Lecture 3: Pediatric Endocrine Flashcards
What is considered an underweight BMI for the 2-18 y/o age group?
BMI <5th percentile for age
What is considered a normal weight BMI for the 2-18 y/o age group?
BMI ≥5th to <85th percentile for age
What is considered an overweight BMI for the 2-18 y/o age group?
BMI ≥85th to <95th percentile for age
What is considered an obese BMI for the 2-18 y/o age group?
BMI ≥95th percentile
What is considered severly obese class II and class III for those 2-18 y/o?
- Class II = ≥120 percent of the 95th percentile or a BMI ≥35 (whichever is lower)
- Class III= ≥140 percent of the 95th percentile or a BMI ≥40 (whichever is lower)
What is the normal growth velocity for school age children (6 y/o to puberty)?
≥5 cm/year (2 inches)
When a childs weight falls off first (or more dramatically) what should you be thinking about first as an underlying cause?
- Nutrition
- Not enough food (emesis, no food)
- Not enough absorbed (mal-absorptive conditions)
- Higher than average caloric requirements
When a childs height falls off first (or more dramatically) what should you be thinking about first as an underlying cause?
- Think endocrine
- GH deficiency
- Hypothyroidism
- Cushing’s syndrome
When a childs head circumference falls off first (or more dramatically) what should you be thinking about first as an underlying cause?
- Primary failure of the brain to grow
- Severe craniosynostosis
What is meant by “delayed bone age” in a child?
Bone age that is two standard deviations below the chronological age is considered delayed
What is essential in developing the differential diagnosis and guiding the work-up for abnormal growth in a child?
Comprehensive history and physical
Which growth curve charts can be used for a patient older than 24 months and how do they differ in terms of how a child is measured?
- If <36 months of age and using 0-36 month curve, measure length while child is supine (length)
- If older than 24 months, MAY use the 2-20 y/o chart but the height must be measured standing up (stature)
What is “catch-up” or “catch-down” growth and when does it occur during a childs development?
- Occurs in first 18 months of life
- Some kids make up to a 25% downward correction on the growth curve —> often occurs as more table food is introduced
- Some kids make up to a 25% upward correction on the growth curve
What is the definition of short stature in a child?
- Height 2 standard deviations below the mean height for age and sex (<3rd %tile)
- Height more than 2 standard deviations below the mid-parental height
What is the importance of Insulin-like Growth Factor (IGF-1) and IGF binding protein 3 (IGFBP3) in the work-up of short stature?
Can point to GH deficiency