Growth and Puberty-Clark

Question 1

How do we determine target height?

Answer 1

Midparental height =
Boys: (M+5)+D /2
Girls: M+(D-5) /2

Target = midparental height +/- 2 inches

Question 2

When does the average child reach 50% of their final height?

Answer 2

2-2/5 yo

Question 3

What do we evaluate bone age for?

Answer 3

To evaluate growth potential

Question 4

When do we begin a growth evaluation for a child?

Answer 4

• Height is below the 3rd percentile, or

- Percentiles are being crossed (which means growth velocity is slow)

Question 5

What are the most common endocrine causes of short stature? What percentage of kids with short stature have these?

Answer 5

• Constitutional growth delay (normal variation)
• Hypothyroidism (will stop growing)
• Cortisol excess (glucocorticoid treatment) (will have weight gain with height loss)
• Growth Hormone deficiency

Question 6

What is the treatment for delayed puberty?

Answer 6

• Goal: To jumpstart puberty!
• Girls: Estrogen pills (Premarin) or Estrogen patch (Vivelle dot) for 3 months
• Boys: Testosterone injections once/month for 3 months

Question 7

What can premature adrenarche be a sign of?

Answer 7

PCOS

most common in 6-8 ear olds. normal puberty occurs at a normal age