growth, puberty and paediatric problems

Question 1

How do you calculate the mid parental height for a boy

Answer 1

Increase the mums height by 15 cm then average with the dad’s height

Question 2

How do you calculate the mid parental heigh of a girl

Answer 2

Reduce the dads height by 15 cm then average it with the mums height

Question 3

What is the first size of the testicle which indicates puberty

Answer 3

4 mm

Question 4

What factors influence height

Answer 4

age, sex, race, nutrition, parental heights, puberty, bone age (skeletal maturity), general health, growth disorders or chronic diseases, socio-economic status and emotional well being

Question 5

What are the most important stages in puberty

Answer 5

breast budding - in females
testicular enlargement - in males
These are the earliest onset signs of puberty beginning

Question 6

What is the relationship between obesity and puberty in girls

Answer 6

Obesity allows for larger growth spurt and earlier puberty

Question 7

What are the indications for referral in relation to growth disorders

Answer 7

Extremely short or tall
Height below target height
Abnormal rate of growth
chronic disease history
obvious dysmorphic syndrome
Early or late puberty

Question 8

What are pathological causes of short stature

Answer 8

Undernutrition
chronic diseases such as IBD and coeliac
steroids
hormonal issues such as growth hormone deficiency and hypothyroidism
syndromes such as turner

Question 9

What is an effective treatment for growth hormone deficiency

Answer 9

Growth hormone replacement therapy

Question 10

What is early puberty in males

Answer 10

less than 9 years old

Question 11

What is delayed puberty in males

Answer 11

older than 14 years old

Question 12

What is early puberty in females

Answer 12

less than 8 years old

Question 13

What is delayed puberty in females

Answer 13

Older than 13 years old

Question 14

What gender does constitutional delay of growth and puberty most commonly occur in

Answer 14

Males

Question 15

What is infantile thelarche

Answer 15

Very young girls who have breast buds which don’t develop

Question 16

What is central precocious puberty

Answer 16

Early activation of the HPG axis - hypothalamus - pituitary - gonad axis which results in the early maturation of sex organs

Question 17

What is the treatment for central precocious puberty

Answer 17

GnRH agonist - gonadotropin releasing hormone agonist

Question 18

What happens in precocious pseudo-puberty and why

Answer 18

Abnormal sex steroid hormone secretion - causes virilasing or feminasing

Question 19

What is virilasing

Answer 19

Women develop man characteristics

Question 20

What is feminasing

Answer 20

Men develop female characteristics

Question 21

What are the common causes of congenital hypothyroidism

Answer 21

Athreosis - absence of thyroid tissue
Hypoplastic - incomplete development of organ
ectopic - fertilised egg plants itself outside the uterus

Question 22

What is the most common cause of acquired hypothyroidism

Answer 22

Autoimmune - hashimotos

Question 23

What childhood issues are associated with acquired hypothyroidism

Answer 23

Lack of height gain
Pubertal delay

Question 24

How does hashimotos thyroiditis work

Answer 24

It has antibodies which block the TSH receptor and this results in the prevention of the production of T3/T3

Question 25

What are causes of thyroid deficiency

Answer 25

Simple obesity
drugs
syndromes
endocrine disorders
hypothalamus damage

Question 26

What drugs can cause weight gain

Answer 26

insulin
steroids
antithyroid drugs
sodium valporate

Question 27

What is the treatment for thyroid defficiency

Answer 27

Diet
exercise
psychological input