Growth, puberty and adolescence

Question 1

what is EAR

Answer 1

estimated average requirement

Question 2

what is RNI

Answer 2

reference nutrient intake
set at 2SD above the estimated average requirement
therefore likely to meet the needs of 97.5% of population

Question 3

what is standard deviation SD

Answer 3

measure of variability

Question 4

what is the z-score

Answer 4

number of SD from the mean

Question 5

you need more than 1 measurement to determine a normal growth rate, true or false

Answer 5

true

Question 6

what is a centile space

Answer 6

distance between 2 centile lines

Question 7

how many phases does a height velocity graph have

Answer 7

3
babies –> nutrition
children –> GH
Puberty –> sex steroid hormones

Question 8

what happens for puberty to occur

Answer 8

increase in GnRH secretion by the hypothalamus causing a pulsatile increase in LH secretion leading to development of secondary sexual characteristics

Question 9

what is the average age of puberty onset in girls and boys

Answer 9

girls - 11yo (anything >8)

boys - 11.5yo (anything >9)

Question 10

what system is used to stage puberty

Answer 10

Tanner staging

Question 11

what does Tanner staging measure in boys and girls

Answer 11

boys - testicular volume (orchidometer)

girls - breast size

Question 12

what testicular volume would be considered as entering puberty

Answer 12

> 4ml

Question 13

what is the order of onset of the following features of puberty in girls
thelarche, menarche and adrenarche

Answer 13

thelarche - breast budding
adrenarche - pubic then axillary hair and odour
menarche - periods starting

Question 14

what is thelarche

Answer 14

breast budding

Question 15

what is adrenarche

Answer 15

body hair and odour

Question 16

define true central precocious puberty TCPP

Answer 16

when normal puberty occurs abnormally early i.e. girls<8 and boys<9

Question 17

define pubertal delay

Answer 17

absence of secondary sexual characteristics in:
girls >13 (no breast development)
boys >14 (no testicular development)

Question 18

at what ages is peak height velocity for girls and boys

Answer 18

girls - 12yo

boys - 14yo

Question 19

true or false:
boys have earlier PHV
girls PHV > boys PHV
boys are taller pre puberty

Answer 19

false, boys have delayed PHV
false, boys PHV > girls PHV
true, boys are taller pre puberty

Question 20

classifications of short stature

Answer 20

genetic 
constitutional 
dysmorphic 
endocrine 
chronic 
psychosocial deprivation

Question 21

define genetic short stature

Answer 21

healthy well child who has short parents

Question 22

define constitutional short stature

Answer 22

delayed maturation causing short stature, delayed bone age

Question 23

what can be used to identify constitutional short stature

Answer 23

bone age

Question 24

causes of dysmorphic short stature

Answer 24

Down’s

Turner’s

Question 25

Causes of endocrine short stature

Answer 25

thyroid
GH
pituitary

Question 26

causes of chronic short stature

Answer 26

IBD
heart disease
coeliac

Question 27

what is bone age

Answer 27

used to radiologically assess the biological and structural maturity of bone in immature patients - used for growth and endocrine disorders

Question 28

precocious puberty can lead to advanced bone age, true or false

Answer 28

true

Question 29

define short stature

Answer 29

<2nd centile or >2SD below mid parental height