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Paediatrics > Paediatric Growth and Endocrine > Flashcards

Paediatric Growth and Endocrine Flashcards

1
Q

List the factors that influence height

A
  • Age
  • Sex
  • Race
  • Nutrition
  • Parental heights
  • Puberty
  • Skeletal maturity
  • General health
  • Chronic disease
  • Specific growth disorders
  • Socio-economic status
  • Emotional well being
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2
Q

Name the three growth spurts that occur during childhood

A
  • Infantile
  • Childhood
  • Pubertal
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3
Q

Name the measurement techniques for assessing growth

A
  • Length
  • Height
  • Sitting height
  • Head circumference
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4
Q

What can a bone age scan tell you about growth?

A

If there is potential for more growth to be done

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5
Q

What should be asked/done in a history and examination when assessing growth?

A
  • Birth weight and gestation
  • PMH
  • FH/SH/schooling
  • Systematic enquiry
  • Dysmorphic features
  • Systemic exam including pubertal assessment
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6
Q

What are the indications for referral for growth disorders?

A
  • Extreme short or tall statures
  • Height below target height
  • Abnormal height velocity (crossing centiles)
  • History of chronic disease
  • Obvious dysmorphic syndrome
  • Early/late puberty
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7
Q

What are the common causes of short stature?

A
  • Familial
  • Constitutional
  • SGA/IUGR
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8
Q

What are the pathological causes of short stature?

A
  • Undernutrition
  • Chronic illness (JCA, IBD and coeliac)
  • Iatrogenic (steroids)
  • Psychological and social
  • Hormonal (GHD, hypothyroidism)
  • Syndromes (Turner, P-W)
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9
Q

What investigations can be used to investigate the cause of short stature?

A
  • FBC and ferritin
  • U&Es, LFTs, Ca and CRP
  • Coeliac serology and IgA
  • IGF-1, TFTs, prolactin and cortisol
  • Karyotype
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10
Q

What are the components of the tanner method of staging puberty?

A
  • Breasts 1-5
  • Genitals 1-5
  • Pubic hair 1-5
  • Axillary hair 1-3
  • Testes 2-20ml
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11
Q

When is puberty early and when it is delayed?

A
  • Early: <9yrs in boys and <8yrs in girls

- Delayed: >14yrs in boys and >13yrs in girls

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12
Q

What are the causes of delayed puberty?

A
  • Constitutional
  • Gonadal dysgenesis (Turner and Klinefelter)
  • Chronic disease (Crohn’s and asthma)
  • Impaired HPG (septo-optic dysplasia, craniopharyngioma and Kallman’s syndrome)
  • Peripheral (cryptorchidism, testicular irradiation)
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13
Q

How does early sexual development present?

A
  • Breast development: hypothalamic activation
  • Secondary sexual characteristics: sex steroid hormone secretion
  • PV bleeding
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14
Q

What is central precocious puberty and how is it investigated?

A
  • Pubertal development: breast development in girls and testicular enlargement in boys
  • Growth spurt
  • Advanced bone age
  • MRI to exclude pituitary lesion
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15
Q

What is precocious pseudopuberty?

A
  • Abnormal sex steroid hormone secretion
  • Gonadotrophin independent
  • Secondary sexual characteristics
  • Congenital adrenal hyperplasia
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16
Q

How can ambiguous genitalia be managed?

A
  • MDT approach
  • Exam gonads/internal organs
  • Karyotype
  • Exclude congenital adrenal hyperplasia
17
Q

What are the causes of congenital hypothyroidism and when is it picked up?

A
  • Athyreosis/hypoplastic/ectopic
  • Dyshormonogenic
  • Picked up on newborn screening
18
Q

How might acquired hypothyroidism appear in a child?

A
  • Lack of height gain
  • Pubertal delay
  • Poor school performance
  • FH of thyroid/autoimmune disorders
19
Q

How can obesity be assessed?

A
  • Weight
  • Height
  • BMI
  • Waist circumference
  • Skin folds
  • History and exams
20
Q

What are the complications of obesity?

A
  • Metabolic syndrome
  • Fatty liver disease
  • Gallstones
  • Reproduction dysfunction
  • Nutritional deficiencies
  • Thromboembolic disease
  • Pancreatitis
  • Central hypoventilation
  • Obstructive sleep apnoea
  • GORD
  • Stress incontinence
  • Injuries
  • Psychological
  • LVH
  • Atherosclerotic CVS disease
  • RHF
21
Q

What are the causes of obesity?

A
  • Simple obesity
  • Drugs
  • Syndromes
  • Endocrine disorders
  • Hypothalamic damage
22
Q

How can obesity be treated?

A
  • Diet
  • Exercise
  • Psychological input
  • Drugs?
23
Q

What is the presentation of diabetes in children?

A
  • Increased thirst
  • Weight loss
  • Tiredness
  • Using the toilet more
  • In under fives: heavier nappies, blurred vision, candidiasis, constipation, recurring skin infections, irritability and behaviour changes
24
Q

What are the signs of DKA in children?

A
  • Nausea and vomiting
  • Abdo pain
  • Ketotic breath
  • Drowsiness
  • Rapid, deep, sighing respiration
  • Coma
25
Q

How should suspected diabetes in children be investigated and managed?

A
  • Finger prick capillary blood glucose test > 11 mmol/l is diabetes
  • Needs same day review by specialist paeds diabetes team

Paediatrics (17 decks)

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