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ENR Biweekly 2 > Kaulfers- Growth Charts, Puberty, Diseases > Flashcards

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)

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2
Q

average amount of growth in inches per year

A

2 inches

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3
Q

average amount of growth in cm per year

A

4-8 cm

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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

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5
Q

true endocrine disease only accounts for ____% of the causes of short stature

A

5%

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6
Q

malnutrition is a major cause of ____ worldwide

A

short stature

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7
Q

most cases of short stature are either ____ or ____

A

familial short stature
late bloomer (constitutional delay of growth)

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8
Q

normal bone age
normal labs
growth curve at target height

A

familial short stature

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9
Q

normal labs
delayed bone age
poor growth until child hits puberty

A

Late Bloomer
(constitutional delay of growth)

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10
Q
A

constitutional delay of growth

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11
Q

the white

A

Turner’s syndrome

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12
Q

45 XO (non-disjunction)
short stature, sterile, web neck

A

Turner’s syndrome

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13
Q

delayed bone age
height falling percentiles
weight more than height percentile

A

growth hormone deficiency

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14
Q

normal labs except low IGF-1 and low IGF-BP3

A

growth hormone deficiency

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15
Q

falling height percentiles
weight percentile for age

A

growth hormone deficiency

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16
Q

GH tells liver to make ___ and ___ and helps bone grow

A

IGF-1 and IGF-BP3

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17
Q

if ____ is high, pituitary is mad at you

A

prolactin

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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

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19
Q

usually due to a brain tumor, traumatic brain injury, or possible ADHD meds

A

acquired growth hormone deficiency

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20
Q

Most common pituitary brain tumor (outgrowth of Rathke’s pouch)

A

craniopharyngioma

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21
Q

short stature kid; what potential tumor

A

craniopharyngioma

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22
Q

most common cause of hypothyroidism

A

Hashimoto’s hypothyroidism

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23
Q

______ will usually not have the typical symptoms of fatigue and weight gain with hypothyroidism but will have short stature

A

children

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24
Q

GH deficiency, acquired hypothyroidism, and Cushing’s syndrome will all have identical what

A

growth charts

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25
Q

Pex: big belly but skinny arms and legs; big round face; buffalo hump on back of neck
short, overweight, high bp

A

Cushing’s syndrome

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26
Q

glucocorticoid excess
can be from ACTH-producing brain tumor or adrenal tumor

A

Cushing’s syndrome

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27
Q

if you overeat carbs, then as a child, you will be _____ than your potential

A

taller

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28
Q

A short thin child – needs to go to ___

A

peds GI

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29
Q

A short overweight child– needs to go to ____

A

Peds endo

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30
Q

A tall overweight child – needs to go to _____

A

dietician

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31
Q
A

do a growth chart

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32
Q

____ disease will have poor weight gain and height

A

celiac disease

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33
Q

liver, kidney, heart, lung, and stomach disease/problems will cause what 2 things

A

poor weight and poor height

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34
Q

all ___ problems have poor height but INCREASED weight

A

hormone

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35
Q

PEx includes palmar crease and face structure

A

Trisomy 21

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36
Q

PEx has short 4th metacarpal, wide arm carrying angle, webbed neck

A

Turner’s syndrome

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37
Q

born before 37 weeks gestational age

A

premature

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38
Q

what is used to determine how well baby tolerated delivery

A

Apgar score

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39
Q

max number you can give but shouldn’t on Apgar score

A

10

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40
Q

when to do Apgar score

A

1 minute of life
5 minutes of life

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41
Q

what does the first # for apgar score tell you

A

how well the baby tolerated the birthing process

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42
Q

what does the second # for apgar score tell you

A

how well the baby tolerated/responded to the resuscitation

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43
Q

anything under _____ on apgar score at the 5 minute mark means that the baby is sick and you need to start figuring out why

A

7

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44
Q

test for determining how old the baby is (term or preterm)

A

Ballard assessment

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45
Q

_____ is used to determine age of infant

A

Ballard assessment

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46
Q

46 XY, but looks 100% like a female on the outside (testes don’t descend)

A

complete androgen insensitivity

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47
Q

15 year old female without a period (workup turns out testes in abdomen)

A

complete androgen insensitivity

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48
Q

2 testicles in abdomen and no uterus

A

Complete androgen insensitivity

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49
Q

this deficiency causes genetic males to look 100% female

A

5-alpha reductase deficiency

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50
Q

“My normal 13 year old girl, who has never had a period, has started growing a penis”

A

5-alpha reductase deficiency

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51
Q

risk factors for what
twins
DM
HTN
trauma
infection

A

delivering preterm

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52
Q

Anyone born before ____ weeks GA is at risk of breathing difficulty due to immature lungs (RDS)

A

35

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53
Q

any child at risk of being born early will be given what to stimulate lungs to mature faster

A

betamethasone
dexamethasone

54
Q
A

(hyaline membrane disease)
respiratory distress syndrome

55
Q

primary defect is surfactant deficiency

A

respiratory distress syndrome

56
Q

machine like continuous murmur that baby got after having resp. distress syndrome

A

PDA

57
Q

diagnose PDA

A

Echo

58
Q

treat PDA

A

Indomethacin
ibuprofen

59
Q

Any baby born before 30 weeks gestation is at risk for _______due to the tiny fragile blood vessels in the brain

A

brain bleeds

60
Q

intraventricular hemorrhage diagnosed with what at 2 weeks of life

A

cranial US

61
Q

intraventricular hemorrhage usually happens within the first ____ days of life

A

3

62
Q

any permanent damage to the brain
(child can have difficulty walking, moving, or controlling body parts)

