Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

paediatrics > Growth and Endocrine > Flashcards

Growth and Endocrine Flashcards

1
Q

history and examination for establishing growth and development?

A

birth weight and gestation

PMH

family history/social history/schooling

systematic enquiry

dysmorphic features

systemic examination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

growth assessment tools

A

height/length/weight

growth charts and plotting

MPH (mid parental height) and target centiles

growth velocity

bone age

pubertal assessment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

tanner method of pubertal staging

A 
Breast development (B): 1 to 5
Genital development (G): 1 to 5
Pubic hair (PH): 1 to 5
Axillary hair (AH): 1 to 3
Testicular volume (T): 2ml to 20ml
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

hormones involved in puberty

A

growth hormones

sex hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

important stages in puberty?

A

breast budding: Tanner stage B2

testicular enlargement: Tanner stage G2 / T4ml)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

growth disorders: indications for referral

A

extreme short or tall stature (off centiles)
height below target height
abnormal height velocity (crossing centiles)
history of chronic disease
obvious dysmorphic syndrome
early/late puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

common causes of short stature

A

familial
constitutional
SGA/IUGR (Small for gestational age)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the pathological causes of short stature?

A
  • Undernutrition
  • Chronic illness (JCA, IBD, Coeliac)
  • Iatrogenic (steroids)
  • Psychological and social
  • Hormonal (GHD, hypothyroidism)
  • Syndromes (Turner, Prader Will)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the most important pubertal stage in a girl?

A

B2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the most important pubertal stage in a boy?

A

T3-4ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is considered early puberty in a boy?

A

<9 years (rare)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is considered late puberty in a boy?

A

> 14 (common, especially CDGP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is considered early puberty in a girl?

A

<8 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is considered late puberty in a girl?

A

> 13 years (rare)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Who does constitutional delay of growth usually affect?

A

Boys particularly those with a family history (dad and brothers. though may difficult to obtain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why does constitutional delay of growth occur?

A

There is bone age delay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Give examples of causes of delated puberty.

A
  • Gonadal dysgenesis (Turner 45X, Klinefelter 47XXY)
  • Chronic disease (Crohn’s, asthma)
  • Impaired HPG axis (septo-optic dysplasia, craniopharyngioma, Kallman’s syndrome)
  • Peripheral (cryptorchidism, testicular irradiation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What can cause early breast development?

A
  • Infantile thelarche
  • Thelarche variant (premature thelarche)
  • True central precocious puberty
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What can cause early secondary sexual characteristics?

A
  • Exaggerated adrenarche

- Precocious pseudopuberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What can cause early PV bleeding?

A

Premature menarche

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does central precocious puberty present with?

A
  • Breast development in girls
  • Testicular enlargement in boys
  • Growth spurt
  • Advanced bone age
22
Q

What causes central precocious puberty?

A
  • Usually idiopathic in girls but pituitary imaging should be done
  • Underlying cause i.e. brain tumour
23
Q

How is central precocious puberty treated?

A

GmRH agonist

24
Q

What is precocious pseudo puberty?

A

Gonadotrophin independent (low /prepubertal levels of LH and FSH) process in which there is abnormal sex steroid secretion leading to early virilisation and secondary sexual characteristics

25
Give examples of endocrine problems that children may present with not related to puberty.
- The new-born with ambiguous genitalia - Congenital hypothyroidism - Acquired hypothyroidism - Thyroid deficiency - Obesity
26
How should you manage the new-born with ambiguous genitalia?
- Do not guess the sex of the baby - Multidisciplinary approach (paediatrics, endocrine, surgery, neonatologist, geneticist, psychologist) - Exam: gonads?/internal organs - Karyotype - Exclude congenital adrenal hyperplasia (Risk of adrenal crisis in first 2 weeks of life')
27
How many births are affected by congenital hypothyroidism?
1 in 4000
28
What causes congenital hypothyroidism?
- Athyreosis/hypoplastic/ectopic | - Dyshormonogenic
29
When should treatment for congenital hypothyroidism be started?
-New born screening followed by commencement of treatment within the first 2 weeks
30
What is the most common cause of acquired hypothyroidism?
Hashimoto's thyroiditis
31
What issues does acquired hypothyroidism present with in childhood?
- Lack of height gain - pubertal delay (or precocity) - Poor school performance (but work steadily)
32
What is abnormal when it comes to obesity?
To be short and obese is abnormal
33
How many children are overweight or obese?
Nearly a third (31%) of children aged 2-15 are overweight or obese
34
Define overweight
- BMI 25-29.9 | - BMI>85th centile or SD >1.04
35
Define obese
- BMI >30 | - BMI>97.5th centile or SD >2
36
How should an individual be assessed for obesity?
- Weight - Body mass index (BMI) (kg/m^2) - Height - Waist circumference - Skin folds - History and examination
37
What is important in gaining in the history when assessing someone's obesity?
- Diet - Physical activity levels - Family history - Symptoms suggestive of a syndrome, hypothalamic-pituitary pathology, endocrinopathy or diabetes.
38
What is important when examining someone when assessing their obesity?
- Dark velvet rash indicative of diabetes - Goitre - BP - Imaging of pituitary
39
Give examples of obesity complications.
- 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
40
What can obesity be caused by?
- Simple obesity - Drugs - Syndromes - Endocrine disorders - Hypothalamic damage
41
What drugs can cause obesity?
- Insulin - Steroids - Antithyroid drugs - Sodium valproate
42
What syndromes can cause obesity?
- Prader Willi syndrome - Laurence-Moon Biedl syndrome - Pseudohypoparathyroidism type I - Down's syndrome
43
What endocrine disorders can cause obesity?
- Hypothyroidism - Growth hormone deficiency - Glucocorticoid excess - Hypothalamic lesion (tumour/trauma/infection) - Androgen excess - Insulinoma - Insulin resistance syndromes - Leptin deficiency
44
What is the treatment for obesity?
- Diet - Exercise - Psychological input - Rarely drugs - Surgery
45
What is the most common cause of obesity?
Simple obesity - Increased intake - Decreased activity
46
How is an early diagnosis of T1DM made in children?
THINK symptoms - Thirsty - Thinner - Tired - Toilet more often
47
What additional symptoms are there in children under 5 with T1DM?
- Heavier than usual nappies - Blurred vision - Candidiasis (oral, vulval) - Constipation - Recurring skin infections - Irritability, behaviour change
48
What is a red flag symptom for T1DM in a child who is toilet trained?
A return to bedwetting or day=wetting in a previously dry child is a red flag symptom for diabetes
49
What should you do if a child presents with suspected T1DM?
Test immediately - Finger prick capillary glucose test. If result >11mmol/l then diabetes, if <11mmol/l other cause - DO NOT request a returned urine sample - DO NOT arrange a fasting blood glucose test - DO NOT arrange an oral glucose tolerance test - DO NOT wait for lab results (urine or blood) - DK
50
What should you if a child with suspected T1DM finger prick test is over 11mmol/l?
Telephone urgently - Contact your local specialist team for a same day review - DKA can occur very quickly in children - If in any doubt about a diagnosis of type I diabetes call for advice - Don't delay the diagnosis
51
What are the symptoms of DKA?
- Nausea and vomiting - Abdominal pain - Sweet smelling 'ketotic' breath - Drowsiness - Rapid, deep 'sighing' respiration - Coma

paediatrics (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions