Paediatric Growth and Endocrinology Flashcards
what is normal growth
wide range within health population
different ethnic groups
normality related to individuals and populations
what are factors affecting height
age race sex nutrition parental heights puberty general health
how are measurements taken
length
height after 2 years-without socks and shoes
sitting height
head circumference
measure both parents and find mid parental height
what is bone age
by a skilled practitioner
can predict growth by a radiograph
what is important in H and E
brith weight and gestation PMH family history systematic enquiary dysmorphic features
what to do with a new born with ambiguous genitilia
do not guess the sex
MDT approach
examine gonads and internal organs
karyotype
what are assessment tools in growth
height/weight/length growth charts MPH and target centiles bone age pubertal assessment
what is the staging of puberty
tanner staging
1 pre pubertal
2 puberty
5 adulthood
what is normal for females during puberty
breast budding
then big growth spurt
then menarche
what is early and late puberty for girls
<9 is early
delayed is after 14
what is normal for males during puberty
onset of testicualr growht
penile growth
advanced changes in puberty
facial hair and shaving
what are causes of delayed puberty
gonadal dysgenesis
chronic disease
peripheral cause-testicular radiation
what are causes of precocious puberty
starts in pituitary gland
advanced bone age
need to exclude pituitary lesion
what is the pathological causes of short stature
undernuturion chronic illness iatrogenic hormonal syndromes
wat investigations would you do
FBC and ferritin U and E LFT coeliac serology IGF-1 , cortisol karotyoe
what to do next
if IGF-1 is low arginuine test insulin tolerance test MRI of pit- ectopic posterior pituitary small anterior pituitary
what causes congenital hypothyroidsm
hypolastic/ectopic pituitary
new born screening
start treatment within 2 weeks
what Is acquired hypothyroidims
most common is hashimotos
issues lead to lack of height
pubertal delay
poor school performance
what are causes of obesity
simple obesity
drugs
syndromes
endocrine diorder
how to assess obesity
weight height BMI waist circumference skin folds history acne xamination
what are the complications of obesity
metabolic syndrome gallstones fatty liver disease PCOS pancreatitis
what to ask in an obesity hisotry
diet
physical acitvity
family history
what is the treatment of obesity
diet
exercise
psychological input
what is the symptoms of diabetes
thirsty thinner tired toilet more test immediately
what is the symptoms of DKA
nausea vomitting abdominal pain sweet swelling breathing drowsiness rapid respiration finger prick test
