Growth disorder Flashcards
What is the failure to thrive?
Inability to gain weight up to the age of 3 years
What is the head circumfrance for a full-term baby, and how it will change in 1 year, 2 years
35cm 1 year: 12 cm 2 year: 2.5 3 year: 0.5 At the end: 1.5cm
What is the optimum weight of a full-term baby?
in 5 months & 1 year what will be the weight? And
3.5 kg
in 5 months: 7kg. “Doubles”
in 12 months: 11.25 “triples”
What does skin fold thickness measure?
Subcutanous fat indicating the neutritional state of the child
When to measure the lenght instead height?
When child is unable to stand
How to measure the length of the baby?
By infantometer
When is the fastest phase of growth
The 2nd trimester in fetal phase “30cm\year”
What are the factors that affect the fetal phase growth?
1- maternal neutrition
2- size of uterine
3- insulin
4- IGFs
Baby of diabetic mother is found to be: “size”
Macrosomic “large” due to insulin and insulin like growth factors
What is the midpoint of growth in the first intrauterine life, and before delivery
- initially: the head
- later-on: the umbilicus
What is the optimum length of a full-term baby?
What will it be in 1 year, 2, 3, 4 and 13 years.
50cm
- 1: +25
- 2: + 12
- 3: +8
- 4: 2x birth length
- 13: 3x birth length
When does the period of linear growth affected by the growth hormone?
> 3 years.
After 3 years of age, what affects linear growth the most?
Growth hormone, thyroid, genetics.
Females and males growth at the same rate of 4-7cm from …… years to …….. years:
From >3 years to puberty.
From newborn > 3 years > 10 years. How does the mid-point changes?
- birth: 1.7 “upper segment > lower”
- 3 years: 1.3
- 10 years: 1.0
If a 10 year old child has segment ratio of 1.3, it means that abnormality is at the:
Lower segment
Name a disease associated with lower and upper segment abnormality:
- genu vulgus, and genu varus
- fractures of verteberal column and malignancies, kyphosis and scoliosis.
Growth spurt during the pubertal phase is associated with increase of:
1- thyroid horome
2- growth hormone
3- sex steroid
Differentiate between males and females in:
1- the peak of length:
2- the time of growth spurt:
3- difference in final height
1- peak of length is higher in males by “3 cm”
2- duration is earlier in females by “2 years”
3- 13 cm.
When are females and males starting to get their growth spurt
- female: breast 3
- male: testicular 4
What is the gene that affect growth?
SHOX
Turner syndrome are short because they lack
X-chromosome
Shox gene
What is leri-weill syndrome
Male disease associated with missing of shox gene “They only have one copy”
What helps growth hormone to increase
- Sleep through the night
- physical activity
“Sweet food decline growth hromone”
Growth hormone metabolic affect
Anabolic, lipolysis
What is the growth plate
Chondrocyte will grow and calcify from the epiphysis to the meta, and diaphysis
“Chondoplasia > osteogeneis > resorption”
Accurate measurement of the height is: the
1- Occipit, shoulder, buttox, heels to the wall.
2- plot on the +-2 SD which is normal.
3- MPH measurment
4- height age
5- growth velocity (measure the difference)
How to differntiate between familial and constitutional delay
- constitutional: bone age is less than normal
- familial: bone age is same
Both: growth is parallel to the line
Endocrine disease are always:
Hypothyroid, Cushing, growth
Short and fat
How to identify endocrinopathies on chart
Their weight to height ratio.
Rapid weight gain, and instant decline in height is associated with which endocrinopathy
Cushing
Chronic disease are always:
Thin and short
