Paediatric Growth Charts

Question 1

Formula to calculate mid-parental height for BOYS

Answer 1

(Father’s height + Mother’s height + 12.5)/2 = total (+/- 8.5)

Question 2

Formula to calculate mid-parental height for GIRLS

Answer 2

(Father’s height + Mother’s height - 12.5)/2 = total (+/- 8.5)

Question 3

What is mid-parental height ?

Answer 3

A child’s projected adult height based on the heights of both parents

Question 4

What is the 50th percentile?

Answer 4

Means that 50% of the children would fall above and 50% below this line (average population is between the 3rd and the 97th percentile)

Question 5

What to do if the child between assessments is above or below more than 2 percentile compared to the previous visit?

Answer 5

Investigate

Question 6

Mnemonic for Short Stature causes

Answer 6

RETARD HEIGHT (Rickets, Endocrine - cretinism/hypopituitarism/cushing, Turner Sd, Achondroplasia, Respiratory - suppurative lung disease, Down Sd + Hereditary, Environmental - post-radiation/post-infection, IUGR, GI - malabsorption, Heart - congenital heart disease, Tilted backbone - scoliosis)

Question 7

Radiologic investigation for Short Stature

Answer 7

Wrist X-Ray

Question 8

Short stature with Bone age > Constitutional age

Answer 8

Parallel to the lower percentile = constitutional delay // Not parallel = abnormal (chronic illness, nutritional deficiency, GH deficiency)

Question 9

Short stature with Bone age = Constitutional age

Answer 9

Parallel to the lower percentile = familial short stature // Not parallel = abnormal (genetic problem)

Question 10

“Late bloomers”

Answer 10

constitutional delay (child always been short before the onset of delayed adolescence, normal physical examination) -> parental reassurance that their child will catch up

Question 11

familial short stature features

Answer 11

all family members are short, child always been short but parallel to the curves, normal physical examination and development

Question 12

Tall stature with Bone age >= Constitutional age

Answer 12

Parallel to the curve = familial tall stature or obesity // Not parallel = abnormal (genetic problem, endocrine problem - gigantism, CNS lesion)

Question 13

Drop-off in weight and then a drop-off in height

Answer 13

Malnutrition or Coeliac disease

Question 14

Coeliac disease markers

Answer 14

tTTG IgA test, IgA antibody, IgA endomysial antibody

Question 15

Coeliac disease: next step investigation

Answer 15

jejunal biopsy

Question 16

Coeliac disease treatment involves…

Answer 16

gluten-free diet

Question 17

View the Short Child Algorithm