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Endocrine System > Lecture 5 & 6 Growth and Develop and Endocrine Problems in Childhood > Flashcards

Lecture 5 & 6 Growth and Develop and Endocrine Problems in Childhood Flashcards

1
Q

Name measurement techniques performed to asses a Childs growth and development

A

Height
Length
Sitting Height
Head circumference

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2
Q

Name charts used for measuring and plotting data in assessing growth and development

A 
RCPCH UK 2-18 growth chart
Birth centiles
Parent height comparator
Mid parental gentile scale
Predicted adult height scale
Target height
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3
Q

How is the potential height if a child calculated

A

add together the father’s height and the mother’s height divide this by two
add 7cm to the total
this gives the mid parental centile

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4
Q

B1

A

Prepubertal

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5
Q

B2

A

Brest bud

Enlargement of areola

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6
Q

B3

A

Further enlargement of breast and areola

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7
Q

B4

A

Areola and papilla form a secondary mound

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8
Q

B5

A

Mature stage

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9
Q

G1

A

Prepubertal

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10
Q

G2

A

Enlargement of scrotum and testes

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11
Q

G3

A

Enlargement of penis length and further growth of testes

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12
Q

G4

A

Increased size of penis with growth in breadth and development of glands

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13
Q

G5

A

Adult genitalia

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14
Q

PH1

A

Prepubertal

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15
Q

PH2

A

Sparse growth of long hair, slightly pigment

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16
Q

PH3

A

Darker, coarser and more curled hair, sparsely spreading over junction of pubes

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17
Q

PH4

A

Hair adult in type, but covering smaller area than adult, no spread to medial surface of thighs

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18
Q

PH5

A

Adult hair in type and quantity

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19
Q

T 1-3ml

A

Prepubertal

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20
Q

T4ml +

A

Pubertal

21
Q

T12-25ml

A

Adults

22
Q

Small testes are an indicator of what

A

primary or secondary hypogonadism

23
Q

Factors influencing height

A
  • Age
  • Sex
  • Race
  • Nutrition
  • Parental Heights
  • Puberty
  • Skeletal maturity
  • General Health
  • Chronic disease
  • Specific growth disorders
  • Socio-economic status
  • Emotional well-being
24
Q

Describe normal growth in the infinite stage

A

 Rapid period of growth 0-2 years

 Depends in factors such as nutrition and IGF1 & IGF2

25
Q

Describe the normal growth during childhood

A

 Long phase of growth from 2-12 years
 Slower, slightly decelerating curve
 More dependent on growth hormone and thyroxine

26
Q

Describe the normal growth during the pubertal stage

A

 From around 12 to final height

 Dependent in the sex steroid hormone (testosterone and oestrogen)

27
Q

What are the most important pubertal stages in girls and boys

A

• Breast budding (Tanner stage B2) in a girl
• Testicular enlargement (Tanner stage G2-T 3-4ml) in boy
Earliest sign of puberty

28
Q

Indicator for growth disorder referral

A
  • Extreme short or tall (off centiles)
  • Height below target height
  • Abnormal height velocity (crossing centiles)
  • History of chronic disease
  • Obvious dysmorphic syndrome
  • Early/late puberty
29
Q

Common causes of short stature

A
  • Familial
  • Constitutional- temporary delay in the skeletal growth
  • SGA/IUGR
30
Q

Pathological causes of short stature

A 
•	Undernutrition
•	Chronic illness
•	Iatrogenic (steroids)
•	Physiological and Social
•	Hormonal (GHD, hypothyroidism)
•	Syndrome 
	Turner
	Prader-Willi
	Noonan’s
	Achondroplasia
31
Q

Constitutional delay of growth and puberty mainly occurs in

A

Boys

People with FH in dad or brother

32
Q

Other causes of delayed puberty

A
  • Gonadal dysgenesis (Turner 45X, Klinefelter 47 XXY)
  • Chronic disease (Crohn’s, asthma)
  • Impaired HPG axis (hypothalamic-pituitary-gonadal)- septo-optic dysplasia, craniopharyngioma, Kallman’s syndrome
  • Peripheral (cryptorchidism, testicular irradiation)
33
Q

Management of new born with ambiguous genitalia

A

 Do not guess the sex
 MDT approach (paed. endo, surg., neonatologist, geneticist, psychologist)
 Exam: gonads/internal organs
 Karyotype
 Exclude congenital adrenal hyperplasia- risk of adrenal crisis in first 2 weeks of

34
Q

Causes of congenital hypothyroidism

A

 Athyreosis ( absence or functional deficiency of the thyroid gland) /hypoplastic (incomplete development)/ectopic (not located in its usual position)
 Dyshormonogenic

35
Q

Whats the most common cause of acquired hypothyroidism

A

autoimmune thyroiditis (Hashimoto’s)

36
Q

What childhood issues an arise with acquired hypothyroidism

A

 Lack of height gain
 Pubertal delay
 Poor school performance

37
Q

What BMI is classified as obese

A

BMI> 97.5th centile or SD >2

38
Q

What BMI is classified as overweight

A

BMI >85th centile or SD >1.04

39
Q

How is Obesity assessed

A
  • Weight
  • BMI
  • Height
  • Waist circumference
  • Skin folds
  • History and examination
  • Complications
40
Q

Name complications of obesity

A
  • Metabolic syndrome
  • Fatty liver disease
  • Gallstones
  • PCOS
  • Nutritional deficiencies
  • Thromboembolic disease
  • Pancreatitis
  • Central hypoventilation
  • Obstructive sleep apnoea
  • GORD
  • Orthopaedic problems
  • Stress incontinence
  • Injuries
  • Psychological
  • LVH
  • Atherosclerotic CVD
  • Right sided heart failure
41
Q

Drugs that causes obesity

A

Insulin
Steroids
Antithyroid drugs
Sodium valproate

42
Q

Syndromes that are linked to obesity

A

 Prader Willi
 Laurence-Moon-Biedl syndrome
 Pseduohypoparathyroidism type 1
 Down’s syndrome

43
Q

Endocrine disorders linked to obesity

A 
	Hypothyroidism
	Growth Hormone deficiency
	Glucocortiocoid excess
	Hypothalmic lesion (tumour/trauma/infection)
	Androgen excess
	Insulinoma
	Insulin resistance syndromes
	Leptin deficiency 
	Growth failure
44
Q

Symptoms of Type 1 diabetes in children

A

Thirst
Weight Loss
Tired
Using the Toilet more

45
Q

Symptoms of type 1 diabetes in children under 5

A
  • Heavier than usual nappies
  • Blurred vision
  • Candidiasis (oral, vulval)
  • Constipation
  • Recurring skin infections
  • Irritability, behaviour change
46
Q

Steps involved in making an early diagnosis for children with suspected diabetes

A

THINK symptoms
Test immediately
Telephone

47
Q

if finger prick capillary glucose test is >11mmol/l the patient is

A

Diabetic

48
Q

if finger prick capillary glucose test is <11mmol/l the patient is

A

not diabetic and there is another cause of the symptoms

49
Q

Symptoms fo DKA

A
  • Nausea & Vomiting
  • Abdominal pain
  • Sweet smelling ketotic breath
  • Drowsiness
  • Rapid, deep sighing respiration
  • Coma

Endocrine System (26 decks)

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