growth & puberty Flashcards
what is standard deviation? what is z score?
standard deviation = measure of variability
z score = standard deviation score (it’s number of standard deviations away from mean score)
what stuff to measure to assess growth?
- weight (have to have no clothes if baby & vest/pants if over 2)
- head circumference at widest
- measure length/height
what is meant when see on xth centile or in centile space?
when on centile line = say on xth centile
centile space = between 2 centile lines
what is average age girl starts puberty?
11
what is the tanner staging for boys & girls?
tanner stages = assess stage of puberty
I = <2.5 testicular volume
II = 2.5-3.2 testicular volume
III = 3.6
IV = 4.1-4.5
V = >4.5
I = no breasts & no hair
II - V = basically just breasts getting bigger & more hair
what is thelarche, adrenarche, menarche?
thelarche = breast budding
adrenarche = body hair & odour
menarche = period
what are some important comm skills areas to be covered if short child?
- ICE (some people not bothered by height)
- cover birth (small etc)
- past medical history
- pubertal symptoms
- fam history (parental heights, parental puberty)
what is mid parental centile?
when draw line between mum & dad height = child should be within 2 centile spaces of the midline
what investigations should be done if short child?
- bloods (gonadotropin, IGF1, testosterone/oestrogen, coeliac)
- bone age (non dominant wrist)
- dynamic function test (stimulates growth hormone, causes hypotensive/hypoglycaemic)
- karyotype - turner’s syndrome
what is constitutional growth delay?
it’s a diagnosis of exclusion, it’s when for some reason don’t grow much in a few years but catch up eventually (don’t need growth hormone)
what are causes of short stature?
- genetic (parents short)
- constitutional growth delay
- dysmorphic syndromes (turners. downs)
- endocrine (pituitary)
- chronic (coeliac, cystic fibrosis)
- psychosocial deprivation (not proper food or loved)
