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Human Development > The fundamental mechanisms of puberty and human growth > Flashcards

The fundamental mechanisms of puberty and human growth Flashcards

1
Q

what are the requirements for normal human growth

A

Absence of chronic disease

Emotional stability, secure family environment

Adequate nutrition

Normal hormone/growth factor actions

Healthy growth plates

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2
Q

what are the 3 phases of growth

A

infancy
childhood
puberty

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3
Q

how do you work out overall growth

A
  • infancy + childhood + puberty
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4
Q

what causes growth in …. and how much do they grow each year

A

infancy

  • nutrition
  • 25cm year

childhood

  • GH IGF
  • 4-8cm a year

puberty

  • sex steroids + increase in GH
  • peak is 8-12cm/year
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5
Q

why do we measure height and weight

A
  • it is useful as an indicator of general health and well being in children
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6
Q

what is illness do height and weight measurements pick up

A

Short stature disorders: Growth hormone deficiency and Turner syndrome

More controversial: Screening for tall stature

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7
Q

what are the elements of a well functioning monitoring

A

Calibrated equipment

Correct measurement technique

Systematically collected growth data

Appropriate, up-to-date growth reference

Screening rules for abnormal growth

Referral criteria

Adherence to guidelines

Appropriate diagnostic work-up

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8
Q

how do you measure weight in babies

A
  • they should not be weighted without any clothes or nappy
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9
Q

how do you measure height in children

A
  • class III clinical electronic scales

- they can be weighed in vest and pants but no shoes, footwear and dolls or teddies in hand

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10
Q

how do you measure length

A

Measure length before age 2 years if concerned

Use proper equipment (length board or mat)

Requires two measures

No nappy of footwear

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11
Q

how do you measure height

A

From 2 years of age using a rigid ruler, or stadiometer

Ensure heels, bottom, back and head are touching the apparatus

Don’t try to stretch up, measure on expiration

No footwear

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12
Q

what do the centiles show

A
  • they show the optimum range of weights and heights
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13
Q

if you are in the 50th percentile what does that mean

A

it means that 50% of other kids are below that measurement

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14
Q

what centiles are half of all children between

A

Half of all children between 25-75 centile

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15
Q

where are preterm babies plotted

A
  • they are plotted on the preterm section
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16
Q

where are term birth measurements made

A

they are made at 0

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17
Q

why is there no 1 week

A
  • because babies loose weight after they are born this is due to the water that they loose
18
Q

if the point is within 1/4..

A

If the point is within 1/4 of a space of the centile line, the child is described as being “on the xth centile (see A) e.g. on the 91st centile.

19
Q

if the point is not between 1/4 ..

A

If not they should be described as being “between centile X and Y (see B) e.g. between the 75th and 91st centile

20
Q

when do individual children need further assessment of growth

A
  1. Where weight or height or BMI is below the 0.4th centile, unless already fully investigated at an earlier age.
  2. If the height centile is more than 3 centile spaces below the mid-parental centile.
  3. A drop in height centile position of more than 2 centile spaces, as long as measurement error has been excluded.
21
Q

what is the diagnosis causing advance bone age

A
  • tall stature

- central precocious puberty - child at the age of 9.5 has an advanced age of puberty

22
Q

wha tis the diagnosis of delayed bone age

A
  • growth failure secondary to paediatric

- Cushings disease- excessive production of cortisol that halts growth

23
Q

what is short stature

A

Short stature is defined as a length or height

less than −2 SDS = 2.3 centile for age and sex of the appropriate reference population

24
Q

how do you evaluate short stature

A
  1. Height centile vs. weight centile
    - Failure to thrive or failure to grow
  2. When started
    - In utero
    - In infancy
    - In childhood
    - In puberty
  3. Body proportions
    - Primary or secondary growth disorder
  4. Presenting signs
    - ISS or a specific diagnosis
25
Q

how do you test proportionate growth failure

A
  • psychosocial assessment - psychosocial growth retardation
  • syndromic features karyotype - Turner syndrome
  • tests for systemic disorders - chronic renal insufficiency, GI Disease nutritional deficiency
  • tests for endocrine disorders - hypothyroidism, hypercortisolism
26
Q

how do you assess linear growth

A
  1. Detailed auxological assessment - Length, height, sitting ht, head circumference (<2 yr). Compare against appropriate national
    growth standards
  2. Consider genetic growth potential from parental heigh
  3. Estimate height velocity over an appropriate period of time
  4. Bone age assessment
  5. Signs and symptoms of underlying cause
  6. Assess pubertal status
27
Q

describe how maturation of the HPG axis works

A
  • There are phases that of through mini puberty – this is where there is a normal physiologial activity and then it goes back down
28
Q

what is puberty

A

Puberty is the normal developmental stage when reproductive capacity is attained

29
Q

what is activated in puberty

A

GnRH secretion and the HPG axis are re-activated

Initiated by pulsatile GnRH release from hypothalamus

30
Q

what is the name that we use to stage puberty

A

Tanner

31
Q

what is puberty onset defined as for girls

A

Tanner stage B2 for girls (budding of the breast)

32
Q

what is puberty onset defined as for boys

A

Tanner Stage G2 = Testis volume > 3mL in boys

33
Q

what is the mean age onset for girls and boys

A

Mean age onset 11yrs for girls and 12yrs for boys

34
Q

where does peak heigh velocity happen in girls and in boys

A
  • early stage in girls

- mid stages in boys

35
Q

what is the range of onset for girls and boys for puberty

A

In girls between 8-13 years

In boys between 9.5-14 years

36
Q

describe boys and height

A
  • they have a 2 additional years of prepubertal growth
  • and a taller prepubertal height in males
  • this leads to a 13cm difference in adult height
37
Q

what is mid puberty for boys

A

10 ml testes

38
Q

what is mid puberty for girls

A

menarche

39
Q

what are factors that influence the timing of puberty

A
  • genetic factors
  • intrauterine growth
  • childhood growth
  • fat mass - leptin
  • nutrition
  • adoption
  • migration
  • endocrine disrupting chemicals
40
Q

what does early puberty leda to

A 
Breast cancer
Endometrial cancer
Type 2 diabetes
Hypertension
Obesity
Adolescent risk behavior
Adult height
Psychosexual development
41
Q

what does late puberty lead to

A 
Cognitive and learning disabilities
Self esteem
Adult height
Osteoporosis
Psychosexual development

Human Development (28 decks)

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