Growth and Endocrine function

Question 1

what factors influence a Childs height?

Answer 1

age
sex
race 
nutrition 
birth weight 
parental heights
puberty
poor health 
medication - steroids 
specific growth disorders 
- socioeconomic status 
deprivation

Question 2

What are key questions when assessing growth?

Answer 2

is the child too short or tall for their age

• has puberty started, is it progressing normal
• is growth normal for stage of puberty
• weight of child

Question 3

The childhood phase of growth is dependent on what hormone?

Answer 3

Thyroxine

Question 4

Infantile phase of growth is dependent on what factors?

Answer 4

nutrition

IGF1 AND IGF2

Question 5

breast budding is what tanner stage?

Answer 5

stage b2

- 11 years

Question 6

testicular enlargement is what tanner stage?

Answer 6

stage g2 tT 4 ML

• 11.5 years

Question 7

in a child who is seen for short stature, what heights do you want to collect?

Answer 7

mid parental height MPH
Target gentile range TCR

can also do bone age- X-ray of left hand - TW20

growth velocity

pubertal assessment

Question 8

Growth disorders - when do we refer?

Answer 8

extreme short or tall statures
height below target 
abnormal height velocity 
history of chronic disease
dysmorphic syndrome 
early/late puberty

Question 9

Common causes of short stature

Answer 9

familial
constitutional
SGA/IUGR

Question 10

Investigations for short stature and pubertal delay - what does FBC and ferritin look for?

Answer 10

general health, coeliac, corns , JCA

Question 11

Investigations for short stature and pubertal delay - what does U&E, LFT, Ca, CRP look for?

Answer 11

general health , renal and liver disease, disorder of calcium metabolism

Question 12

Coeliac serology an IgA looks for?

Answer 12

coeliac disease

Question 13

IGF-1. TFT, population, cortisol looks for?

Answer 13

hormonal disorders

Question 14

Karoyype and microarray looks for?

Answer 14

Turners syndrome in girls

chromosomal abnormalities

Question 15

what is IGF-1

Answer 15

marker of growth hormone production

Question 16

If IGF-1 is low, what can you do next?

Answer 16

• GH stim test
• Arginine test
• insurance tolerance test

Question 17

If you fail IGF-1 tests, what does that show ?

what do you look at after?

what to give?

Answer 17

isolated GH deficiency

• pituitary gland MRI
  (ectopic posterior), (small anterior)

growth hormone

Question 18

what hormones are involved in puberty

Answer 18

GnRH- hypothalamus

pituitary - LSH, FSH - STIMULATES gonads

• testosterone and estradiol

Question 19

early and late puberty in boy and girls

Answer 19

boys early <9, >14 LATE = CDGP

GIRLS EARLY< 8 , late > 13