W13_01 growth Flashcards
what’s the main growth factor in the intrauterine period of growth?
insulin
what’s the main growth factor system after birth?
the hypothalamic-pituitary axis
what are the three general factors that may restrict intrauterine growth? (triangle)
fetal, placental, maternal
note: always correct for time in premature babies for a growth chart
ok. E.g. a 3 month baby that was 2 months early = 1 month baby
note: there’s a special growth chart for turner syndrome females
it’s shorter than the general population
note: the WHO growth curves use 0.1%-99.5%ile to describe normal
CPEG uses 3-97%ile
average birth head circumference?
35cm;
increases 12cm in first year, and 2 cm in second year
what defines childhood
from 3 years old until puberty
note: growth velocity might be more meaningful than absolute height
ok
how to calculate the midparental height
1/2*(father’s height + mother’s height plus/minus 12.5) if boy/girl
what’s the first sign of puberty in females?
breast development;
then growth spurt;
menarche (growth almost complete)
when’s the onset of puberty in females?
7-13;
early is common, late is rare
what’s stage 2 of the tanner staging?
breast buds
what’s stage 4 of the tanner staging?
areola protrude from breast
what’s stage 5 of the tanner staging?
areola recede and stay flush with rest of the breast. Final stage
when’s the onset of puberty in males?
9-14 years
what’s the first sign of puberty in males?
testicular growth
what are the “four questions that provide all the answers?”
was the child IUGR?
Is the child disproportionate or proportionate?
Is the growth velocity normal or slow?
Is the bone age normal or delayed?
what’s the the upper:lower segment ratio? (pubic symphysis is the dividing line)
1 to 1
what are the two very common normal slow growth velocity conditions
familial short stature;
constitutional delay of growth
are males or females more commonly affected by constitutional delay of growth?
males»_space;»»> femlaes
how to check the bone age?
image the child’s left hand. Check for bone maturation (calcification) and compare to images of a reference age
what happens to the bone age for constitutional delay? For familial short stature?
CD: bone age is less than chronological age;
FSS: bone age is same as chronological age
which endocrine disorders could cause slow growth velocity?
hypothyroidism;
hypopituitarism;
cortisol excess
