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Pediatrics I - OSCE > Short Stature > Flashcards

Short Stature Flashcards

1
Q
A
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2
Q

Def of Short Stature

A
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3
Q

Z-Score

A
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4
Q

Def of Short Stature

  • Proportionate
A
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5
Q

Def of Short Stature

  • Disproportionate
A
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6
Q

Tools used to define growth in children

A
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7
Q

Factors affecting height & growth

A
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8
Q

Mid parental height

A
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9
Q

Causes of abnormal growth in children

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10
Q

Causes of abnormal growth in children

  • Normal Variants
A
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11
Q

Causes of abnormal growth in children

  • Syndromes
A
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12
Q

Causes of abnormal growth in children

  • Chronic Diseases
A
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13
Q

Causes of abnormal growth in children

  • Endocrine
A
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14
Q

CA, BA, HA in Familial (Genetic) Short Stature

A

(CA = ВА) > НА

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15
Q

Growth Velocity in Familial (Genetic) Short Stature

A

Normal

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16
Q

Prognosis of Familial (Genetic) Short Stature

A
  • The child grows within the expected target height centile (MPH +- 5).
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17
Q

CA, BA, HA in Constitutional Short Stature

A

СА > (BA = НА)

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18
Q

Constitutional Short Stature is associated with …..

A

associated with delayed puberty

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19
Q

Hx in Constitutional Short Stature

A

positive family history

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20
Q

TTT of Constitutional Short Stature

A

Testesterone for 6 months at bone age 12.5 years for growth & 2ry sex characters

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21
Q

Compare between Familial Short Stature in terms of

A
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22
Q

Compare between Familial Short Stature in terms of

  • Sex
  • Family Hx
  • Height Velocity
  • Puberty
  • Bone Age
  • Final Height
A
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23
Q

Def of

  • CA
  • BA
  • HA
A
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24
Q

Classification of Short Stature

A
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25
Q

Classification of Short Stature

  • Normal Variants
A
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26
Q

Classification of Short Stature

  • Pathological Variants
A
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27
Q

Classification of Short Stature

  • Proportionate
A
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28
Q

Classification of Short Stature

  • Disproportionate
A
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29
Q

Assessment of Short Stature

A
  • Hx
  • Ex
  • INVx
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30
Q

Assessment of Short Stature

  • Hx
A
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31
Q

Clues to Etiology of Short Stature From History

  • History of Delayed of Puberty in Parents
A

Constitutional delay of growth

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32
Q

Clues to Etiology of Short Stature From History

  • LBW
A

SGA

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33
Q

Clues to Etiology of Short Stature From History

  • Neonatal Hypoglycemia, Jaundice, Micropenis
A

GH deficiency

34
Q

Clues to Etiology of Short Stature From History

  • Dietary Intake
A

Under nutrition

35
Q

Clues to Etiology of Short Stature From History

  • Headache, Vomiting, Visual Problems
A

Pituitary/ hypothalamic SOL

36
Q

Clues to Etiology of Short Stature From History

  • Lethargy, Constipation, Weight Gain
A

Hypothyroidism

37
Q

Clues to Etiology of Short Stature From History

  • Polyuria
38
Q

Clues to Etiology of Short Stature From History

  • Social History
A

Psychosocial dwarfism

39
Q

Clues to Etiology of Short Stature From History

  • Diarrhea, Greasy Stools
A

Malabsorption

40
Q

Assessment of Short Stature

  • Complete Physical Exam
41
Q

Pointers to Etiology of Short Stature

  • Midline defects, micropenis, Frontal bossing, depressed nasal bridge, crowded teeth
A

