accurate (use dots instead of crosses)
- Serial measurements: more data = easier analysis
What is bone age? What can it be used to predict?
- The average age at which a child reaches a specific level of bone maturation. Usually equal to biological age but can be greater or lesser for those who hit early / late growth spurts
Bone age + height of a child can be used to predict adult height
What is another way to analyze the development of adolescents? Tools / criteria used?
- Pubertal assessment
- Tanner method (stages pubertal development according to breast development, pubic hair, axillary hair and genital development)
- Prader Orchidometer (tool for measuring testicular volume)
Why is it hard to precisely define “normal development”?
- Wide range (genetic diversity)
- Differences in ethnic subgroups
- Inequality in basic health and nutrition
What are the three important stages in normal growth? What rate of growth occurs at each?
- Infantile: starts with a high rate of growth, decreases into childhood
- Childhood: Rate of growth still slowly decreasing from highest infantile stage
- Pubertal: Large spike in growth rate, decreases to zero into adulthood
Which gender reaches puberty earlier? What are the earliest signs of puberty based on gender?
Why are these signs important?
- Females reach puberty earlier
- Breast budding (tanner stage B2) in females
- Testicular enlargement (Tanner stage G2) in males
- Once these signs are present, usually confirms puberty will progress onwards
What are some indications for referral if growth disorder is suspected?
- Extreme tall or short stature
- Abnormal height change velocity
- Obvious dysmorphic syndrome
- Early / late puberty
What are some pathological causes of short stature?
- Undernutrition
- Chronic illness (JDA, IBD, Coeliac)
- Iatrogenic (steroids)
- Hormonal (GHD, hypothyroidism)
- Syndromes (turner / P-W)
Signs of Growth Hormone Deficiency?
- Child’s face appears younger
- Short stature
- Increased fat around face and stomach
- Delayed puberty / tooth development
What can excess glucocorticoid exposure lead to?
- Cushing’s syndrome
- Rapid weight gain can be seen in children with the condition
Developmental signs of Turner Syndrome?
- Short stature
- Thick neck tissue
- Swollen extremities at birth
Developmental signs of Prader-Willi Syndrome?
- Excessive weight gain
- Short stature
- Lack of genital development
Developmental signs of Noonan Syndrome?
- Unusual facial features (drooping eyelids and wide distance between eyes, large forehead)
- Short stature
Developmental signs of Achondroplasia?
- Dwarfism
- Small fingers
- Limited range of motion at elbows
