growth, puberty and paediatric problems Flashcards
How do you calculate the mid parental height for a boy
Increase the mums height by 15 cm then average with the dad’s height
How do you calculate the mid parental heigh of a girl
Reduce the dads height by 15 cm then average it with the mums height
What is the first size of the testicle which indicates puberty
4 mm
What factors influence height
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
What are the most important stages in puberty
breast budding - in females
testicular enlargement - in males
These are the earliest onset signs of puberty beginning
What is the relationship between obesity and puberty in girls
Obesity allows for larger growth spurt and earlier puberty
What are the indications for referral in relation to growth disorders
Extremely short or tall
Height below target height
Abnormal rate of growth
chronic disease history
obvious dysmorphic syndrome
Early or late puberty
What are pathological causes of short stature
Undernutrition
chronic diseases such as IBD and coeliac
steroids
hormonal issues such as growth hormone deficiency and hypothyroidism
syndromes such as turner
What is an effective treatment for growth hormone deficiency
Growth hormone replacement therapy
What is early puberty in males
less than 9 years old
What is delayed puberty in males
older than 14 years old
What is early puberty in females
less than 8 years old
What is delayed puberty in females
Older than 13 years old
What gender does constitutional delay of growth and puberty most commonly occur in
Males
What is infantile thelarche
Very young girls who have breast buds which don’t develop
What is central precocious puberty
Early activation of the HPG axis - hypothalamus - pituitary - gonad axis which results in the early maturation of sex organs
What is the treatment for central precocious puberty
GnRH agonist - gonadotropin releasing hormone agonist
What happens in precocious pseudo-puberty and why
Abnormal sex steroid hormone secretion - causes virilasing or feminasing
What is virilasing
Women develop man characteristics
What is feminasing
Men develop female characteristics
What are the common causes of congenital hypothyroidism
Athreosis - absence of thyroid tissue
Hypoplastic - incomplete development of organ
ectopic - fertilised egg plants itself outside the uterus
What is the most common cause of acquired hypothyroidism
Autoimmune - hashimotos
What childhood issues are associated with acquired hypothyroidism
Lack of height gain
Pubertal delay
How does hashimotos thyroiditis work
It has antibodies which block the TSH receptor and this results in the prevention of the production of T3/T3
What are causes of thyroid deficiency
Simple obesity
drugs
syndromes
endocrine disorders
hypothalamus damage
What drugs can cause weight gain
insulin
steroids
antithyroid drugs
sodium valporate
What is the treatment for thyroid defficiency
Diet
exercise
psychological input
