Week 1 - H - