Pediatric Endocrine Disorders

Question 1

Normal weight in youth 2-18 yrs

Answer 1

BMI >5th to <85th percentile for age

Question 2

Growth rate from 6 yrs to puberty

Answer 2

> 5cm/year (2 inches)

Question 3

When looking at a growth chart, what (in general) should you think of when weight falls off first?

Answer 3

Nutrition issue

Question 4

When looking at a growth chart, what (in general) should you think of when length falls off first?

Answer 4

Endocrine issue

Question 5

When looking at a growth chart, what (in general) should you think of when head circumference falls off first?

Answer 5

Primary failure of brain to grow; severe craniosynostosis

Question 6

Clinical applications for measuring bone age

Answer 6

Provides a rough estimate of a child’s skeletal maturation by assessing ossification of the epiphyseal centers

Helps estimate the child’s growth potential using X-ray of the left hand and wrist

Question 7

What parameter for bone age is considered delayed?

Answer 7

Bone age that is 2 standard deviations below the chronologic age is considered delayed

Question 8

The more points on the growth curve, the more meaningful it is.

If the child is less than 36 months of age and using the 0-36 month growth curve, measure while child is ______

If older than 24 months, you may use the 2-20 yo chart, but you must measure when the child is _______

Answer 8

Supine (length)

Standing (stature)

Question 9

What normal alteration in growth pattern may be expected in the first 18 months of life?

Answer 9

Some kids make up a 25% downward correction on the growth curve — often occurs as more table food is introduced

Question 10

Define short stature

Answer 10

Height 2 standard deviations below the mean height for age and sex (<3rd percentile)

Height more than 2 standard deviations below the mid-parental height

Question 11

With delayed puberty/short stature in females, always check a _______, as short stature can occur in the absence of other clinical features of _______

Answer 11

Karyotype (45 XO); Turner syndrome

Question 12

Define precocious puberty

Answer 12

Full activation of HPG axis before age 8 in girls and age 9 in boys

Question 13

Clinical signs of precocious puberty in girls

Answer 13

Progressive breast development

Crossing major percentile lines upward on linear growth chart

Question 14

Clinical signs of precocious puberty in boys

Answer 14

Evidence of both testicular and penile enlargement

Crossing major percentile lines upward on the linear growth chart