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Phase 3A - Paediatrics > Growth And Puberty > Flashcards

Growth And Puberty Flashcards

1
Q

Why do you measure children?

A

They provide a sensitive indication of health in childhood. Great rates and narrowly defined and healthy children with adequate nutrition and emotional supportive environment. Changes and great for it can provide an early insensitive point to healthcare problems in children

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2
Q

What are important determinants of growth

A

Parental phenotype and genotype, quality and duration of pregnancy, nutrition, specific set stem and organ integrity, psychosocial environment, growth promoting hormones and factors

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3
Q

What is another word for Growth?

A

ChrondroGenesis

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4
Q

What are regulators of growth

A

Endocrine signals, nutrition, inflammatory cytokines, Extracellular fluid, oxygen deficiency, acidosis, toxins

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5
Q

What factors are measured in growth?

A

Parental height, weight gain, social inequalities and ethnic background

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6
Q

What are the different stages of the assessment of growth?

A
  1. initial measurement - Routine screening, on the basis of concern
  2. recording
  3. interpretation
  4. action - If no concern = Continue routine chat
    - if possible concern = specific plan and follow-up to aid evaluation
    - if great concern = referral for fuller assessment
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7
Q

What is achondroplasia

A

genetic disorder whose primary feature is dwarfism

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8
Q

What is the condition associated with short limbs

A

Hypochondroplasia

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9
Q

What is associated with short back and long legs

A

Delayed puberty

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10
Q

What does head circumference interpretation depend on

A

Centile position, adherence to or deviation from a centre position with serial measurements, relation to body size degree of correlation with length forward – height and weight centile positions, features of sutures and fontanelles and evidence of abnormal intercranial pressure, familial factors

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11
Q

What are reasons of unreliable measurements of head circumference

A

Inaccuracy- faulty technique, faulty equipment

Uncooperative child, different observers, different times of the day

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12
Q

What equation predicts a boy’s height

A

Fathers height plus (mothers height +12.5 cm) divided by two

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13
Q

What equation predicts a girls height

A

Mothers height plus (fathers height -12.5 cm) divided by two

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14
Q

When do you have the fastest growth rate

A

In utero and infancy

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15
Q

When does Growth end

A

Fusion of epiphyses

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16
Q

What stage do you use to measure puberty?

A

Tanner staging

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17
Q

What is Tanner stage 1 in boys?

A

Pre-puberty no pubic hair
Testicular length less than 2.5 cm
Test stick your volume less than 3 millilitres

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18
Q

What is Tanners stage two in boys

A

Sparse growth of slightly curly pubic hair, mainly at the base of peanuts
Testes larger than 3 mL and larger than 2.5 cm and longest diameter
Scrotum thinning and reddening

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19
Q

What is Tanners stage three in boys

A

Thicker and curlier hair spread to Mons PUbis

Growth of penis in width and length further growth of testes

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20
Q

What is Tanner is stage four in boys

A

Adult type hair Not yet spread to medial surface of thighs
Penis further enlarged
Testes larger
Darker scrotal skin colour

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21
Q

What is stage five of Tanners in boys

A

Adult type hair spread to meet your surface of phis thighs

Genitalia adult size and shape

22
Q

What is Klinefelter syndrome?

A

genetic condition that results when a boy is born with an extra copy of the X chromosome. Klinefelter syndrome is a genetic condition affecting males, and it often isn’t diagnosed until adulthood.
Klinefelter syndrome may adversely affect testicular growth, resulting in smaller than normal testicles, which can lead to lower production of testosterone. The syndrome may also cause reduced muscle mass, reduced body and facial hair, and enlarged breast tissue. The effects of Klinefelter syndrome vary, and not everyone has the same signs and symptoms.

23
Q

What chromosomes does someone with Klinefelter syndrome have

A

47, XXY

24
Q

What is the presentation of Klinefelter syndrome

A 
Primary hypogonadism
Azoospermia and gynaecomastia
Reduced secondary sexual hair
Osteoporosis 
Tall stature 
Reduced IQ in 40%
20% increase in breast cancer
25
Q

What is the HPG axis?

