Growth and Puberty

Question 1

To be able to accurately interpret weight and height how many recordings are needed on a growth chart?

How are readings marked on a growth chart?

Answer 1

At least 2 - need to be able to see how it is progressing
- should be moving on a curve not flat

As a dot

Question 2

Why are overweight children more likely to undergo precocious puberty?

What defines precocious puberty in girls and boys?

Answer 2

Leptin (released from adipose tissue) has a link to triggering the release of gonadotrophs (LH and FSH)

Girls <8y/o
Boys <9y/o

Question 3

Tanner stage II is the definition of the beginning of puberty.
What defines Tanner stage II in girls and boys?

Answer 3

Girls - formation of breast buds

Boys - 4ml testicular volume

Question 4

How many years after the formation of breast buds (thelarche) does menstruation start?

Answer 4

2-3years

Question 5

What is the average age of the start of puberty in boys and girls

Answer 5

Girls - 11y/o

Boys - 11.5y/o

Question 6

When measuring height for a growth chart what is important to note?

Answer 6

NO SHOES

Question 7

When measuring baby length/weight, what must be remembered to be removed?

Answer 7

Nappy

Question 8

How many times should a head circumference be measured before an average is taken.
Over what part of the head should the head circumference be taken?

Answer 8

3x + then average

Over widest part of the head

Question 9

What does a Z-score of 2 mean?

Answer 9

2 SDs away from the mean

Question 10

What is constitutional growth delay?

Why are GH supplements no longer used?

Answer 10

For unknown reason someone is behind their peers growth wise - diagnosis of exclusion

GH supplements were shown to have no difference on end height (just made them get there quicker) so no indication for their use anymore

Question 11

If a medical professional is concerned about a child’s growth. What hormone can be measured?

Answer 11

IGF-1 - produced by the liver in response to GH

GH can be measured after a glucose tolerance test (put the patient into hypo and GH secretion should increase due to stress)
NB: not done in Tayside as too dangerous

Question 12

What defines delayed puberty in females and males?

Answer 12

Females >13y/o
Males >14y/o

To reach Tanner stage II

Question 13

A mother brings in her baby concerned about the number of recurrent infections the baby keeps getting.

However the baby’s growth is normal. How can the mother be reassured?

Answer 13

Babies get 12-15 infections in the early years

Normal growth means the baby is very unlikely to have any major underlying pathology

Question 14

In what order do the following occur in girls at puberty:

• breast buds
• growth of pubic hair
• growth of axillary hair

Answer 14

• breast buds
• growth of pubic hair
• growth of axillary hair