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child health > growth and puberty > Flashcards

growth and puberty Flashcards

1
Q

what is the definition of short stature ?

A

below the 3rd percentile for chronological age and sex

height below 2 SD

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2
Q

what are the classifications for short stature ?

A

either pathological or normal variants

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3
Q

what are the types of pathological causes of short stature ?

A

proportionate

disproportionate

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4
Q

what are the cause of disproportionate short stature ?

A 
skeletal dysplasia 
rickets 
hypothyroidism 
achondroplasia 
hypochondroplasia
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5
Q

what is the difference between familial and constitutional height ?

A

familial short stature :
normal bone age, normal growth velocity, and the predicted family height is appropriate to their height
constitutional short stature :
delayed bone age and predicted adult height appropriate to the familial patterns

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6
Q

what are the family trends in familial short stature and constitutional short stature ?

A

history of delayed puberty in constitutional

history of short stature in familial

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7
Q

what is the clinical presentation of a child with growth hormone deficiency ?

A

short chubby child

weight is good for their age but not for their height

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8
Q

what type of brain tumors usually affect stature ?

A

craniopharyngoma

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9
Q

what are the features of congenital hypothyroidism ?

A 
large tongue 
coarse hair 
swollen eyelids 
depressed nasal bridge
cretinism 
poor feeding / prolonged jaundice
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10
Q

what is the presentation of precocious after fusion of the epiphyses ?

A

very tall as children

short as adults

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11
Q

what must all short girls be tested for ?

A

turner syndrome

even if there is no symptoms

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12
Q

what is the difference in affection between nutritional causes and endocrine causes in terms of anthropometric measurements ?

A

nutritional causes :
weight is more affected than height
endocrine causes :
height is more affected than weight

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13
Q

if the child is disproportionate what is this an indication off ?

A

skeletal dysplasia:
rickets
achondroplasia

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14
Q

what are the endocrinal check-ups ?

A

thyroid hormone
growth hormone provocative test
insulin growth like factor
cortisol am and pm

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15
Q

what is the UKs biggest nutritional problem ?

A

obesity

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16
Q

how is BMI calculated ?

A

weight over heigh in meters squared

17
Q

what is the classification of an overweight child ?

A

between the 85th and 95th percentile

over 1.5 SD

18
Q

what is the classification of an obese child ?

A

over the 95th percentile

19
Q

what are the different classifications of the causes of obesity ?

A

exogenous
endogenous
syndromic

20
Q

what are the presentations of exogenous, endogenous and syndromic obesity ?

A

exogenous : tall and over weight
endogenous : short and overweight
syndromic: has associated clinical features

21
Q

what is the presentation of prader willi syndrome ?

A 
poor muscle tone 
distinctive facial features : almond shaped eyes 
epicanthal folds 
thin upper lip 
poor suckling reflex 
underdeveloped genitalia 
child never feels full
22
Q

what are the three stages of puberty from history ?

A

pre-pubertal
inn puberty
completing puberty

23
Q

which tanner stages correspond to each stage of puberty

A

pre puberty - tanner stage 1
in puberty - tanner stage 2 and 3
completing puberty - tanner stage 4 and 5

24
Q

what is the tanner staging for boys genitals according to tanner staging ?

A 
G1: testicular volume less than 3mls 
G2: enlargement of testes mean age 12
G3: lengthening of penis 
G4: broadening of the penis and further enlargement of the testes 
G5: adult
25
Q

what is the testicular volume during the start of puberty ?

A

reaches 4mls

26
Q

what tool is used to measure testicular volume ?

A

prader orchidometer

27
Q

what is the tanner stage for girls breasts ?

A 
pre puberty : B1 
in-puberty phase : B2 - breast bud begins to appear mean age 11
B3 : enlargement of the whole breast 
B4: further areolar development 
B5: adult
28
Q

when does a secondary mount in the breasts start to appear ?

A

stage 4

29
Q

what is the age for precocoiuos puberty in males and females ?

A

girls < 8 years

boys < 9 years

30
Q

what are the causes of precocious puberty ?

A

central ( True ) PP : mostly idiopathic in girls , in boys they have a high incidence of brain tumors
peripheral ( pseudo PP) : adrenal tumor, testicular or ovarian tumors

31
Q

what physical findings are associated with true PP vs pseudo PP in males ?

A

true PP - enlargement of testes and penis (both FSH and LH are high )
pseudo PP - penile enlargement but no testicular enlargement

32
Q

what are the age limits for the diagnosis of delayed puberty ?

A

boys over the age of 14 with no signs of puberty

girls over the age of 13

33
Q

what are the different causes of delayed puberty ?

A

central - hypogonadotropic hypogonadism
or
primary gonadal failure - hypergonadotrophic hypogonadism

34
Q

what is the difference between hypogonadotrophic and hypergonadotrophic hypogonadism ?

A

hypogonadotropic means the problem is from the hypothalamus or the pituitary gland
hypergonadotropic means the problem is from the testes or ovaries

35
Q

what are the causes of hypergonadotrophic hypogonadism ?

A

turner syndrome

klinefelter syndrome

36
Q

what are the causes of hypogonadotrophic hypogonadism ?

A 
long term glucocorticoid ( associated with cushing disease )
high prolactin levels due to prolactinoma
kallmans syndrome ( cant smell )
37
Q

what are the psychological causes of delayed puberty ?

A

anorexia nervosa

38
Q

what are the most important hormones to asses regarding delayed and precocious puberty ?

A

LH
FSH
testosterone
estradiol

child health (40 decks)

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