Normal growth Flashcards
What does the 50th centile in a growth chart represent?
The mean (height or weight)
What can the height and weight centiles be used to calculate?
The BMI centiles (above the 98th centile is obese)
What measurement should be taken before the age of two years?
Length, rather than height. Length can vary considerably
When is puberty in boys
a) precocious
b) delayed
a) commences before age 9
b) if no signs are present by 14, or completes after 17
What is the underlying stimulus for the onset of puberty?
Increased hypothalamic secretion of GnRH causes increased LH secretion, causing increased release of sex steroids
What is the staging system for puberty?
Tanner: stage 1 is pre-puberty, 2-3 is in puberty, 4-5 is completing puberty
What is the first sign/stage of puberty in females? When does menarche usually occur in relation to this?
Breast budding (thelarche). About 2 years after
When is puberty in girls
a) precocious
b) delayed
a) before 8
b) no signs by 13, not completed by 16
When is the peak height velocity of boys and girls?
Boys- 14 years, girls- 12 years
What investigations might be carried out when a growth problem is suspected?
Bloods- FSH/LH, IGF1, sex steroids, thyroid Karyotype Dynamic function tests MRI pituitary USS uterus
What are the common causes of short stature?
Genetic Constitutional growth delay Dysmorphic syndromes Endocrine disease Chronic disease Psychosocial deprivation
What methods can be used to predict adult height?
Extrapolation from a) the mid-parental centile or b) the child’s current height centile
What is the “normal” distribution of height and weight?
+/- 2 standard deviations from the mean. Children below the 0.4th centile in height/weight should be investigated
When should a child be described as a) overweight b) obese according to the BMI centile chart?
a) above the 91st centile
b) above the 98th centile
