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Endocrine Physiology > Growth and Development And Endocrine Problems in Childhood > Flashcards

Growth and Development And Endocrine Problems in Childhood Flashcards

1
Q

What would be measured when assessing normal growth in children?

A

Height
Length
Sitting Height
Head circumference

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2
Q

What staging Is used for the staging of puberty?

A

Tanner

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3
Q

What is involved in the Tanner staging of puberty?

A 
B 1 - 5 = breast development
G 1-5 = genital development
PH 1-5 = pubic hair 
AH 1-3 = axillary hair
T 2ml - 20ml
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4
Q

What is used to assess testicular maturation?

A

Prader Orchidometer

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5
Q

Factors influencing height

A 
Age
Sex
Race
Nutrition 
Parental heights
Puberty
Skeletal maturity (bone age)
General health 
Chronic disease
Specific growth disorders
Socio-economic status
Emotional well being
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6
Q

What in the tanner staging shows the earliest objective signs of puberty?

A

Breast budding - tanner stage 2 in a girl

Testicular enlargement - tanner stage T 3-4ml in a boy

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7
Q

Indications for referral for a growth disorder

A

Extreme tall or short stature (off centiles)
Height below target height
Abnormal height velocity (crossing centiles)
History of chronic disease
Obvious dysmorphic syndrome
Early/late puberty

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8
Q

Pathological causes of short stature

A 
Undernutrition 
Chronic illness (JCA, IBD, coeliac)
Iatrogenic (steroids)
Psychological and social
Hormonal (GHD, hypothyrodisim)
Syndromes e.g. PW, Turners, noonans
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9
Q

Whats classified as early puberty in boys and how common is this?

A

< 9 years old

Rare

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10
Q

Whats classified as delayed puberty in boys and how common is this?

A

> 14 y/o

Common, especially CDGP

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11
Q

Whats classified as early puberty in girls?

A

< 8 years

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12
Q

Whats classified as delayed puberty in girls and how common is this?

A

> 13 years (rare)

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13
Q

Who is constitutional delay of growth and puberty (CDGP) seen in mainly and what is common with it?

A

Boys mainly
FH in dads or brothers (difficult to obtain)
Bone age delay

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14
Q

Causes of delayed puberty

A

CDGP
Gonadal dysgenesis (Turner 45X, Klinefelter 47XXY)
Chronic disease (chrons, asthma)
Impaired HPG axis (e.g. kallmans syndrome)
Peripheral (e.g. cryptorchidism, testicular irridation)

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15
Q

Treatment of central precocious puberty

A

GnRH agonist

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16
Q

Presentation of precocious pseudopuberty

A

Secondary sexual characteristics

17
Q

When should treatment be started with congenital hypothyroidism?

A

Within first 2 weeks

18
Q

What is the most common cause of acquired hypothyroidism ?

A

Autoimmune (Hashimoto’s) thyroiditis

19
Q

Childhood issues who have acquired hypothyroidism

A

Lack of height gain
Pubertal delay (or precocity)
Poor school performance (but work steadily)

20
Q

What BMI centile is classed as overweight?

A

BMI >85th centile

21
Q

What BMI centile is classified as obese?

A

BMI > 97.5th centile

22
Q

Complications of obesity in children

A 
Metabolic syndrome
Fatty liver disease (non alcoholic steatohepatitis)
Gallstones
Reproductive dysfunction (e.g. PCOS)
Nutritional deficiencies 
Thromboembolic disease
Pancreatitis
Central hypoventilation Obstructive sleep apnoea
Gastroesophageal reflux disease
Orthopaedic problems (slipped capital femoral epiphysis, tibia vara)
Stress incontinence
Injuries
Psychological 
Left ventricular hypertrophy 
Atherosclerotic cardiovascular disease
Right sided heart failure
23
Q

Drugs that cause obesity

A

Insulin
Steriods
Antithyroid drugs
Sodium valproate

24
Q

Syndromes that cause obesity

A

Prader willi syndrome
Pseudohypoparathyroidsm type 1
Downs syndrome

25
Q

Endocrine disorders that cause obesity

A 
Hypothyroidism 
GH definciency 
Hypothalamic lesion (tumour/trauma/infection)
Androgen excess
Insulinoma 
Insulin resistance syndromes
Leptin deficiency
26
Q

The 4 Ts of symptoms of diabetes in children

A

Thirsty
Thinner
Tired
using the Toilet more

27
Q

If you suspect diabetes mellitus in a child, what test would you do?

A

Finger prick capillary glucose test

28
Q

What would indicate DM in a child after a finger prick capillary glucose test?

A

> 11 mmol/l

29
Q

What is a RED FLAG symptom for diabetes in children?

A

Return to bedwetting or day wetting in a previously dry child

30
Q

Symptoms of diabetes in children < 5 y/o

A 
Heavier than usual nappies
Blurred vision 
Candidiasis (oral, vulval)
Constipation 
Recurring skin infections
Irritability, behaviour change
31
Q

Symptoms of diabetic ketoacidosis

A 
Nausea and vomiting 
Abdominal pain 
Sweet smelling, "ketotic breath"
Drowsiness
Rapid, deep "sighing" respiration 
Coma

Endocrine Physiology (8 decks)

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