Growth Charts and Physiology

Question 1

Height measurement is recorded to the nearest complete centimetre with one decimal place. True/False?

Answer 1

False

Nearest complete millimetre to one decimal place

Question 2

Shoes must be removed for height measurement. True/False?

Answer 2

True

Question 3

Is height measurement taken on inspiration or expiration?

Answer 3

Expiration

Question 4

What do birth centile charts show?

Answer 4

Child’s size compared with children of the same age and sex

Question 5

What measurement is the best indicator of thinness/fatness in children over 2 years old?

Answer 5

BMI

Question 6

List signs from the patient history of puberty in girls

Answer 6

Any of:
Breast enlargement
Pubic/axillary hair

Question 7

List signs from the patient history of puberty in boys

Answer 7

Any of:
Deepening voice
Pubic/axillary hair
Enlarged testes/penis

Question 8

List signs from the patient history of post-puberty in girls

Answer 8

All of:
Start of periods
Pubertal development

Question 9

List signs from the patient history of post-puberty in boys

Answer 9

Any of:
Fully-broken voice
Facial hair
Adult-sized penis

Question 10

After what age will children usually be in pre-puberty?

Answer 10

8 years old

Question 11

When is puberty classed as delayed?

Answer 11

When no signs of puberty by age 13 in girls or 14 in boys

Question 12

At what age is puberty usually completing?

Answer 12

16 in girls

17 in boys

Question 13

The more obese you are, the faster you grow. True/False?

Answer 13

True, generally

Question 14

How far are centile lines apart?

Answer 14

2/3 of a standard deviation

Question 15

What is the criteria for a value being on a centile?

Answer 15

Exactly on/ within a 1/4 of space

Question 16

What is puberty?

Answer 16

Secretion of gonadotrophins from hypothalamus, pituitary and gonads

Question 17

What is the average age of onset of puberty?

Answer 17

11 in girls

11.5 in boys

Question 18

Define thelarche, adrenarche and menarche

Answer 18

Thelarche: breast budding
Adrenarche: body hair, odour
Menarche: periods begin

Question 19

How long is there roughly between thelarche and menarche?

Answer 19

2 years

Question 20

What scale is used to stage puberty?

Answer 20

Tanner scale (I: prepuberty, V: adult)

Question 21

Define true central precocious puberty

Answer 21

Early puberty
8 years old for girls
9 years old for boys

Question 22

What is adult height predictor on a growth chart used for?

Answer 22

Estimate adult height given childs current height using table

Question 23

What is mid-parental centile on a growth chart used for?

Answer 23

Join up parents heights, using table, and get average adult height expected for all children of these parents

Question 24

What is ‘short stature’ defined as?

Answer 24

Child is below the 2nd centile for height or greater than 2 standard deviations below the mid-parental height

Question 25

List the two main physiological causes of short stature

Answer 25

Genetic (FHx)
Constitutional delay (delay in pubertal growth meaning growth spurt occurs later than average)

Question 26

List the main pathological causes of short stature

Answer 26

Dysmorphic disease - fetal alcohol, turners, skeletal dysplasia
Chronic disease - Crohns, CF
Psychosocial deprivation
GI disease - coeliac
Endocrine - reduced GH, thyroid, cortisol excess