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SUGER > Growth And Puberty > Flashcards

Growth And Puberty Flashcards

1
Q

Body proportions in newborns

A

Larger head
Smaller mandible
Short neck
Chest rounded
Abdomen prominent
Limbs short

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2
Q

Adult body proportions

A

Relative growth of limbs compared to trunj

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3
Q

Infancy component of infancy-childhood-puberty model

A

Rapid but rapidly decelerating growth in first 2-3 years
Determined by nutrition
Long-term growth failure of underfed in infancy

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4
Q

Childhood component of infancy-childhood-puberty model

A

Switch from nutritional to hormonal dependence
Height velocity slows 2-3 yrs to puberty

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5
Q

Puberty component of infancy-childhood-puberty model

A

Growth spurt, increase height velocity due to growth hormone and oestrogen/testosterone
Age 14-15 girls 16-17 boys

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6
Q

When does growth end

A

Fusion of epiphyses due to influence of oestrogens in boys and girls

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7
Q

How do boys produce oestrogen

A

Convert testosterone to oestrogen in fatty tissue

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8
Q

What is growth in the infancy component of infancy-childhood-puberty model dependent on

A

Nutrition

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9
Q

What is growth in the childhood component of infancy-childhood-puberty model dependent on

A

Hormone

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10
Q

Growth and height velocity

A

Fastest growth rate in utero and infancy
Gradually decreasing rate to puberty
Pubertal growth spurt
Growth ends with fusion of epiphyses

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11
Q

Important determinants of growth

A

Parental phenotype and genotype
Quality and duration of pregnancy
Nutrition
Specific system and organ integrity
Psycho-social environment
Growth promoting hormones and factors

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12
Q

Chondrogenesis

A

Growht

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13
Q

What affects growth rate at the growth plate and bone architecture

A

Nutrition and calcium/phosphate supply

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14
Q

Regulators of growth

A

Endocrine signals
Nutrition
Inflammatory cytokines
Extra cellular fluid- oxygen deficiency, acidosis, toxins

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15
Q

Achondroplasia

A

Disproportion can give clues to diagnosis
Short limbs—- hypochondroplasia
Short back and long legs —- delayed puberty

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16
Q

What promotes growth hormone secretion

A

Growth hormone releasing hormone GNRH

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17
Q

What does growth hormone activate

A

Insulin like growth factor 1

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18
Q

What inhibits growth hormone secretion

A

Somatostatin
High levels of insulin like growth factor 1

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19
Q

Where are GHRH cell bodies

A

Arcuate nucleus, project to portal capillaries

20
Q

What regulates release of GHRH from hypothalamus

A

Food
Sleep
Steroids

21
Q

Neurotransmitters in hypothalamus for GHRH

A

Adrenergic
Cholinergic
Opioids

22
Q

What cells secrete growth hormone

A

Somatotrophs

23
Q

Effect of growth hormone

A

Decrease glucose use
Increase lipolysis
Increase muscle mass

24
Q

When is pulsatile secretion of growth hormone greatest

A

At night

25
Q

How is growth hormone transported

A

Growth hormone binding protein GHBP

26
Q

GH stimulation

A

Exercise
Stress
Hypoglycaemia
Fasting
High protein meals
Perinatal development
Puberty

27
Q

GH suppression

A

Hypothyroidism
Hyperglycaemia
High carbohydrate meals
Glucocorticoid excess
Aging

28
Q

Puberty

A

The physiological, morphological and behavioural changes as the gonads switch from infantile to adult forms

29
Q

Definitive signs of female puberty

A

Menarche- first menstrual bleeding

30
Q

Definitive signs of male puberty

A

First ejaculation - often nocturnal

31
Q

Female puberty

A

Ovarian oestrogens regulate the growth of breast and female genitalia
Ovarian and adrenal androgens control pubic and Axillary hair

32
Q

Male puberty

A

Testicular androgens control:
- external genitalia and public hair growth
-enlargement of larynx and laryngeal muscles —>voice deepening

33
Q

Tanner stage 1 in boys

A

Prepubertal- no pubic hair
Testicular length <2.5cm
Testicular volume <3 ml

34
Q

Tanner stage 2 in boys

A

Sparse growth of slightly curly pubic hair, mainly base of penis
Testes >3ml (>2.5cm in longest diameter)
Scrotum thinning and reddening

35
Q

Tanner stage 3 in boys

A

Thicker, curlier hair spread to mons pubis
Growth of penis in width and length; further growth of testes

36
Q

Tanner stage 4 in boys

A

Adult-type hair , not yet spread to medial surface of thighs
Penis further enlarged- testes larger, darker scrotal skin colour

37
Q

Tanner stage 5 in boys

A

Adult-type hair spread to medial surface of thighs
Genitalia adult size and shape

38
Q

Tanner stage 1 in girls

A

Prepubertal: no pubic hair
Elevation of papilla only

39
Q

Tanner stage 2 in girls

A

Sparse growth of long, straight or slightly curly, minimally pigmented hair mainly on labia
Breast bud noted/palpable; enlargement of areola

40
Q

Tanner stage 3 in girls

A

Darker, coarser hair spreading over mons pubis
Further enlargement of breasts and areola, with no separation of contours

41
Q

Tanner stage 4 in girls

A

Thick adult-type hair, not yet spread to medial surface of thighs
Projection of areola and papilla to form secondary mound above level of breast

42
Q

Tanner stage 5 in girls

A

Hair adult-type and distributed in classic inverse triangle
Adult contour breast with projection papilla only

43
Q

Common age range for height spurt in girls

A

9.5 - 14.5

44
Q

Common age range for height spurt in boys

A

10.5- 16 and 13-17.5

45
Q

Precocious puberty

A

Onset of secondary sexual characteristics before 8 in girls and 9 in boys
Menarche before 9 may lead to short stature

46
Q

Delayed puberty

A

Absence of secondary sexual characteristics by 14 in girls and 16 in boys
Delayed puberty leads to reduced peak bone mass and osteoporosis

47
Q

Arun, a 14 year old boy, comes into clinic with his mum as she is concerned with his short height and is getting bullied at school because of this. What can be said about the release pattern of the hormone he is most likely to be deficient in?

A

Arun’s presentation is indicative of growth hormone deficiency. This can result in short stature, forehead prominence and maxillary hypoplasia. The release of growth hormone is controlled by growth hormone releasing hormone, which is released by the hypothalamus in a pulsatile manner.

SUGER (17 decks)

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