GH deficiency

42
Q

Pointers to Etiology of Short Stature
- Rickets

A

Renal failure, RTA, malabsorption

43
Q

Pointers to Etiology of Short Stature
- Pallor

A

Renal failure, malabsorption, nutritional anemia

44
Q

Pointers to Etiology of Short Stature
- Malnutrition

A

PEM, malabsorption, celiac disease, cystic fibrosis

45
Q

Pointers to Etiology of Short Stature
- Obesity

A

Hypothyroidism, Cushing syndrome,
Prader Willi syndrome

46
Q

Pointers to Etiology of Short Stature
- Metacarpal Shortening

A

Turner syn., pseudohypoparathyroidism

47
Q

Pointers to Etiology of Short Stature

  • Cardiac Murmur
  • Mental Retardation
A
  • Congenital heart disease, Turner syndrome
  • Hypothyroidism, Down/ Turner syndrome, pseudohypoparathyroidism
48
Q

Pointers to Etiology of Short Stature from Ex

  • Disproportion
A

Skeletal dysplasia, rickets, hypothyroidism

49
Q

Pointers to Etiology of Short Stature from Ex

  • Dysmorphism
A

Congenital syndromes

50
Q

Pointers to Etiology of Short Stature from Ex

  • HTN
51
Q

Pointers to Etiology of Short Stature from Ex

  • Goiter, Coarse Skin
A

Hypothyroidism

52
Q

Pointers to Etiology of Short Stature from Ex

  • Central Obesity, Striae
A

Cushing syndrome

53
Q

Investigations for Short Stature

54
Q

Investigations for Short Stature

  • Bone Age
55
Q
  • Patients diagnosed with growth hormone deficiency should undergo an MRI of the head to exclude a brain tumor (e.g., craniopharyngioma)
56
Q
  • 15% of patients with growth hormone deficiency have an abnormality of the pituitary gland (e.g., ectopic bright spot, empty or small Sella).
57
Q

TTT of Short Stature

58
Q

TTT of Short Stature

  • From Notes
59
Q

TTT of Short Stature

  • Small for Gestational Age
A

growth hormone therapy

60
Q

TTT of Short Stature

  • Psychosocial Dwarfism
A

psychological support

61
Q

When to Refer Cases of Short Stature?

62
Q

When to Refer Cases of Short Stature?

  • Anthropometry
63
Q

When to Refer Cases of Short Stature?

  • Female Puberty
A
  • If no breast disk /pubic hair /axillary hair at age of 13ys for females.
  • If no menarche at age of 16 years.
64
Q

When to Refer Cases of Short Stature?

  • Male Puberty
A
  • If size of testes is less than 3ml at age of 14 years.
65
Q

When to Refer Cases of Short Stature?

  • General Examination
66
Q

Algorithm for Short Stature

67
Q

Etiology of GH Deficiency (Pituitary Dwarfism)

68
Q

Etiology of GH Deficiency (Pituitary Dwarfism)

  • Most Common Cause
A

Idiopathic

69
Q

CP of GH Deficiency (Pituitary Dwarfism)

70
Q

CP of GH Deficiency (Pituitary Dwarfism)

  • At Birth
71
Q

GH Deficiency (Pituitary Dwarfism)

  • During Childhood
72
Q

CP of GH Deficiency (Pituitary Dwarfism)

  • Cases with Destructive pituitary lesion
73
Q

INVx for GH Deficiency (Pituitary Dwarfism)

74
Q

INVx for GH Deficiency (Pituitary Dwarfism)

  • GH Provocation Test
75
Q

TTT of GH Deficiency (Pituitary Dwarfism)

76
Q

TTT of GH Deficiency (Pituitary Dwarfism)

  • GH Replacement
77
Q

TTT of GH Deficiency (Pituitary Dwarfism)

  • Dose of GH
A
  • Total dose: 0.3 mg/kg/week or 15 IU/m2/week.
  • 6-7 shots/week
78
Q

TTT of GH Deficiency (Pituitary Dwarfism)

  • Effects of GH Therapy
A
  • It gives drama catch up growth (10-12 cm/y) in the 1st year, then 1.5 times of normal in subsequent years.
79
Q

TTT of GH Deficiency (Pituitary Dwarfism)

  • When to Stop GH?
A

Growth hormone therapy is discontinued at bone age:

  • 16 years in males
  • 14 years in females
80
Q

TTT of GH Deficiency (Pituitary Dwarfism)

  • Replacement therapy for other hormones

Pediatrics I - OSCE (20 decks)

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