A

From the hypothalamus GnRH released, to the anterior pituitary gland releasing LH and FSH, To the gonads releasing gonadal sex hormones

26
Q

Where is the problem in primary hypogonadism?

A

In the gonads

27
Q

Where is the problem in secondary hypogonadism?

A

Pituitary

28
Q

Where is the problem in tertiary hypogonadism?

A

Hypothalamus

29
Q

What are causes of hypogonadotrophic hypogonadism

A

CNS

  • Tumours - craniopharyngiomas, germinomas
  • Langerhan’s histiocytosis
  • post infectious lesions of the CNS
  • radiation
  • head trauma

Isolated gonadotropin deficiency

  • kallmann’s syndrome
  • LHRH receptor mutation
  • congenital adrenal hypoplasia
  • LH deficiency
  • FSH deficiency

Miscellaneous

  • prader willi syndrome
  • sickle cell disease
  • CF
  • AIDS
  • malnutrition
  • bulimia
  • exercise amenorrhea
  • hypothyroidism
  • DM
  • cushing’s
  • hyperprolactinemia
30
Q

Tanner stage 1 in girls

A

Prepubertal - no pubic hair

Elevation of papilla only

31
Q

Tanner stage 2 in girls

A

Sparse growth of long straight or curly minimally pigmented hair mainly on labia
Breast bud noted palpable
Enlargement of areola

32
Q

Tanner stage 3 in girls

A

Darker courser hair spreading over mons pubis

Further enlargement of breast and areola with no separation of contours

33
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

34
Q

Tanner stage 5 in girls

A

Hair adult type and distributed in classic inverse triangle

Adult contour breast with projection of papilla only

35
Q

What is turners syndrome?

A

Turner syndrome, a condition that affects only females, results when one of the X chromosomes (sex chromosomes) is missing or partially missing

36
Q

What is the presentation of turners at birth?

A

Oedema of dorsa of hands, feet and loose skinfolds at the nape of the neck

37
Q

What is the presentation of turners syndrome

A 
Webbing of neck
Low posterior hairline
Small mandible 
Prominent ears 
Epicanthal folds 
High arched palate
Broad chest
Cubitus valgus 
Hyperconvex fingernails 
Cardiovascular malformation 
Renal malformation 
Recurrent otitis media 
Short stature
38
Q

What is the first sign of puberty in girls

A

Breast budding

39
Q

What is the first sign of puberty in boys

A

Testicular enlargement

40
Q

What age indicates delayed puberty in girls

A

Over 13

41
Q

What age indicates delayed puberty in boys?

A

Over 14

42
Q

What age indicates early puberty in girls?

A

Under the age of 8

43
Q

What age indicates early puberty in boys

A

Less than 9

44
Q

What are factors that affect birth weight?

A 
Maternal size and weight 
Parity 
Gestational diabetes 
Smoking
Paternal size
45
Q

What are common causes of short stature?

A 
Constitutional slow maturation, delayed puberty
Idiopathic 
Environmental 
Nutrition 
Physical disease 
Skeletal disease 
Turners syndrome 
Endocrine
46
Q

Chronic diseases that can cause short stature

A 
Gastrointestinal- coeliacs, IBD
CVS - CHD 
Renal disease 
Haematological - chronic severe anaemia 
Pulmonary - CF, bronchopulmonary dysplasia 
Chronic inflammation and infection
47
Q

What are causes of overgrowth with impaired final height

A

Precocious puberty
Congenital adrenal hyperplasia
Mcalbright syndrome
Hyperthyroidism

48
Q

What are causes of overgrowth with increased final height

A

Androgen/oestrogen deficiency/ oestrogen resistance
GH excess
Klinefelter syndrome XXY
Marfans

49
Q

Psycho social short stature

A

Over 3 years old
Emotional rejection key factor
Physical sexual abuse can be associated
50% shoe reversible GH deficiency, poor response to GH treatment

50
Q

Obesity drives growth

A

.

51
Q

Nutritional obesity

A

Tall and fat

52
Q

Endocrine obesity

A

Short and fat

Phase 3A - Paediatrics (11 decks)

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