A

cerebral palsy

63
Q

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

A

necrotizing enterocolitis

64
Q

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

A

necrotizing enterocolitis

65
Q

____ can cause necrotizing enterocolitis in neonates

A

PPIs

66
Q

1 way to reduce the risk of NEC (necrotizing enterocolitis) is by giving the baby _____

A

breastmilk

67
Q

why do opthalmologist check premature babies eyes

A

check for retinopathy of prematurity

68
Q
A

retinopathy of prematurity

69
Q

having trouble breathing after c-section

A

transient tachypnea of the newborn (TTN)

70
Q

baby couldn’t resorb all the fluid beforehand so born with fluid in lungs

A

Transient tachypnea of the newborn

71
Q

how to treat transient tachypnea of the newborn

A

oxygen and time

72
Q
A

Meconium aspiration syndrome

73
Q

_____, if leaked into the amniotic fluid, can cause a lot of problems——-prenatal infection and irritate baby’s skin

A

meconium

74
Q

how to treat meconium aspiration syndrome

A

suction it out

75
Q

meconium aspiration syndrome can lead to persistent pulmonary HTN; how to treat

A

NO, milrinone, sildenafil

76
Q

onset of breast development

A

Thelarche

77
Q

onset of sexual hair growth

A

Pubarche

78
Q

onset of menses

A

Menarche

79
Q

appearance of sperm in seminal fluid

A

Spermarche

80
Q

onset of adrenal androgen production that contributes to pubarche

A

Adrenarche

81
Q

before puberty, there is no pulsatile release of _____ from hypothalamus

A

GnRH

82
Q

at puberty, hypothalamus starts releasing ___

A

GnRH

83
Q

plastics, brain injury, diet can cause early _____ release from hypothalamus

A

GnRH

84
Q

in girls, LH acts on ____ cells in ovary
in boys, LH acts on _____ cells in testes

A

theca
leydig

85
Q

in girls, FSH acts on ____ cells in ovary
in boys, FSH acts on ____ cells in testes

A

granulosa
sertoli

86
Q

how is estrogen made in ovary

A

theca cell makes a precursor that is sent to granulosa cell to be converted to estradiol by aromatase

87
Q

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

A

HPG axis

88
Q

child born with no testes but empty scrotum; what 2 tests to do

A

karyotype
US (to check for a uterus)

89
Q

46 XY
testes in abdomen (no uterus)
low LH, FSH, testosterone

A

congenital hypopituitarism

90
Q
A

mini-puberty of the newborn

91
Q

early puberty is anyone who gets breasts before age ___

A

8

92
Q

main hormone made in adrenal gland

A

DHEA-S (androgen)

93
Q

main hormone in ovaries

A

estradiol

94
Q

main hormone in testes

A

testosterone

95
Q

all 3 glands, ovary, testes, adrenal, can but they’re not supposed to do what

A

can make both kinds of hormones

96
Q

out of control ovary can make tons of androgens, causing woman to get facial hair and bad acne

A

PCOS

97
Q
A

he started making more testosterone as LH pulses got stronger, and his fat cells were turning that into estrogen (will self-resolve)

98
Q

at the time of puberty, this zone of adrenal gland starts making lots of androgens

A

zona reticularis

99
Q

all of the parts of puberty that girls hate is due to what

A

adrenal glands

100
Q
A

premature adrenarche (benign)

101
Q
A

adrenal gland: DHEA-S

102
Q

half of pubertal growth spurt is due to ___ and the other half is due to ____

A

testosterone; GH

103
Q

brain injury in 12 yr old boy can cause what

A

GH deficiency

104
Q

obesity will lead to early ____

A

puberty

105
Q

is early puberty in a girl okay

A

yes

106
Q

is early puberty in a boy okay

A

no

107
Q

sexual maturity rating aka

A

Tanner Staging

108
Q

prepubertal state on tanner staging

A

tanner 1

109
Q

puberty complete on tanner staging

A

tanner 5

110
Q

development of breast buds tanner staging

A

tanner 2

111
Q

mature adult breast tanner stage

A

tanner 5

112
Q

tanner stage that happens a month before you get period

A

tanner 4

113
Q

first sign of puberty in girls

A

breast buds

114
Q

tanner stage when girls have growth spurt

A

tanner 2-3 (10 yrs old)

115
Q

_____ is completely independent of puberty (but typically occurs with it)

A

adrenarche

116
Q

no pubic hair tanner stage

A

tanner 1

117
Q

dark curly hair on thighs now tanner stage

A

tanner 5

118
Q

tanner stage for prepubertal in boys

A

tanner 1

119
Q

adult size/shape of penis and testicles tanner stage

A

tanner 5

120
Q

first sign of puberty in boys

A

enlarged testicles

121
Q

when penis gets wider than a pencil means what

A

making testosterone

122
Q

tanner stage in boys when only private parts get bigger

A

1-3

123
Q

tanner stage in boys when others start to notice they are changing

A

tanner 4

124
Q

tanner stage when boys get their main growth spurt

A

tanner 4

125
Q

non-invasive way to assess where a child is at in puberty

A

skeletal maturation (bone age xray)

126
Q

growth plates are called

A

epiphyses

127
Q

girls grow until the bones are ___ yrs old

A

14

128
Q

boys grow until the bones are ___ yrs old

A

16

129
Q

bone age capping means what

A

middle of growth spurt

130
Q

all of epiphyses are fused w/ the metaphyses

A

growth complete

ENR Biweekly 2 (11 decks)

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