Kaulfers- Growth Charts, Puberty, Diseases Flashcards
1
Q
most important feature of growth charts; the pattern of growth over time can help identify medical conditions
A
growth velocity (are they growing)
2
Q
average amount of growth in inches per year
A
2 inches
3
Q
average amount of growth in cm per year
A
4-8 cm
4
Q
genetic potential; mid-parental; target height calculation for future kids
A
girls: dad’s ht - 5 inches + moms ht / 2
boys: mom’s ht plus 5 inches + dads ht / 2
5
Q
true endocrine disease only accounts for ____% of the causes of short stature
A
5%
6
Q
malnutrition is a major cause of ____ worldwide
A
short stature
7
Q
most cases of short stature are either ____ or ____
A
familial short stature
late bloomer (constitutional delay of growth)
8
Q
normal bone age
normal labs
growth curve at target height
A
familial short stature
9
Q
normal labs
delayed bone age
poor growth until child hits puberty
A
Late Bloomer
(constitutional delay of growth)
10
Q
A
constitutional delay of growth
11
Q
the white
A
Turner’s syndrome
12
Q
45 XO (non-disjunction)
short stature, sterile, web neck
A
Turner’s syndrome
13
Q
delayed bone age
height falling percentiles
weight more than height percentile
A
growth hormone deficiency
14
Q
normal labs except low IGF-1 and low IGF-BP3
A
growth hormone deficiency
15
Q
falling height percentiles
weight percentile for age
A
growth hormone deficiency
16
Q
GH tells liver to make ___ and ___ and helps bone grow
A
IGF-1 and IGF-BP3
17
Q
if ____ is high, pituitary is mad at you
A
prolactin
18
Q
due to hypopituitarism (that can be associated w/ midline structural defects)
no TSH, LH, FSH, GH, ACTH, prolactin
A
congenital growth hormone deficiency
19
Q
usually due to a brain tumor, traumatic brain injury, or possible ADHD meds
A
acquired growth hormone deficiency
20
Q
Most common pituitary brain tumor (outgrowth of Rathke’s pouch)
A
craniopharyngioma
21
Q
short stature kid; what potential tumor
A
craniopharyngioma
22
Q
most common cause of hypothyroidism
A
Hashimoto’s hypothyroidism
23
Q
______ will usually not have the typical symptoms of fatigue and weight gain with hypothyroidism but will have short stature
A
children
24
Q
GH deficiency, acquired hypothyroidism, and Cushing’s syndrome will all have identical what
A
growth charts
25
Pex: big belly but skinny arms and legs; big round face; buffalo hump on back of neck
short, overweight, high bp
Cushing's syndrome
26
glucocorticoid excess
can be from ACTH-producing brain tumor or adrenal tumor
Cushing's syndrome
27
if you overeat carbs, then as a child, you will be _____ than your potential
taller
28
A short thin child – needs to go to ___
peds GI
29
A short overweight child– needs to go to ____
Peds endo
30
A tall overweight child – needs to go to _____
dietician
31
do a growth chart
32
____ disease will have poor weight gain and height
celiac disease
33
liver, kidney, heart, lung, and stomach disease/problems will cause what 2 things
poor weight and poor height
34
all ___ problems have poor height but INCREASED weight
hormone
35
PEx includes palmar crease and face structure
Trisomy 21
36
PEx has short 4th metacarpal, wide arm carrying angle, webbed neck
Turner's syndrome
37
born before 37 weeks gestational age
premature
38
what is used to determine how well baby tolerated delivery
Apgar score
39
max number you can give but shouldn't on Apgar score
10
40
when to do Apgar score
1 minute of life
5 minutes of life
41
what does the first # for apgar score tell you
how well the baby tolerated the birthing process
42
what does the second # for apgar score tell you
how well the baby tolerated/responded to the resuscitation
43
anything under _____ on apgar score at the 5 minute mark means that the baby is sick and you need to start figuring out why
7
44
test for determining how old the baby is (term or preterm)
Ballard assessment
45
_____ is used to determine age of infant
Ballard assessment
46
46 XY, but looks 100% like a female on the outside (testes don't descend)
complete androgen insensitivity
47
15 year old female without a period (workup turns out testes in abdomen)
complete androgen insensitivity
48
2 testicles in abdomen and no uterus
Complete androgen insensitivity
49
this deficiency causes genetic males to look 100% female
5-alpha reductase deficiency
50
"My normal 13 year old girl, who has never had a period, has started growing a penis"
5-alpha reductase deficiency
51
risk factors for what
twins
DM
HTN
trauma
infection
delivering preterm
52
Anyone born before ____ weeks GA is at risk of breathing difficulty due to immature lungs (RDS)
35
53
any child at risk of being born early will be given what to stimulate lungs to mature faster
betamethasone
dexamethasone
54
(hyaline membrane disease)
respiratory distress syndrome
55
primary defect is surfactant deficiency
respiratory distress syndrome
56
machine like continuous murmur that baby got after having resp. distress syndrome
PDA
57
diagnose PDA
Echo
58
treat PDA
Indomethacin
ibuprofen
59
Any baby born before 30 weeks gestation is at risk for _______due to the tiny fragile blood vessels in the brain
brain bleeds
60
intraventricular hemorrhage diagnosed with what at 2 weeks of life
cranial US
61
intraventricular hemorrhage usually happens within the first ____ days of life
3
62
any permanent damage to the brain
(child can have difficulty walking, moving, or controlling body parts)
cerebral palsy
63
Happens in preemies once they start getting fed.
