Growth, puberty and adolescence Flashcards
what is EAR
estimated average requirement
what is RNI
reference nutrient intake
set at 2SD above the estimated average requirement
therefore likely to meet the needs of 97.5% of population
what is standard deviation SD
measure of variability
what is the z-score
number of SD from the mean
you need more than 1 measurement to determine a normal growth rate, true or false
true
what is a centile space
distance between 2 centile lines
how many phases does a height velocity graph have
3
babies –> nutrition
children –> GH
Puberty –> sex steroid hormones
what happens for puberty to occur
increase in GnRH secretion by the hypothalamus causing a pulsatile increase in LH secretion leading to development of secondary sexual characteristics
what is the average age of puberty onset in girls and boys
girls - 11yo (anything >8)
boys - 11.5yo (anything >9)
what system is used to stage puberty
Tanner staging
what does Tanner staging measure in boys and girls
boys - testicular volume (orchidometer)
girls - breast size
what testicular volume would be considered as entering puberty
> 4ml
what is the order of onset of the following features of puberty in girls
thelarche, menarche and adrenarche
thelarche - breast budding
adrenarche - pubic then axillary hair and odour
menarche - periods starting
what is thelarche
breast budding
what is adrenarche
body hair and odour
define true central precocious puberty TCPP
when normal puberty occurs abnormally early i.e. girls<8 and boys<9
define pubertal delay
absence of secondary sexual characteristics in:
girls >13 (no breast development)
boys >14 (no testicular development)
at what ages is peak height velocity for girls and boys
girls - 12yo
boys - 14yo
true or false:
boys have earlier PHV
girls PHV > boys PHV
boys are taller pre puberty
false, boys have delayed PHV
false, boys PHV > girls PHV
true, boys are taller pre puberty
classifications of short stature
genetic constitutional dysmorphic endocrine chronic psychosocial deprivation
define genetic short stature
healthy well child who has short parents
define constitutional short stature
delayed maturation causing short stature, delayed bone age
what can be used to identify constitutional short stature
bone age
causes of dysmorphic short stature
Down’s
Turner’s
Causes of endocrine short stature
thyroid
GH
pituitary
causes of chronic short stature
IBD
heart disease
coeliac
what is bone age
used to radiologically assess the biological and structural maturity of bone in immature patients - used for growth and endocrine disorders
precocious puberty can lead to advanced bone age, true or false
true
define short stature
<2nd centile or >2SD below mid parental height
