Newman HYHO Pediatric Endocrine Flashcards

1
Q

What information is gathered from a single point on a growth chart?

A

only gives information about THAT DAY

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2
Q

What’s essential to evaluate the growth pattern on a growth chart?

A

multiple points. Only way to evaluate if rate of growth is adequate

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3
Q

Range of healthy BMI

A

18.5 - 24.9

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4
Q

Normal growth velocity for school age children

A

5cm/year (2 inches/year)

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5
Q

Growth parameter most commonly first affected in children with endocrine growth disorders

A

length or height is typically affected first

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6
Q

Define “delayed bone age”

A

a bone age that is 2 standard deviations or more below the chronologic age of the patient is considered delayed

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7
Q

Growth parameters plotted on a growth chart (4)

A

1) height (or length if <24 months-of age)
2) weight
3) BMI (if >36 months of age)
4) head circumference ( if <24 months of age)

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8
Q

Cause of deviation on growth chart: if height (or length) changes first or most dramatically

A

think endocrine disorder

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9
Q

Cause of deviation on growth chart: if weight changes first or most dramatically

A

think calories/nutrition

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10
Q

Cause of deviation on growth chart: if head circumference changes first or most dramatically

A

think brain/skull/hydrocephalus

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11
Q

short stature definition

A

height >2 standard deviations below the mean height for age and sex (height would be less than 3rd percentile on growth chart)

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12
Q

Benign causes of short stature (3)

A

1) familial
2) constitutional
3) idiopathic

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13
Q

describe familial short stature

A
  • parents are small
  • grows with normal velocity parameters, they simply plot lower on the growth curve
  • *bone age is consistent with chronological age
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14
Q

describe constitutional short stature

A
  • grow at a low normal rate and plot low on the growth curve
  • puberty is delayed
  • family h/o “late bloomers”
  • puberty and growth spurt occur later, end height is normal
  • *hallmark = delayed bone age
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15
Q

describe idiopathic short stature

A
  • height greater than 2 standard deviations below the mean height for age
  • no endocrine, metabolic, or other Dx present
  • no family h/o short stature
    • bone age is consistent with chronological age
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16
Q

IGF-1 function

A

major mediator of growth hormone stimulated somatic growth

17
Q

IGFBP-3 function

A

main IGF-1 transport protein in the blood stream

18
Q

Important lab values in short stature

A

decreased levels of IGF-1 and IGFBP-3 levels are consistent with growth hormone deficiency

19
Q

When should you draw levels of IGF-1 and IGFBP-3?

A

Can be drawn at any time, levels stay stable during the day

20
Q

What should be done if levels of IGF-1 and IGFBP-3 are decreased?

A

growth hormone stimulation testing should be performed

1) administration of glucagon
2) administration of arginine
3) insulin-induced hypoglycemia

21
Q

Definition of precocious puberty

A

onset of secondary sexual characteristics

  • before 8 years of age in girls
  • before 9 years of age in boys
22
Q

Consider precocious puberty in girls if

A

they have progressive breast development and crossing major percentile lines upward on the linear growth chart

23
Q

Consider precocious puberty in boys if

A

they have evidence of both testicular and penile enlargement and crossing major percentile lines upward on the linear growth chart

24
Q

Start of basic workup for suspected precocious puberty

A

perform a complete and thorough history and physical exam:

  • family h/o precocious puberty
  • exogenous source of steroids
  • thorough neurologic ROS and exam
25
Q

laboratory tests for suspected precocious puberty

A
  • LH
  • FSH
  • estradiol and/or testosterone
  • 17-hydroxyprogesterone
26
Q

imaging for suspected precocious puberty

A
  • bone age (will be advanced in precocious puberty)
  • MRI head
  • ultrasound of gonads