Pediatric Endocrinology Flashcards
What is the normal linear growth for <4 years old?
- At least 7 cm/year
What is the normal linear growth for 4-6 years old?
- At least 6 cm/year
What is the normal linear growth for 6 years old to puberty?
- At least 5 cm/year (2 inches)
When is peak velocity for boys and girls?
- Boys: 13.5 years
- Girls: 11.5 years
How do you estimate a boy’s height?
- ((Dads ht + moms ht) + 5)/2
How do you estimate a girl’s height?
- ((Dads ht + moms ht) - 5)/2
What should you think about when the weight falls off first in growth parameters?
- Think nutrition
- Not enough in
- Not enough absorbed
- Higher than average caloric needs
What should you think about when the length falls off first in growth parameters?
- Think endocrine
- GH deficiency
- Hypothyroidism
- Cushing’s syndrome
What should you think about when the head circumference falls off first in growth parameters?
- Primary failure of the brain to grow
- Severe craniosynostosis
What is the bone age?
- Provides a rough estimate of a child’s skeletal maturation by assessing the ossification of the epiphyseal centers
What is considered delayed in bone age?
- When it is two standard deviations below the chronologic age
What is the catch up or catch down growth seen in kids younger than 18 months?
- 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
When do most kids start to track on the same growth curve?
- After 24 months
- Stay on it until puberty
What is needed to evaluate if a child is growing as expected?
- More points on the growth curve
What is special about using the 0-36 months growth curve?
- Child must be lying down
What is special about using the 2-20 yo growth curve?
- Child must be standing
When do you plot premature infants?
- Adjust for weight and height for the first 2 years
- Plot gestational age, not chronological age
What is short stature?
- Height 2 standard deviation below the mean height for age and sex
- Height more than 2 standard deviation below the mid-parental height
What are some benign causes of short stature?
- Constitutional growth delay
- Familial short stature
- Idiopathic short stature
What are some pathologic causes of short statures?
- Endocrine
- Genetic syndromes
- Nutritional disorders
- Chronic illnesses/drugs
What are some endocrine causes of short stature?
- Hypothyroidism
- Untreated precocious puberty
- Turner syndrome
- Growth hormone deficiency
- Cushing disease/syndrome
What are some indicators of growth hormone deficiency in neonates?
- Midline defects
- Microphallus
- Hypoglycemia
- GH not relevant for growth during the first year of life
What are some indicators of growth hormone deficiency in children?
- Decreasing growth velocity
- Low IGF-1 and low IGFBP-3 levels
- Low GH levels during stimulation test
When is precocious puberty seen in boys and girls?
- Boys: 9 years old
- Girls: 8 years old
