Paediatric Growth and Endocrine Flashcards
What are the factors that influence height?
Sex Age Race Nutrition Parental heights Puberty Skeletal maturity General health Chronic disease Specific growth disorders Socio economic status Emotional well-being
What are the phases of growth?
Infantile
Childhood
Pubertal
What are the different measurement techniques?
Length Height Weight Sitting height Head circumference Target height and mid parental height Bone age
What are the indications for referral fro growth disorders?
Extreme short or tall stature Height below target weight Abnormal height velocity History of chronic disease Obvious dysmorphic syndrome Early/late puberty
What are the common causes of short stature?
Familial
Constitutional
SGA/IUGR
What are the pathological causes of short stature?
Undernutrition Chronic illness (JCA, IBD, Coeliac) Iatrogenic (steroids) Psychological and social Hormonal (GHD, hypothyroidism) Syndromes (Turner, P-W)
What investigations can be used to diagnose growth disorders?
FBC and ferritin U&Es, LFTs, Ca, CRP Coeliac serology and IgA IGF-1, TFT, prolactin and cortisol Karyotype
What is the Tanner method of staging puberty?
B 1 to 5 (breast development) G 1 to 5 (genital development) PH 1 to 5 (pubic hair) AH 1 to 5 (axillary hair) T 2ml to 20 ml SO
What can be used to assess testicular development?
Prader orchidometer
What is classed as early puberty in boys?
<9 years
What is classed as late puberty in boys?
> 14 years
What is classed as early puberty in girls?
<8 years
What is classed as late puberty in girls?
> 13 years
What are some other causes of delayed puberty?
Gonadal dysgenesis (Turner 45X, Klinefelter 47XXY)
Chronic disease (Crohn’s, asthma)
Impaired HPG axis (septo-optic dysplasia, craniopharyngioma, Kallman’s syndrome)
Peripheral (cryptorchidism, testicular irradiation)
What are the features of central precocious puberty?
Pubertal development (breast development and testicular enlargement)
Growth spurt
Advanced bone age
What are the features of precocious pseudo puberty?
Abnormal sex steroid hormone secretion
Gonadotrophin independent
What is the management approach for ambiguous genitalia?
Examination of gonads and internal organs
Karyotope
What are the causes of congenital hypothyroidism?
Athyreosis/ hypoplastic/ ectopic
Dyshormonogenic
What is the common cause of acquired hypothyroidism?
Autoimmune thyroiditis (Hashimoto’s)
What are the childhood issues associated with acquired hypothyroidism?
Lack of height gain
Pubertal delay
Poor school performance
What are the assessment tools for childhood obesity?
Weight BMI Waist circumference Skin folds History and examination
What are the complications of childhood obesity?
Metabolic syndromes Gallstones Fatty liver disease Reproductive dysfunction (PCOS) Pancreatitis Sleep apnoea Left ventricular hypertrophy Right sided heart failure Atherosclerotic cardiovascular disease Orthopaedic problems
What are the causes of childhood obesity?
Simple obesity Drugs Syndromes Endocrien disorders Hypothalamic damage
What is the treatment for simple obesity?
Diet
Exercise
Psychological input
What are the symptoms for type 1 diabetes in children?
Thirsty Thinner Tired Using the toilet more Return to bed-wetting
How can a child be tested for type 1 diabetes?
Finger prick capillary glucose test >11mmol/L
What are the symptoms of diabetic ketoacidosis?
Nausea and vomiting Abdominal pain Sweet smelling "ketotic" breath Drowsiness Rapid, deep "sighing" respiration Coma
