Lecture 23 - Post Natal Growth

Question 1

Factors of normal somatic growth?

Answer 1

good general health, nutrition, genetics, caring environment

Question 2

Disorders leading to abnormal growth?

Answer 2

genetic, endocrine, cartilage or bone, general chronic disease

Question 3

Phases of growth?

Answer 3

infant (rapid, less GH dependent), childhood (constant, GH dependent), puberty (rapid growth dependent on sex steroids and increased GH)

Question 4

Mid-parental height formula - boys?

Answer 4

(dad’s height + (mum’s height +13))/2 +/- 8cm

Question 5

Mid parental height formula - girls?

Answer 5

((dad’s height - 13cm) + mum’s height)/2 +/- 8cm

Question 6

Height velocity chart?

Answer 6

growth is too fast in 0-3 so is missing, slow decline until spike in puberty, right shifted spike indicates delayed puberty

Question 7

Short stature history?

Answer 7

mid-parental height, FHx of delayed puberty, other siblings, symptoms of underlying illness

Question 8

Growth disorders - normal height velocity?

Answer 8

familial short stature, constitutional delay in growth and development

Question 9

Growth disorders - poor height velocity?

Answer 9

proportionate (IUGR, illness, psychosocial) or disproportionate (turner’s syndrome, hypothyroid) pathologies

Question 10

Bone age method?

Answer 10

Gruelich & Pyle standards (X-ray Atlas)

Question 11

Differences of Constitutional Delay of growth to Familial Short Stature?

Answer 11

slow late childhood HV, delayed bone age (>1yr), delayed puberty, normal final height (rather than short)

Question 12

Growth hormone secretion?

Answer 12

pulsatile with low baseline, primarily in stages III - IV sleep

Question 13

Growth hormone secretion increased by?

Answer 13

sleep, exercise hypoglycaemia stress, amino acids, malnutrition, sex steroids

Question 14

Growth hormone secretion decreased by:?

Answer 14

obesity, psychosocial deprivation

Question 15

Growth hormone actions?

Answer 15

inhibits glucose uptake and promotes glycogenolysis, stimulate protein synthesis, promote lipolysis

Question 16

Male without estrogen?

Answer 16

bone plates fail to fuse, leading to abnormal continuous growth

Question 17

Hypothyroid presentations?

Answer 17

severe short stature, developmental delay, deafness

Question 18

Growth promoting hormones - fetus?

Answer 18

IGF-II, insulin, PDGF, EGF, FGF

Question 19

Growth promoting hormones - child?

Answer 19

GH, IGF-1, T4/T3

Question 20

Growth promoting hormones - puberty?

Answer 20

GH, IGF-1, estrogen/test, insulin, T4/3

Question 21

IUGR?

Answer 21

intrauterine growth retardation, <10pc birth weight, catch-up growth possible but leads to short final height if not before 2 years, typically do not reach mid-parental height

Question 22

Turner’s syndrome - presentations?

Answer 22

short stature, poor HV, delayed puberty, potentially: neck webbing, wide spaced nipples

Question 23

Diagnosing turners syndrome?

Answer 23

XO karyotype, normal thyroid function, elevated LH and FSH