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medicine > Growth and Growth Disturbances > Flashcards

Growth and Growth Disturbances Flashcards

1
Q

What is the most common cause of short stature in children?

A

familial short stature

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2
Q

What is the definition of short stature?

A

height below the 3rd percentile

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3
Q

What is the difference bw growth and stature?

A 
growth = velocity
stature = height
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4
Q

What is the period of fastest growth in children?

A

puberty

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5
Q

What are the 5 stages of growth?

A

1) intrauterine/neonatal
2) infancy
3) toddler
4) childhood
5) adolescence

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6
Q

What is the most influential factor in intrauterine/neonatal growth?

A

maternal factors (obesity)

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7
Q

What is toddler aged and what is growth like during this time?

A

1) 12-36 months

2) fairly constant rate of about 3.9 inches/yr

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8
Q

What happens to a childs growth after age 3?

A

After age 3, kids follow a percentile channel that tracts toward genetic potential

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9
Q

When do growth spurts occur for girls and boys respectively during puberty?

A

1) girls - early in puberty

2) boys - late in puberty

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10
Q

On what two scales are an infant/toddler assessed on?

A

1) head circumference

2) weight for length

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11
Q

What is the first physical change in puberty for boys?

A

gonadal enlargement

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12
Q

What is the first physical change in puberty for girls?

A

thelarchy (breast development)

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13
Q

What does the American Academy of Pediatrics recommend for assessing length in infants/toddlers?

A

1) 3 times in the first 6 months of life
2) then every 3-4 months until 2 years of age
3) toddlers should be measured/weighed at least twice per year

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14
Q

What constitutes “normal” growth?

A

1) proportionality
2) values track after age 3
3) relative final height estimated and compared to AMPH

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15
Q

How does the growth chart add up as an index of overall health?

A

1) high sensitivity (you can tell if something is wrong)

2) low specificity (don’t know what the diagnosis is)

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16
Q

What are the three phases of human growth?

A

1) infancy
2) childhood
3) puberty

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17
Q

What influences growth the most during infancy?

A

entirely dependent on nutrition

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18
Q

What is catch up and catch down growth?

A

1) occurs bw 1-3 years of life
2) represents a readjustment to the genetic blueprint for growth
3) often a cause for concern by parents
4) usually benign

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19
Q

What is AMPH (adjusted mid parental height) and what is its limitations?

A

1) purpose is to estimate a target adult height for a given child
2) it adjusts the stature chart for a child’s parent’s height
3) limitation - its just a guide - not a final height predictor

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20
Q

How do you calculate AMPH?

A

1) find MPH (mid parental height)

2) add 6.5 cm for boys and subtract 6.5 cm for girls

21
Q

What is the standard deviation for AMPH?

A

+/- 4 inches (10cm)

22
Q

Why are men generally tallers than women?

A

more pre-pubertal growth

higher maximum peak growth rate

23
Q

How do you calculate growth velocity?

A

(visit 2 - visit 1) / (time interval) = growth velocity

24
Q

What is the difference between growth and height?

A

growth is relative

height is cumulative

25
Q

What are growth chart red flags?

A

1) rounded off plotting (points at even years)
2) crossing channels after age 3
3) proportionality (low height for weight)
4) height falling off before weight
5) “overweight, overtall for age” common in exogenous obesity

26
Q

What are the practical applications of the bone age assessments?

A

1) bone age value can be used to correct actual height (young bone age gives you more time to grow and visa versa)
2) growth correlates more with bone age than chronologic age

27
Q

When is a head MRI or CT recommended on a kid?

A

with proven GH deficiency

28
Q

What is the typical order of secondary sexual development in boys?

A

1) pubic hair
2) gonadal enlargement
3) growth spurt
4) voice change
5) penile growth

29
Q

What is the typical order of secondary sexual development in girls?

A

1) pubic hair
2) menarche
3) growth spurt
4) breast budding
5) acne

30
Q

what are the clinical features of classic constitutional delay?

A

1) borderline short stature
2) marked bone age delay (1-4 years)
3) normal predicted adult height
4) family history of constitutional delay
5) delayed puberty (after 14 in boys, 13 in girls)
6) late growth spurt
7) eventual attainment of adult height

31
Q

What characterizes familial short stature?

A

markedly short, but otherwise healthy

falls within normal genetic expectations

32
Q

What characterizes growth delay/constitutional delay of growth and puberty (CDGP)

A

biological age delayed 2 years
decline in growth velocity at ages 2-3
family history

33
Q

what is psychosocial short stature due to?

A

1) deprivation

2) psychosocial dwarfism

34
Q

What characterizes short stature due to psychosocial deprivation?

A

1) lack of nurturing
2) often results in a failure to thrive
3) children generally recover with sufficient nourishment and attention

35
Q

What characterizes short stature due to psychosocial dwarfism?

A

1) abnormal parent-child interaction leads to functional hypopituitarism
2) when removed from home may exhibit catch-up growth

36
Q

What are systemic diseases that can affect growth?

A

1) chronic anemia
2) cardiac disease
3) immune system diseases
4) renal disease
5) cystic fibrosis

37
Q

What are some nutritional diseases that can affect growth and development?

A

1) IBD and celiac disease
2) chronic liver disease (insulin like GF)
3) malnutrition
4) malabsorption

38
Q

What is the primary cause of growth failure?

A

malnutrition

39
Q

What is turner syndrome?

A

missing or abnormal X chromosome

40
Q

What are the symptoms/consequences of turner syndrome?

A

1) short stature
2) delayed sexual development
3) infertility
4) cardiovascular disease
5) renal anomalies

41
Q

What characterizes prader-willi syndrome?

A

1) itrauterine and early post natal growth retardation
2) hypotonia
3) poor linear growth
4) delayed sexual development
5) development delay
6) hyperphagia - obesity
7) behavior problems
8) sleep and respiratory difficulties

42
Q

What is Kleinfelter syndrome?

A

XXY

43
Q

What are the symptoms of kleinfelters?

A

1) tall stature
2) less muscular
3) decreased level of testosterone
4) gynecomastia during puberty
5) infertile

44
Q

What are the symptoms of Noonan syndrome?

A

1) short stature
2) delayed puberty
3) webbed neck
4) developmental delay may occur
5) heart defects

45
Q

How is noonan sydrome diagnosed?

A

diagnosed via clinical assessment

46
Q

What are the symptoms of silver-russell syndrome?

A

1) intrauterine growth retardation
2) small triangular face
3) short stature
4) macrocephaly
5) skeletal asymmetry
6) genital anomalies

47
Q

What is Marfan syndrome?

A

abnormality in fibrilin-1 gene

48
Q

What 3 systems are affected by marfans?

A

1) skeletal
2) eyes
3) cardiovascular

49
Q

What are the characteristics of marfans?

A

tall stature
long, thin limbs and fingers
subluxation of the lens of the eye

medicine (15 decks)

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