Growth in Childhood

Question 1

Describe the centile charts for growth examination

Answer 1

Based on surveys of large numbers of children
Age (x axis) plotted against height (y axis)
For cumulative height
50% of children will be shorter than the 50th centile, 25% of children shorter than the 25th centile etc.

Question 2

What is height velocity

Answer 2

Change in height (cm) / number of years over which this change has happened

Question 3

Define what constitutes a normal growth pattern

Answer 3

Normal children will keep growing on the line for a certain centile

When a child falls in their centile position, this is abnormal

Question 4

Give examples of causes of abnormal growth

Answer 4

Genetic (turners, downs, PDWS)
Skeletal dysplasias 
Malabsorption 
Endocrine disorders
Malnutrition
Emotional deprivation 
Systemic disease (CF, RA)

Question 5

What is Turners syndrome

Answer 5

One X chromosome missing
Only affects females
Short height, failure of ovaries development, heart defects

Question 6

List the hormonal control of growth and factors that can influence growth patterns

Answer 6

Growth hormone releasing factors (hypothalamus)
Growth hormone (Ant. pit.)
Insulin-like growth factor (IGF-1, target organs)
GH has a -ve feedback effect on the hypothalamus
Somatostatin from the hypothalamus has the same effect

Question 7

Define obesity in adults

Answer 7

BMI > 25kg/m2 = overweight

BMI >30kg/m2 = obese

Question 8

How is obesity assessed in children

Answer 8

the BMI centile position.

Question 9

Why does obesity occur

Answer 9

balance between energy taken in as food VS energy expenditure.

There is a small number of individuals with a single gene mutation affecting leptin