Pediatric Endocrinology Flashcards

1
Q

What is the normal linear growth for <4 years old?

A
  • At least 7 cm/year
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2
Q

What is the normal linear growth for 4-6 years old?

A
  • At least 6 cm/year
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3
Q

What is the normal linear growth for 6 years old to puberty?

A
  • At least 5 cm/year (2 inches)
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4
Q

When is peak velocity for boys and girls?

A
  • Boys: 13.5 years

- Girls: 11.5 years

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5
Q

How do you estimate a boy’s height?

A
  • ((Dads ht + moms ht) + 5)/2
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6
Q

How do you estimate a girl’s height?

A
  • ((Dads ht + moms ht) - 5)/2
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7
Q

What should you think about when the weight falls off first in growth parameters?

A
  • Think nutrition
  • Not enough in
  • Not enough absorbed
  • Higher than average caloric needs
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8
Q

What should you think about when the length falls off first in growth parameters?

A
  • Think endocrine
  • GH deficiency
  • Hypothyroidism
  • Cushing’s syndrome
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9
Q

What should you think about when the head circumference falls off first in growth parameters?

A
  • Primary failure of the brain to grow

- Severe craniosynostosis

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10
Q

What is the bone age?

A
  • Provides a rough estimate of a child’s skeletal maturation by assessing the ossification of the epiphyseal centers
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11
Q

What is considered delayed in bone age?

A
  • When it is two standard deviations below the chronologic age
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12
Q

What is the catch up or catch down growth seen in kids younger than 18 months?

A
  • Some kids make up to a 25% downward correction on the growth curve, usually when table food is introduced
  • Some kids make a 25% upward correction
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13
Q

When do most kids start to track on the same growth curve?

A
  • After 24 months

- Stay on it until puberty

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14
Q

What is needed to evaluate if a child is growing as expected?

A
  • More points on the growth curve
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15
Q

What is special about using the 0-36 months growth curve?

A
  • Child must be lying down
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16
Q

What is special about using the 2-20 yo growth curve?

A
  • Child must be standing
17
Q

When do you plot premature infants?

A
  • Adjust for weight and height for the first 2 years

- Plot gestational age, not chronological age

18
Q

What is short stature?

A
  • Height 2 standard deviation below the mean height for age and sex
  • Height more than 2 standard deviation below the mid-parental height
19
Q

What are some benign causes of short stature?

A
  • Constitutional growth delay
  • Familial short stature
  • Idiopathic short stature
20
Q

What are some pathologic causes of short statures?

A
  • Endocrine
  • Genetic syndromes
  • Nutritional disorders
  • Chronic illnesses/drugs
21
Q

What are some endocrine causes of short stature?

A
  • Hypothyroidism
  • Untreated precocious puberty
  • Turner syndrome
  • Growth hormone deficiency
  • Cushing disease/syndrome
22
Q

What are some indicators of growth hormone deficiency in neonates?

A
  • Midline defects
  • Microphallus
  • Hypoglycemia
  • GH not relevant for growth during the first year of life
23
Q

What are some indicators of growth hormone deficiency in children?

A
  • Decreasing growth velocity
  • Low IGF-1 and low IGFBP-3 levels
  • Low GH levels during stimulation test
24
Q

When is precocious puberty seen in boys and girls?

A
  • Boys: 9 years old

- Girls: 8 years old

25
Q

What is precocious puberty defined as?

A
  • Full activation of the HPG axis before 8 years of age in girls and 9 years of age in boys
26
Q

When should you consider the diagnosis of precocious puberty in girls?

A
  • If there is progressive breast development

- Crossing major percentile lines upward on the linear growth chart

27
Q

When should you consider the diagnosis of precocious puberty in boys?

A
  • Evidence of both testicular and penile enlargement

- Crossing major percentile lines upward on the linear growth chart