Lecture 3: Pediatric Endocrine Flashcards

1
Q

What is considered an underweight BMI for the 2-18 y/o age group?

A

BMI <5th percentile for age

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2
Q

What is considered a normal weight BMI for the 2-18 y/o age group?

A

BMI ≥5th to <85th percentile for age

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3
Q

What is considered an overweight BMI for the 2-18 y/o age group?

A

BMI ≥85th to <95th percentile for age

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4
Q

What is considered an obese BMI for the 2-18 y/o age group?

A

BMI ≥95th percentile

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5
Q

What is considered severly obese class II and class III for those 2-18 y/o?

A
  • 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)
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6
Q

What is the normal growth velocity for school age children (6 y/o to puberty)?

A

≥5 cm/year (2 inches)

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7
Q

When a childs weight falls off first (or more dramatically) what should you be thinking about first as an underlying cause?

A
  • Nutrition
  • Not enough food (emesis, no food)
  • Not enough absorbed (mal-absorptive conditions)
  • Higher than average caloric requirements
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8
Q

When a childs height falls off first (or more dramatically) what should you be thinking about first as an underlying cause?

A
  • Think endocrine
  • GH deficiency
  • Hypothyroidism
  • Cushing’s syndrome
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9
Q

When a childs head circumference falls off first (or more dramatically) what should you be thinking about first as an underlying cause?

A
  • Primary failure of the brain to grow
  • Severe craniosynostosis
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10
Q

What is meant by “delayed bone age” in a child?

A

Bone age that is two standard deviations below the chronological age is considered delayed

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11
Q

What is essential in developing the differential diagnosis and guiding the work-up for abnormal growth in a child?

A

Comprehensive history and physical

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12
Q

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?

A
  • 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)
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13
Q

What is “catch-up” or “catch-down” growth and when does it occur during a childs development?

A
  • 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
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14
Q

What is the definition of short stature in a child?

A
  • 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
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15
Q

What is the importance of Insulin-like Growth Factor (IGF-1) and IGF binding protein 3 (IGFBP3) in the work-up of short stature?

A

Can point to GH deficiency

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16
Q

With delayed puberty/short stature in females must always check what?

A

Karyotype for Turner Syndrome

17
Q

Can short stature occur in the absence of other clinical features?

A

YES

18
Q

What is the definition of precocious puberty in both boys and girls?

A

Full activation of the HPG axis before 8 years old in girls and before 9 years old in boys

19
Q

Precocious puberty should be considered a diagnosis in a girl with what characteristics?

A
  • Progressive breast development
  • Crossing major percentile lines upward on the linear growth chart
20
Q

Precocious puberty should be considered a diagnosis in a boys with what characteristics?

A
  • Evidence of both testicular and penile enlargement
  • Crossing major percentile lines upward on the linear growth chart