paediatric growth and endocrine Flashcards

https://www.abdn.ac.uk/medical/learning/pluginfile.php/11497/mod_page/content/3/Year%203%20Paediatric%20endocrinology%20and%20diabetes%20slides%20-%20A%20Mayo.pdf

1
Q

growth assessment tools

A
height/length, weight
growth charts + plotting
MPH and target centiles
growth velocity
bone age 
pubertal assessment
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2
Q

growth disorders: indications for referral

A
  • extreme short/tall stature (off centiles)
  • height below target height
  • abnormal height velocity (crossing centiles)
  • hx chronic disease
  • obvious dysmorphic syndrome
  • early/late pubery
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3
Q

common causes of short stature

A

familial
constitutional
SGA/IUGR

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4
Q

growth investigaions

A
FBC + ferritin 
U&E, LFTs, Ca, CRP
coeliac serology and IgA
IGF-1, TFT, prolactin, cortisol
karyotype/microarray
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5
Q

staging of puberty: tanner method

A

breast development
genital development
pubic hair
axillary hair

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6
Q

early and delayed puberty: boys

A

early <9yrs

delayed >14

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7
Q

early and delayed puberty: girls

A

early <8yrs

delayed >13

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8
Q

constitutional delay of growth and puberty

A

boys mainly
FH in dad or brothers
bone age delay
need to exclude organic disease

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9
Q

pathological causes of short stature

A
undernutrition 
chronic illness - IBD, coeliac
iatrogenic - steroids
psychological, social
hormonal (GHD, hypothyroid, glucocorticoid excess) 
syndromes - Turner, P-W, Noonan, PHPT
skeletal dysplasias
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10
Q

Turner syndrome: gene and who

A

45X0

girls

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11
Q

turner syndrome features

A
poor growth, short stature
1ry amenorrhea (ovarian dysgenesis) 
delayed/absent pubertal development
webbed neck 
skeletal abnormalities
congenital heart defects: aortic coarctation, bicuspid aortic valve
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12
Q

prader-willi syndrome genes

A

deletion of 15q11-q13 chromosome region

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13
Q

noonan’s syndrome features

A
autosomal dominant
short stature
abnormal facial features
congenital heart defects: pulm valve stenosis 
chest deformities
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14
Q

causes of delayed puberty

A

chronic disease - Crohn’s, asthma
constitutional
primary gonadal disorders
impaired HPG axis

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15
Q

central precocious puberty

A

true pubertal development - breast development/testicular enlargement
growth spurt
advancing bone age

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16
Q

assessment of childhood obesity

A
weight 
BMI 
height
waist circumference
skin folds
hx and exam
complications
17
Q

obese + short =

18
Q

complications of childhood obesity

A
metabolic syndrome 
fatty liver disease
gallstones
thromboembolic disease
pancreatitis
obstructive sleep apnoea
GORD
psychological
left ventric hypertrophy
RS heart failure
19
Q

causes of childhood obesity

A
simple obesity
drugs 
syndromes
endocrine disorders
hypothalamic damage
20
Q

managing childhood obesity

A

diet
exercise
psychological input
drugs»

21
Q

small and obese child: endocrine cause

A

growth failure

22
Q

small and obese child: syndromes

A

learning difficulties

23
Q

small and obese child: hypothalamic cause

A

loss of appetite control

24
Q

small and obese child: genetic causes

A

starts <5yrs

25
diabetic symptoms chldhood
thirsty tired thinner using toiler more return to bedwetting - reg flag for diabetes
26
other diabetes features in kids <5yrs
``` heavier nappies than usual blurred vision candidiasis - oral, vulval constipation recurring skin infection irritability ```
27
first test for childhood diaberes
finger prick capillary blood test >11 mmol/l - diabetes <11mmol/l - other cause
28
making early diagnosis of childhood diabetes
T symptoms (thirsty, thinner, tired, toilet more) test - finger prick glct test telephone - same day specialist review
29
tanner I
prebupertal
30
tanner II
minimal pubic hair | breast budding
31
tanner III
voice changes, pubic hair over penis PH, AH, breast enlargement
32
tanner IV
adult pubic hair | areolar enlargement
33
tanner V
as adult
34
pader willi syndrome features
short stature infantile hypotonia/poor feeding childhood hyperphagia, obesity developmental delay
35
early sexual development: breast development
hypothalamic activation | e.g. central precocious puberty
36
early sexual development: secondary sexual characteristics
sex steroid hormone secretion | e.g. precocious pseudopuberty