The lining of the bowel wall gets injured and infected, causing fluid-filled loops of bowels on babygram
necrotizing enterocolitis
64
Worst case scenario is if the bowel perforates and the intestines lose blood flow and have to be removed, leaving the child with a “short-gut” and malabsorption
necrotizing enterocolitis
65
____ can cause necrotizing enterocolitis in neonates
PPIs
66
#1 way to reduce the risk of NEC (necrotizing enterocolitis) is by giving the baby _____
breastmilk
67
why do opthalmologist check premature babies eyes
check for retinopathy of prematurity
68
retinopathy of prematurity
69
having trouble breathing after c-section
transient tachypnea of the newborn (TTN)
70
baby couldn't resorb all the fluid beforehand so born with fluid in lungs
Transient tachypnea of the newborn
71
how to treat transient tachypnea of the newborn
oxygen and time
72
Meconium aspiration syndrome
73
_____, if leaked into the amniotic fluid, can cause a lot of problems-------prenatal infection and irritate baby's skin
meconium
74
how to treat meconium aspiration syndrome
suction it out
75
meconium aspiration syndrome can lead to persistent pulmonary HTN; how to treat
NO, milrinone, sildenafil
76
onset of breast development
Thelarche
77
onset of sexual hair growth
Pubarche
78
onset of menses
Menarche
79
appearance of sperm in seminal fluid
Spermarche
80
onset of adrenal androgen production that contributes to pubarche
Adrenarche
81
before puberty, there is no pulsatile release of _____ from hypothalamus
GnRH
82
at puberty, hypothalamus starts releasing ___
GnRH
83
plastics, brain injury, diet can cause early _____ release from hypothalamus
GnRH
84
in girls, LH acts on ____ cells in ovary
in boys, LH acts on _____ cells in testes
theca
leydig
85
in girls, FSH acts on ____ cells in ovary
in boys, FSH acts on ____ cells in testes
granulosa
sertoli
86
how is estrogen made in ovary
theca cell makes a precursor that is sent to granulosa cell to be converted to estradiol by aromatase
87
sometimes after birth at 8 wks of life, _____ gets temporarily turned on from withdrawal of maternal estrogens and this is called mini-puberty of newborn
HPG axis
88
child born with no testes but empty scrotum; what 2 tests to do
karyotype
US (to check for a uterus)
89
46 XY
testes in abdomen (no uterus)
low LH, FSH, testosterone
congenital hypopituitarism
90
mini-puberty of the newborn
91
early puberty is anyone who gets breasts before age ___
8
92
main hormone made in adrenal gland
DHEA-S (androgen)
93
main hormone in ovaries
estradiol
94
main hormone in testes
testosterone
95
all 3 glands, ovary, testes, adrenal, can but they're not supposed to do what
can make both kinds of hormones
96
out of control ovary can make tons of androgens, causing woman to get facial hair and bad acne
PCOS
97
he started making more testosterone as LH pulses got stronger, and his fat cells were turning that into estrogen (will self-resolve)
98
at the time of puberty, this zone of adrenal gland starts making lots of androgens
zona reticularis
99
all of the parts of puberty that girls hate is due to what
adrenal glands
100
premature adrenarche (benign)
101
adrenal gland: DHEA-S
102
half of pubertal growth spurt is due to ___ and the other half is due to ____
testosterone; GH
103
brain injury in 12 yr old boy can cause what
GH deficiency
104
obesity will lead to early ____
puberty
105
is early puberty in a girl okay
yes
106
is early puberty in a boy okay
no
107
sexual maturity rating aka
Tanner Staging
108
prepubertal state on tanner staging
tanner 1
109
puberty complete on tanner staging
tanner 5
110
development of breast buds tanner staging
tanner 2
111
mature adult breast tanner stage
tanner 5
112
tanner stage that happens a month before you get period
tanner 4
113
first sign of puberty in girls
breast buds
114
tanner stage when girls have growth spurt
tanner 2-3 (10 yrs old)
115
_____ is completely independent of puberty (but typically occurs with it)
adrenarche
116
no pubic hair tanner stage
tanner 1
117
dark curly hair on thighs now tanner stage
tanner 5
118
tanner stage for prepubertal in boys
tanner 1
119
adult size/shape of penis and testicles tanner stage
tanner 5
120
first sign of puberty in boys
enlarged testicles
121
when penis gets wider than a pencil means what
making testosterone
122
tanner stage in boys when only private parts get bigger
1-3
123
tanner stage in boys when others start to notice they are changing
tanner 4
124
tanner stage when boys get their main growth spurt
tanner 4
125
non-invasive way to assess where a child is at in puberty
skeletal maturation (bone age xray)
126
growth plates are called
epiphyses
127
girls grow until the bones are ___ yrs old
14
128
boys grow until the bones are ___ yrs old
16
129
bone age capping means what
middle of growth spurt
130
all of epiphyses are fused w/ the metaphyses
growth complete
