Tall Statue Flashcards
1
Q
Ddx of Tall Statue
A
- Constitional familial tallness
- Prenatal factors - IDM, Beckwith, Sotos Syn
- Chromosomal - Klinefelters (Thin)
- Simple Obesity
- Endocrine causes - Gigantism, Precocious Puberty, Thyrotoxicosis (Fat)
- Skeletal abnormalities - Marfans, homocysteinuria (Thin)
- Hydrocephalus
2
Q
Steps to clinical examination of Tall Statue
A
- Impression of tallness. Look at parents ht
- Measure body proportions - US / LS ratio, arm span to ht. Marfans US/LS ratio 4/9
- LL - Bowing / Knock knees, Pes Planus
- 2nd Sexual characteristics - Axillary / pubic hair, Breast, genitalia
- Chest - deformity, murmurs of AI/MI/MVP
- Abdo - Organomegaly
- Visual fields, slit lamp (lens dislocation)
3
Q
Steps to clinical examination of Tall Statue Steps to clinical examination of Tall Statue (3-5)
A
- Dysmorphism
- Assess mentality
- UL - Arachnodactyly (Steinsberg and wrist signs), Hypermobility -Beightons score >4/9
4
Q
Sotos Syndrome
A
Tall >90 percentile - final adult ht might not be increased Prominent forehead large elongated face high arched palate Hypertelorism Large ears and jaw, pointed chin MR Coarse facial features Advanced bone age
5
Q
Beckwith Wiedemann Syndrome
A
Mild Microcephaly Macroglossia Ear lobe linear creases with pits on pina Facial port wine stain Exomphalos Hemi-hypertrophy Wilms tumor islet cell hyperplasia and causing perinatal hypoglycaemia
6
Q
Klinefelter’s Syndrome
A
1/500, male Increase with maternal age mild MR Tall and thin long limbs Gynaecomastia, breast Ca Small testes, infertile Antisocial
