Paediatric Growth and Endrocrine Flashcards
1
Q
What is normal growth?
A
- Precise definition difficult:
- – Wide range within healthy population – Different ethnic subgroups
- – Inequality in basic health and nutrition
- – Normality may relate to individuals or populations (genetic influence)
2
Q
What factors can influence height?
A
- Age
- Sex
- Race
- Nutrition
- Parental heights
- Puberty
3
Q
What assessment tools can we use to assess development?
A
- Height/Weight/length
- Growth charts and plotting
- MPH (mid parental height) and target centiles
- Growth velocity
- Bone age
- Pubertal assessment
4
Q
What are indicators for referral from growth disorders?
A
- Extreme tall or short
- Height below target height
- Abnormal velocity
- History of chronic disease
- Obvious dysmorphic sundrome
5
Q
Pathological causes of short stature?
A
- Undernutrition
- Chronic illness
- Iatrogenic (steroids)
- Hormonal
- Turner syndrome
6
Q
Explain tanner staging of puberty:
A
- B: Breast development (1 to 5)
- G: Genital development (1 to 5)
- PH: pubic hair (1 to 5)
- AH: Axillary hair (1 to 3)
- T: testes 2-20ml
7
Q
What is early/delayed puberty for male and female?
A
Boys
- <9 is early
- >14 is delayed
Girls
- <8 is early
- >13 is delayed
8
Q
What is main cause of delayed puberty?
A
Constitutional delay of growth and puberty (CDGP)
9
Q
What is central precocoius puberty?
A
Causes EaRLY sexual development
- Causes breast growth gals and testes growth lads
- Growth spurt
- Advanced bone age
- NEED to exclude pituitary lesion
10
Q
What is precocious pseudopuberty?
A
- Abnormal sex steroid hormone secretion
- Gonadotrophin independent (low levels of LH and FSH)
- Clinical picture: 2ndary sexual characteristics
- Need to exlude congenital adrenal hyperplasia
11
Q
How do we manage ambigious genitalia?
A
- Do not guess the sex of the baby!
- Multidisciplinary approach (paed endo, surg, neonatologist, geneticist, psychologist)
- Exam: gonads?/ internal organs
- Karyotype
- Exclude Congenital Adrenal Hyperplasia!- risk of adrenal crisis is first 2 weeks of life
12
Q
What is most common cause of acquired hypothyroidism?
What issues may child have?
A
- Hashimotos (autoimmune thyroiditis)
- FH
- Lack of height gain, pubertal delay, poor school performance
13
Q
How do we assess obesity?
A
- Weight
- BMI
- Height
- Waist circumference
- Skin folds
14
Q
Obese + ……… = abnormal
A
SHORT
15
Q
What are causes of obesity?
A
- Simple obesity: increased intake and decreased exercise
- Drugs
- Endocrine disorders = associated growth failure
- Hypothalamic damage = loss of appetite control
