Paediatric Growth & Endocrine

Question 1

What factors can infleunce a childs hight?

Answer 1

Age

Sex

Race

Nutrition

Chronic disease

Specific growth disorders

Question 2

What are the different stages of normal growth?

Answer 2

Infantile

Childhood

Pubertal

Question 3

During which stage of growth is the sharpest decrease in rate of height gain per year?

Answer 3

Infancy

Question 4

During which stage of growth is the sharpest increase in rate of height gain per year?

Answer 4

Puberty

Question 5

What is the measurement used to determine growth in infancy?

Answer 5

Length

Question 6

What is the measurement used to determine growth in childhood?

Answer 6

Height

Question 7

What is the name of the standard growth chart used in the UK?

Answer 7

RCPCH UK 2-18 Growth chart

Question 8

What are the growth assessment tools used to assess child development?

Answer 8

Growth charts and plotting

Mid Parental Height

Childs height/length

Bone age

Question 9

What are some indications for referal for growth disorders?

Answer 9

• Extremes of height (short or tall)
• Height below target height
• Abnormal height velocity
• Earyly/late puberty

Question 10

What are the common causes of short stature?

Answer 10

Familial

Constitutional

SGA/IUGR (small for gestational age/intra-uterine growth restriction)

Question 11

What is meant by constitutional growth delay?

Answer 11

A temporary delay in skeletal growth

Question 12

What is familial short stature?

Answer 12

When a child is growing at their normal/predicted growth rate but both parents are of short stature (mother < 5’1, father < 5’5)

Question 13

What are some pathological causes of short stature?

Answer 13

1 - Undernutrition

2 - IBD, Coeliac, Juvenille Chronic arthritis

3 - Steroids

4 - Turner syndrome

5 - Prader-willi syndrome

Question 14

What are common investigations carried out to investigate growth disorders?

Answer 14

1 - FBC & Ferritin

2 - U&E’s

3 - LFT’s

4 - CRP

5 - Karyotype

Question 15

Which method is used to compute the stage of puberty?

Answer 15

Tanner method

Question 16

What are the components of the Tanner staging method?

Answer 16

Breast development

Genital development

Pubic hair

Axillary hair

Testes volume

Question 17

At what age do male testes start to grow?

Answer 17

12 years

Question 18

At what age do the female breasts begin to bud?

Answer 18

11 years

Question 19

Male puberty at which age is considered early?

Answer 19

< 9

Question 20

Male puberty at which age is considered delayed?

Answer 20

> 14 (CDGP)

Question 21

Female puberty at which age is considered early?

Answer 21

< 8

Question 22

Female puberty at which age is considered to be delayed?

Answer 22

> 13

Question 23

In which sex is CDGP more common?

Answer 23

Boys

Question 24

What is central precocious puberty?

Answer 24

Early sexual development in boys and girls

Question 25

What are the features of central precocious puberty?

Answer 25

- Early development of breasts and testes - Growth spurts - Advanced bone age

Question 26

What is precocious pseudopuberty?

Answer 26

Abnormal sex steroid hormone secretion (estrogen in girls and testosterone in boys)

Question 27

What happens to the level of FSH and LH in precocious pseudopuberty?

Answer 27

Unaffected

Question 28

What are the characteristic features of someone with precocious pseudopuberty?

Answer 28

Secondary sexual characteristics: Boys - genital enlargement and pubic hair before 9.5 years Girls - Breast enlargement before 7

Question 29

At what Tanner stage do female breasts start budding?

Answer 29

B2

Question 30

At what Tanner stage do boys testicles start enlarging?

Answer 30

G2 T 3-4ml

Question 31

What are some common endocrine problems affecting childhood growth?

Answer 31

Congenital hypothyroidism Acquired hypothyroidism - Autoimmune thyroiditis most common

Question 32

What are the issues encountered during childhood relating to acquired hypothyroidism?

Answer 32

1 - Lack of height gain 2 - Delay in puberty 3 - Poor school performance

Question 33

What are the symptoms of Type 1 diabetes in childhood?

Answer 33

Thirsty Thinner Tired Using Toilet more often

Question 34

If Type 1 diabetes is suspected in a child, what test must be performed immediately?

Answer 34

Finger prick capillary glucose test

Question 35

What result from a finger prick capillary glucose test indicates urgent help is required?

Answer 35

\> 11 mmol/l

Question 36

What is a red flag symptom that could indicate Type 1 diabetes in a child?

Answer 36

A return to bed wetting after having been dry

Question 37

What are the symptoms of DKA?

Answer 37

Nausea & vomitting Abdo pain Sweet smelling breath Drowsiness Rapid, deep breathing Coma