Pediatric Endocrine

Question 1

What does a single point on a growth curve tell you?

Answer 1

How they plot on the curve on THAT DAY

Question 2

Multiple points on a growth curve are needed to evaluate the growth pattern. What does that assess?

Answer 2

If the rate of growth is adequate!

Question 3

How many points on a growth curve do you need to assess if the rate of growth is adequate?

Answer 3

MULTIPLE

Question 4

Normal BMI

Answer 4

18.5 - 24.9

Question 5

What is the normal linear growth rate for kids between 5 - puberty?

Answer 5

5 cm per year

2 inches per year

Question 6

What growth parameters is the first to be affected in endocrine disorders?

Answer 6

Height/Length

Question 7

What defines Delayed Bone Age?

Answer 7

Bone age is > 2 SD BELOW the chronologic age

Question 8

What are the 4 parameters on a growth chart?

Answer 8

Height/Length
Weight
BMI
Head circumference

Question 9

When should you be concerned when you are looking at a growth chart?

Answer 9

When points plotted start to deviate up or down from normal growth rate for that child

Question 10

If the height starts to deviate up or down, what should you consider?

Answer 10

Endocrine disorder

Question 11

If the weight starts to deviate up or down, what should you consider?

Answer 11

Calories or nutrition issues

Question 12

If the head circumference starts to deviate up or down, what should you consider?

Answer 12

Brain, skull, hydrocephalus

Question 13

What defines Short Stature?

Answer 13

Height is > 2 SD BELOW mean for age/sex

Question 14

Short Stature is below what percentile?

Answer 14

3rd percentile

Question 15

What is seen with Familial Short Stature?

Answer 15

Parents are small

- Child grows with normal velocity but is simply lower on the curve

Question 16

Familial Short Stature end height?

Answer 16

Mid-parental height

Question 17

What is the Bone Age with Familial Short Stature?

Answer 17

Bone age is consistent with chronological age

Question 18

What is seen with Constitutional Short Stature?

Answer 18

Plotting low on the growth curve and puberty is delayed

Question 19

With Constitutional Short Stature, what will be in the family history?

Answer 19

Late bloomers – delayed puberty and growth

Question 20

With Constitutional Short Stature, when will growth and puberty occur? End height?

Answer 20

LATER than normal

– End height = normal

Question 21

What is the Bone Age with Constitutional Short Stature?

Answer 21

Bone age is DELAYED

Question 22

What is the Bone Age with Idiopathic Short Stature?

Answer 22

Bone age is consistent with chronological age

Question 23

If a child presents with short stature, what are 2 things to measure?

Answer 23

IGF-1

IGFBP-3

Question 24

If a child presents with short stature, what are 2 things to measure and what are they?

Answer 24

IGF-1 = mediator of GH
IGFBP-3 = blood transport protein for IGF-1

Question 25

With short stature due to GH deficiency, what are the levels of IGF-1 and IGFBP-3?

Answer 25

LOW

Question 26

If IGF-1 and IGFBP-3 are both LOW what should be suspected?

Answer 26

GH deficiency

Question 27

What should be performed next after LOW levels of IGF-1 and IGFBP-3 are found?

Answer 27

GH stimulation testing

Question 28

What are 3 GH stimulation tests?

Answer 28

1. Administer Glucagon
2. Administer Arginine
3. Insulin induced hypoglycemia

Question 29

What does linear growth depend on?

Answer 29

Balance between proliferation and deterioration of chondrocytes at the growth plate

Question 30

What does linear growth depend on?

Answer 30

Balance between proliferation and deterioration of chondrocytes at the growth plate

Question 31

What is a major prerequisite for normal bone maturation?

Answer 31

T3

Question 32

What is a regulator of post-natal growth, skeletal maturation, bone and mineral metabolism?

Answer 32

T3

Question 33

T3 is a major prerequisite for?

Answer 33

Normal bone maturation