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Growth (108, 121) > Growth Faltering, 121 > Flashcards

Growth Faltering, 121 Flashcards

1
Q

Hormones secreted by the anterior pituitary gland.

A 
FSH.
LH.
ACTH.
TSH.
Prolactin.
Endorphin. (not growth related)
Growth Hormone
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2
Q

Effect of GH

A

via IGF1, stimulates chondrocytes to undergo mitosis.

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3
Q

Normal levels of PTH

A

stimulates osteoblast activity.

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4
Q

High levels of PTH

A

stimulates osteoclast activity

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5
Q

Phases of growth

A

Foetal.
Infantile.
Childhood.
Pubertal.

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6
Q

What stops growth?

A

Oestrogen causes fusion of epiphyseal plates.

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7
Q

How does growth stop in boys?

A

testosterone is converted into oestrogen, causing fusion of epiphyseal plates.

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8
Q

Why is testosterone not given to boys who have faltered growth?

A

testosterone is converted into oestrogen and causes fusion of epiphyseal plates, therefore causing an early growth cessation.

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9
Q

oxandralone

A

steroid given to boys to encourage growth. It is not converted into oestrogen, therefore will not stop bone growth.

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10
Q

What is the main contributor to growth faltering in children under 2?

A

Poor feeding.

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11
Q

Twin-twin transfusion

A

one twin receives a disproportional amount of blood. Growth is not equal.

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12
Q

Foetal Alcohol Syndrome

A

low birth weight.
growth faltering.
developmental delay.
dysmorphic facial features.

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13
Q

Main causes of foetal and childhood faltering

A

Nutrition (maternal/feeding).
Genetic.
Environment.

NB. Hormonal influences do not really have an effect - a child with low GH will have a normal birth weight and first year.

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14
Q

4 Chronic conditions causing faltering

A

Coeliac.
Down’s.
Cystic Fibrosis.
Turner’s.

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15
Q

How does Cystic Fibrosis cause faltering?

A

Increased secretions (in airways AND GI tract) - malabsorption in GI.

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16
Q

Pubertal faltering is mainly caused by

A

oestrogen/testosterone levels.

17
Q

Adrenarche

A

adrenal androgen secretion - pubic and axillary hair.

18
Q

Gonadarche

A

GnRH secretion - LH/FSH - Testosterone/oestrogen - gonad development.

19
Q

Target Centile Range (how to calc)

A

average parents’ height, +7 for boys, -7 for girls. +/-8.5cm gives range.
94% expected to be in range.

20
Q

4 key factors in growth

A

Genetics.
Hormones.
Environment/Emotional/Economic.
Nutritional.

21
Q

Do precocious pubescent children end up taller?

A

NO. early initial growth, early epiphyseal fusion, shorter adults.

22
Q

Child with reduced weight to height ratio. Acute/chronic malnutrition?

A

Acute

23
Q

Child with normal height:weight ratio, but decreased height for age. Acute/chronic malnutrition?

A

Chronic

24
Q

Signs/symptoms of Marasmus

A

thin flaccid skin.
reduced fat and muscle.
alert, irritable.

25
Q

Signs/symptoms of Kwashiokors

A 
Oedema.
flaky dermatitis.
thin, dry hair.
hepatomegaly.
apathy, misery, lethargy.
26
Q

1st line investigations for growth faltering

A 
FBC.
Iron.
Vitamins.
Real function.
LFT.
Bone age.
Thyroid.
27
Q

normal weight gain for 0-3/12

A

200g/week

28
Q

normal weight gain for 4-6/12

A

150g/week

29
Q

normal feed for 0-3/12

A

150-200ml/kg/day

30
Q

normal feed for 4-6/12

A

140ml/kg/day

31
Q

normal feed for 1+ year

A

600ml/day, plus water

32
Q

Colostrum composition (compared to normal breast milk)

A 
9 X protein than normal.
less fat.
80% Whey.
20% Casein (phosphoprotein).
antiinfective agents.
Growth Factors.
33
Q

Mature (normal) breast milk composition (compared to colostrum)

A

more fat.
60% Whey.
40% Casein (phosphoprotein).
Lactose.

34
Q

Formula milk (compared to breast milk)

A

Higher in iron.
iron has reduced bioavailability.
fatty acids.
more calories.

35
Q

when should a child start to be weaned onto food?

A

from 4-6 months. continue with milk feeding indefinitely.

36
Q

When should a child stop breast/formula milk?

A

1 year - switch to cows milk.

37
Q

Signs/symptoms of Cows Milk Protein (CMP) intolerance

A

after switching to cows milk: Months of irritability, crying, poor sleep. Loose stools, increased vomiting, reduced weight gain.

38
Q

Management of CMP intolerance.

A

stop feeding cows milk. improvement? regular re-challenges with cows milk. CMP intolerance often passes.

Growth (108, 121) (2 decks)

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