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RED > L21: Childhood Growth > Flashcards

L21: Childhood Growth Flashcards

1
Q

What is measuring children important

A
  • measurement allows to provide a sensitive indication of health in child related
  • growth rates are well defined in healthy children with adequate nutrition
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2
Q

What do changes in growth rate indicate

A

A health problem in the child

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3
Q

What are the typical body portions of babies like

A

Large head
Small mandible
Short neck
Limbs short

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4
Q

How can we measure

A

Arm span

Sitting height

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5
Q

Name the conditions that involve alterations to the normal body proportions

A 
Short trunk dysplasia 
Short limb dysplasia 
Rhizomelic dysplasia 
Mesomelic dysplasia 
Acromelic dysplasia
Asymmetry
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6
Q

What is short trunk dysplasia

A

When the trunk does not grow much

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7
Q

What is short limb dysplasia

A

When the both limbs do not grow much

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8
Q

What is rhizomelic dysplasia

A

Arms and thighs do not grow well

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9
Q

What is mesomelic dysplasia

A

Forearm and leg do not grow well

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10
Q

What is acromelic

A

Hands and feet do not grow well

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11
Q

What is asymmetry

A

Differences in one side/half of the body

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12
Q

What chart do we use to compare the growth of a patient against white children

A

Growth charts

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13
Q

What is the normal range of height between

A

3rd and 97th percentile

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14
Q

What are the components of the infancy, childhood and puberty model

A

Infancy component
Childhood component
Puberty component

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15
Q

What is the infancy component

A

This is driven by nutrition where there is a rapid decelerating growth in the first years

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16
Q

What is the childhood component

A

Growth and thyroid hormone are important

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17
Q

What is the puberty component

A

Pubertal hormone i.e oestrogen and testosterone are important which causes a growth spurt

18
Q

When does the growth spurt stop

A

When the fusion of epihyseal stop

19
Q

What hormone causes epihyseal fusion

A

Oestrogen

20
Q

How is oestrogen produced in males

A

Testosterone is converted to oestrogen by aromatase in adipose tissue

21
Q

Which gender is taller than the other

A

Males

22
Q

What is the first sign of puberty in females

A

Breast development

23
Q

What is the first sign of puberty in males

A

Increased in testicular volume

24
Q

What are the determinants of growth

A 
Parental phenotype and genotype 
Quality and duration of pregnancy 
Nutrition 
Specific system and organ integrity 
Psycho-social environment 
Growth promoting hormones
25
Q

How can we estimate the growth of a male using the heights from parents

A

(Mothers height + fathers height + 12.5) / 2

26
Q

How are females height calculated using the heights from parents

A

(Mothers height + father’s height - 12.5)/ 2

27
Q

Where does growth occurs

A

At growth plates where chondrogenesis happens

28
Q

What factors affect the growth plate

A

Calcium
Phosphate
Nutrition

29
Q

Which factors can inhibit growth at the growth plate

A

Inflammatory cytokines
Acidosis
Toxins

30
Q

What are the ways in which we can classify growth retardation

A

1) primary growth plate abnormality
2) secondary growth disorders
3) idiopathic short stature

31
Q

What are categories of primary growth plate abnormalities that can occur

A

Osteochondrodyplasias (skeletal dysplasia)

chromosomal abnormalities

32
Q

What are osteochondrodysplasia

A

Genetic abnormalities of cartilage and bone growth that lead to abnormal size of the skeleton and disproportion of the long bones, spines, head.

33
Q

What are the chromosomal abnormalities that can occur

A

Turners syndrome (45,X)

34
Q

What doe secondary growth disorders include

A

Malnutrition
Chronic disease
Intra uterine growth retardation
Endocrine disorders

35
Q

Give an example of a endocrine disorder that can cause growth retardation

A

GH and IGF-1 deficiency

36
Q

Describe the the growth hormone regulation axis

A

1) hypothalamus secreted GHRH to the anterior pituitary gland
2) anterior pituitary gland releases GH to the liver or GH stimulates directly the bone
3) liver produced IGF-1 that acts on the bone for growth
4) IGF-1 and GH inhibit the anterior pituitary and hypothalamus later on

37
Q

What are the causes of IGF deficiency

A
  • GH deficiency due to hypothalamic dysfunction or pituitary GH deficiency
  • GH insensitivity: signalling cascade is disrupted or primary defects of IGF1 synthesis
  • IGF1 resistance- due to defects of IGF-1 receptors or post receptor defect
38
Q

How is IGF1 transported in the serum

A

Via:
ALS
IGF-BP3

39
Q

What are the 3 causes of idiopathic short stature

A

1) familial short stature
2) constitutional delay of growth and puberty with normal height prediction
3) overlap of familial and constitutional delay

40
Q

How can we asses patients with GH deficiency

A

Take an x-ray of their left hand and look for a delayed bone age

41
Q

What is psychosocial short startup

A

It is the emotional rejection inside a family so when the child is removed from the stressful environment they can grow

RED (19 decks)

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