Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Paediatrics Brian > Paediatric Growth and Endocrinology > Flashcards

Paediatric Growth and Endocrinology Flashcards

1
Q

Normal growth varies due to what?

A
  • Ethnic groups
  • Inequality in basic health and nutrition
  • Genetic influence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are investigations for assessing growth?

A
  • Measure parents height for mid parental height to obtain target centile range and compare current trajectory on growth chart
  • Measure height over time and plot on growth chart
  • X-ray to determine bone age, plot bone age over time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Summarise assessment tools for growth and pubertal development?

A
  • Height/length/weight
  • Growth charts and plotting
  • MPH and target centiles
  • Growth velocity
  • Bone age
  • Pubertal assessment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are indications for referral for growth disorders?

A
  • Extreme short or tall stature (off centiles)
  • Height below target height
  • Abnormal height velocity (crossing centiles)
  • History of chronic disease
  • Obvious dysmorphic syndrome
  • Early/late puberty
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Short stature - aetiology

A
  • Familial
  • Constitutional delay of growth and puberty
    • Younger bone age, ‘late developer’
  • SGA/IUGR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Short stature - investigations

A
  • IGF-1 often low
    • Perform GH stimulation test
      • Arginine test
      • Insulin tolerance test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Growth hormone deficiency - investigations

A
  • MRI of pituitary gland
    • Small anterior pituitary gland
    • Ectopic posterior pituitary gland
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Growth hormone deficiency - clinical features

A

Small stature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Growth hormone deficiency - treatment

A
  • Growth hormone replacement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What can puberty be assessed by?

A

Tanner staging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe tanner staging?

A
  • Tanner staging
    • Assessment by clinical examination
    • B 1 to 5 (breast development)
    • G 1 to 5 (genital development)
    • PH 1 to 5 (pubic hair)
    • AH 1 to 3 (axillary hair)
    • T 2ml to 20ml
    • Example of statement – B3 PH3 or G2 PH2 6/6
  • 5 stages
    • 1 s pre-puberty
    • 2 is beginning of puberty
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What hormones are released during puberty?

A

Boys - testosterone

Girls - estradiol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Compare the relationship between growth and other changes in puberty in boys and girls?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When is puberty late and early in:

  • boys
  • girls
A
  • Boys
    • Early <9 years (rare)
    • Delayed >14 years (common)
  • Girls
    • Early <8 years
    • Delayed >13 years (rare)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does CDGP stand for?

A

Constitutional delay of growth and puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

CDGP - epidemiology

A

Mainly boys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

CDGP - clinical features

A
  • FH in dad or brothers
  • Bone age delay
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Abnormal growth and pubertal development - aetiology (pathological)

A
  • Undernutrition
  • Chronic illness
    • JCA, IBD, coeliac
  • Iatrogenic
    • Steroids
  • Psychological and social
  • Hormonal
    • GHD, hypothyroidism, glucocorticoid excess
  • Syndromes
    • Turner, P-W, Noonan, PHPT
  • Skeletal dysplasias
19
Q

Thyroid deficiency - clinical features

A
  • Suddenly drops growth trajectory lines
20
Q

Turners syndrome - aetiology

A
  • Genetic - 45X
21
Q

Turners syndrome - clinical features

A
  • Short stature
  • Ovarian dysgenesis
  • Associated disorders
    • Cardiac, renal, thyroid, ENT problems
  • Psychosocial/education difficulties
  • Physical stigmata
22
Q

Turners syndrome - management

A
  • Growth hormone replacement
23
Q

Prader-Willi syndrome - aetiology

A
  • Deletion of 15q11-q13 chromosomal region
24
Q

Prader-Willi syndrome - clinical features

A
  • Infantile hypotonia/feeding problems
  • Hyperphagia/obesity in childhood
  • Short stature
  • Developmental delay
  • Hypogonadism
25
Q

Prader-willi syndrome - management

A
  • Growth hormone replacement
26
Q

Noonan syndrome - clinical features

A
  • Typical facies
    • Spaced eyes
  • Short stature
  • Congenital heart disease
    • Often pulmonary valve stenosis
27
Q

Achondroplasia - clinical features

A
  • Short limbs
  • Short stature
28
Q

Achondroplasia - management

A
  • Growth hormone DOES NOT work
29
Q

Psychosocial growth disturbance - clinical features

A
  • Stop growing due to being abused or poor social circumstances
30
Q

Delayed puberty - aetiology

A
  • Chronic disease
    • Crohn’s, asthma
  • Constitutional
  • Primary gonadal disorders
    • Gonadal dysgenesis (Turner’s Klinefelter’s DSD)
    • Testicular irradiation
  • Impaired HPG axis
    • Septo-optic dysplasia
    • Craniopharyngioma
    • Kallman’s syndrome
31
Q

Early sexual development - aetiology

A
32
Q

Central precocious puberty - clinical features

A
  • True pubertal development
    • Breast development in girls
    • Testicular enlargement in boys
  • Growth spurt
  • Advanced bone age
33
Q

Central precocious puberty - investigations

A
  • MRI
    • Exclude pituitary lesion
34
Q

Precocious pseudopuberty - clinical features

A
  • Secondary sexual characteristics
  • Gonadotrophin independent
    • Low levels of LH and FSH
  • Early menarche (most common)
35
Q

Obesity - aetiology

A
  • Syndrome
  • Hypothalamic-pituitary pathology
  • Endocrinopathy
  • Diabetes
  • Drugs
  • Poor diet (most common)
    • Refer to dietician
36
Q

Obesity - assessment

A
  • Weight
  • BMI
    • Kg/m2
    • Changes with age for children
  • Height
  • Skin folds
37
Q

Simple obesity - treatment

A
  • Diet
  • Exercise
  • Psychological input
  • Maybe drugs but not often in childhood
38
Q

Other than simple obesity, what are other causes of obesity?

A
39
Q

Diabetes - classification

A
  • Type 1 diabetes
  • Type 2 diabetes
40
Q

T1 diabetes - presentation

A
  • 4Ts
    • Thirsty
    • Tired
    • Thinner
    • Using Toilet more
  • In children under 5 also think
    • Heavier than usual nappies
    • Blurred vision
    • Candidiasis (oral, vulval)
    • Constipation
    • Recurring skin infections
    • Irritability, behavioural changes
41
Q

T1 diabetes - management

A
  • Early diagnosis
  • DKA prevention
  • Manage blood sugars
42
Q

Diabetic ketoacidosis - presentation

A
  • Nausea and vomiting
  • Abdominal pain
  • Sweet smelling “ketotic” breath
  • Drowsiness
  • Rapid, deep “sighing” respiration
  • Coma
43
Q

Diabetic ketoacidosis - investigations

A
  • Finger prick capillary blood glucose test
    • >11moll/L – diabetes
    • <11mmol/L – other cause

Paediatrics Brian (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions