Paediatric growth + endocrine Flashcards
Describe the patterns of normal growth from foetal life through puberty with its normal and abnormal variations.
Understand how growth measurements are taken - see endocrine
Be able to plot and interpret a growth chart.
Know the history and examination features to be identified when assessing growth disorders.
Describe the variations in the normal pattern of growth and pubertal development
Know how to assess and interpret pubertal development in childhood
State the common causes and principles of investigation of precocious and delayed puberty
Discuss the approach to short stature including investigation and differential diagnosis
Be aware of the main patterns of growth disorders (Short and thin, Short and obese, Short and dysmorphic)
Describe the more common endocrinopathies including congenital hypothyroidism, congenital adrenal hyperplasia and growth hormone deficiency.
Recognise genetic syndromes that affect growth (Short and Tall stature)
Understand the assessment and management of childhood obesity
Recognise and promptly refer new patients with suspected diabetes
History and examination features to be identified when assessing growth disorders.
Birth weight, current weight
Height/length
Head circumference
PMH
Dysmorphic features
Pubertal assessment - breasts, testicles
Main patterns of growth disorders (3)
Short and thin
Short and obese
Short and dysmorphic
Common endocrinopathies in childhood
Congenital hypothyroidism
Congenital adrenal hyperplasia
Growth hormone deficiency.
Genetic syndromes that affect growth
Turner
Prader willi
Causes/differentials of short stature
See endocrine
Investigations of short stature
FBC and ferritin - coeliac, IBD
U&E, LFT, Ca, CRP - renal/liver disease, Ca metabolism
Coeliac serology and IgA
IGF-1, TFT, Prolactin, Cortisol, (gonadotrophins and sex hormones) - hormone disorders
Karyotype - turner’s syndrome
Investigations of childhood obesity
Weight
Body mass index (BMI)
Height
History for childhood obesity
Diet
Physical activity
Family history
Symptoms of underlying disease, eg. genetic syndrome, DM, pituitary tumour
Complications of obesity
Diet Physical activity Family history Nutritional deficiencies Thromboembolic disease Obstructive sleep apnea GORD Stress incontinence CAD Heart failure
Causes of obesity
SIMPLE OBESITY - COMMONEST
Drugs
Genetic syndromes
Endocrine disorders
Hypothalamic damage
Causes of obesity (5)
SIMPLE OBESITY - COMMONEST
Drugs
Genetic syndromes –> learning difficulties
Endocrine disorders –> growth failure (fail to thrive)
Hypothalamic damage –> loss of appetite control
