Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Priority 1 > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

Non-pathological influences on growth

A 
Age
Genetics
Socioeconomic status
GH secretion
Secular trend
Environmental (altitude, urbanisation, passive smoking, stress)
Diurnal
Seasonal
Nutritional
Sex
Puberty
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pattern of growth

A

Foetal growth:
Genetics (placental hormones)

Infancy:
Environment and nutrition, thyroid hormone

Childhood:
Growth hormone

Puberty:
Sex hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Assessment of growth

A

Weight:
Important in first few years

Height:
Equipment, technique, consistency, growth chart, puberty stages, bone age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Causes of short stature

A

Familial
Constitutional delay of pubertal growth spurt
IUGR
Genetic mutation (Down’s syndrome, Russel silver, Turner syndrome, achondroplasia)
Skeletal dysplasia (achondroplasia, rhizomelic dwarfism, macrocephaly, frontal bossing, flat nasal bridge, trident hand)
Endocrine disorders (GH deficiency, hypothyroidism, hypopituitarism, Cushing’s)
Chronic illness (congenital heart disease, chronic renal failure, CF, cerebral palsy)
Inadequate nutrition
emotional or psychological deprivation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Causes of tall stature

A 
Familial/idiopathic
Obesity (advanced puberty)
Endocrine disorders: 
Excess GH (gigantism - GH secreting tumour, GHGR secreting tumour)
Sex steroids (precocious puberty)
Adrenal androgens (CAH, adrenal tumour)
Hyperthyroidism
Syndromes: Klinefelter's (XXY), Marfan's, homocystinuria, soto syndrome, fragile X
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Investigations for short stature

A

FBC, ferritin, U&E, LFT, bone profile
Bone age
Pituitary function
Thyroid function
LH, FSH, oestradiol/testosterone or LHRH stimulation test
Prolactin
Growth hormone provocation tests
Genetics
Karyotype in girls
Other genetics test/referral
Pelvic USS females - uterine size/ovarian follicles
Brain MRI with pituitary views if pituitary disease is suspected
Skeletal survey if suspected skeletal dysplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Investigations for tall stature

A

History + exam (growth measures, visual fields, thinking tumour)
IGF-1, IGF BP3, growth hormone suppression test
Baseline LH, FSH, oestradiol, testosterone
SynACTHen test, urine steroids
TFT
Prolactin
Bone age
Pelvic USS
Neuro imaging if central precocious puberty is confirmed
Chromosomes and genetic test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Features of growth hormone deficiency

A 
Short stature
Slow growth
Hypogylcaemia
Mid-face hypoplasia
Relative mactocephaly
Central adiposity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Investigations for growth hormone deficiency

A

GH stimulation tests
Abnormal cranial imaging
History of intracranial pathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Management of growth hormone deficiency

A

Growth hormone replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Features of hypothyroidism

A 
Tiredness
Poor concentration
Short stature
Dry skin
Feels cold
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Investigations for hypothyroidism

A

Raised TSH

Low T4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Define growth faltering

A

A description/symptom - looks at trends over time

5-10% in community, more in disadvantaged families

Suboptimal weight gain or growth in infants and young children

Height or weight below the 3rd percentile

Crossing 2 major percentiles in 6 months

Low weight-for-height (may be nutritionally deprived)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Symptoms of growth faltering

A 
Pallor
Listless
Reduced fat and muscle
PICA
Other deficiencies
Sparse or thin hair
No features apart from growth chart
Symptoms of underlying cause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Non-organic causes of growth faltering

A

Inadequate availability of food:
Breast feeding, bottle feeding, insufficiency diet offered

Psychosocial:
Maternal depression, poor interaction between infant and mother, poor maternal education

Abuse:
Munchausen-by-proxy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Organic causes of growth faltering

A

Constitutional:
Small person, in proportion

Inadequate intake:
Impaired suck or swallow (cleft lip palate, oromotor dysfunction, neurological disorder e.g. cerebral palsy)

Chronic illness:
Causing anorexia e.g chronic renal or liver failure

Vomiting (GORD)

IUGR (1/3 remain short)

Increased energy expenditure:
Malignancy, CF, congenital heart disease, chronic renal failure, chronic infection, thyrotoxicosis

Malabsorption:
Coeliac disease, CF, pyloric stenosis, intestinal inflammation, short gut post-op

Failure to utilise nutrients:
Chromosomal disorders, congenital infection, metabolic disorders

Hormonal:
GH deficiency, hypothyroidism, hypopituitarism, Cushing’s

Genetic mutations:
Down’s syndrome, Russel silver, Turner, achondroplasia, etc.

Noonan

Extreme prematurity

17
Q

Investigations for growth faltering

A

History:
Good intake/outtake, description of mealtimes and circumstances a home, PMH, prematurity, IUGR

Growth charts

Bloods:
Sweat test, stool fat, Igs, FBCs, TFTs

Mid-parental height (genetics)

18
Q

Management of growth faltering

A 
SALT
Social worker
Child psychologist
Health visitor
GP

Priority 1 (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions