W13_01 growth

Question 1

what’s the main growth factor in the intrauterine period of growth?

Answer 1

insulin

Question 2

what’s the main growth factor system after birth?

Answer 2

the hypothalamic-pituitary axis

Question 3

what are the three general factors that may restrict intrauterine growth? (triangle)

Answer 3

fetal, placental, maternal

Question 4

note: always correct for time in premature babies for a growth chart

Answer 4

ok. E.g. a 3 month baby that was 2 months early = 1 month baby

Question 5

note: there’s a special growth chart for turner syndrome females

Answer 5

it’s shorter than the general population

Question 6

note: the WHO growth curves use 0.1%-99.5%ile to describe normal

Answer 6

CPEG uses 3-97%ile

Question 7

average birth head circumference?

Answer 7

35cm;
increases 12cm in first year, and 2 cm in second year

Question 8

what defines childhood

Answer 8

from 3 years old until puberty

Question 9

note: growth velocity might be more meaningful than absolute height

Answer 9

ok

Question 10

how to calculate the midparental height

Answer 10

1/2*(father’s height + mother’s height plus/minus 12.5) if boy/girl

Question 11

what’s the first sign of puberty in females?

Answer 11

breast development;
then growth spurt;
menarche (growth almost complete)

Question 12

when’s the onset of puberty in females?

Answer 12

7-13;
early is common, late is rare

Question 13

what’s stage 2 of the tanner staging?

Answer 13

breast buds

Question 14

what’s stage 4 of the tanner staging?

Answer 14

areola protrude from breast

Question 15

what’s stage 5 of the tanner staging?

Answer 15

areola recede and stay flush with rest of the breast. Final stage

Question 16

when’s the onset of puberty in males?

Answer 16

9-14 years

Question 17

what’s the first sign of puberty in males?

Answer 17

testicular growth

Question 18

what are the “four questions that provide all the answers?”

Answer 18

was the child IUGR?
Is the child disproportionate or proportionate?
Is the growth velocity normal or slow?
Is the bone age normal or delayed?

Question 19

what’s the the upper:lower segment ratio? (pubic symphysis is the dividing line)

Answer 19

1 to 1

Question 20

what are the two very common normal slow growth velocity conditions

Answer 20

familial short stature;
constitutional delay of growth

Question 21

are males or females more commonly affected by constitutional delay of growth?

Answer 21

males&raquo_space;»»> femlaes

Question 22

how to check the bone age?

Answer 22

image the child’s left hand. Check for bone maturation (calcification) and compare to images of a reference age

Question 23

what happens to the bone age for constitutional delay? For familial short stature?

Answer 23

CD: bone age is less than chronological age;
FSS: bone age is same as chronological age

Question 24

which endocrine disorders could cause slow growth velocity?

Answer 24

hypothyroidism;
hypopituitarism;
cortisol excess