Paediatric Growth and Endocrinology

Question 1

what is normal growth

Answer 1

wide range within health population
different ethnic groups
normality related to individuals and populations

Question 2

what are factors affecting height

Answer 2

age
race
sex
nutrition
parental heights 
puberty
general health

Question 3

how are measurements taken

Answer 3

length
height after 2 years-without socks and shoes
sitting height
head circumference
measure both parents and find mid parental height

Question 4

what is bone age

Answer 4

by a skilled practitioner

can predict growth by a radiograph

Question 5

what is important in H and E

Answer 5

brith weight and gestation
PMH
family history
systematic enquiary
dysmorphic features

Question 6

what to do with a new born with ambiguous genitilia

Answer 6

do not guess the sex
MDT approach
examine gonads and internal organs
karyotype

Question 7

what are assessment tools in growth

Answer 7

height/weight/length
growth charts
MPH and target centiles
bone age
pubertal assessment

Question 8

what is the staging of puberty

Answer 8

tanner staging
1 pre pubertal
2 puberty
5 adulthood

Question 9

what is normal for females during puberty

Answer 9

breast budding
then big growth spurt
then menarche

Question 10

what is early and late puberty for girls

Answer 10

<9 is early

delayed is after 14

Question 11

what is normal for males during puberty

Answer 11

onset of testicualr growht
penile growth
advanced changes in puberty
facial hair and shaving

Question 12

what are causes of delayed puberty

Answer 12

gonadal dysgenesis
chronic disease
peripheral cause-testicular radiation

Question 13

what are causes of precocious puberty

Answer 13

starts in pituitary gland
advanced bone age
need to exclude pituitary lesion

Question 14

what is the pathological causes of short stature

Answer 14

undernuturion
chronic illness
iatrogenic 
hormonal 
syndromes

Question 15

wat investigations would you do

Answer 15

FBC and ferritin
U and E
LFT
coeliac serology 
IGF-1 , cortisol
karotyoe

Question 16

what to do next

Answer 16

if IGF-1 is low
arginuine test
insulin tolerance test
MRI of pit-
ectopic posterior pituitary
small anterior pituitary

Question 17

what causes congenital hypothyroidsm

Answer 17

hypolastic/ectopic pituitary
new born screening
start treatment within 2 weeks

Question 18

what Is acquired hypothyroidims

Answer 18

most common is hashimotos
issues lead to lack of height
pubertal delay
poor school performance

Question 19

what are causes of obesity

Answer 19

simple obesity
drugs
syndromes
endocrine diorder

Question 20

how to assess obesity

Answer 20

weight
height
BMI
waist circumference
skin folds 
history acne xamination

Question 21

what are the complications of obesity

Answer 21

metabolic syndrome
gallstones
fatty liver disease
PCOS
pancreatitis

Question 22

what to ask in an obesity hisotry

Answer 22

diet
physical acitvity
family history

Question 23

what is the treatment of obesity

Answer 23

diet
exercise
psychological input

Question 24

what is the symptoms of diabetes

Answer 24

thirsty
thinner
tired
toilet more 
test immediately

Question 25

what is the symptoms of DKA

Answer 25

nausea
vomitting
abdominal pain
sweet swelling breathing 
drowsiness 
rapid respiration 
finger prick test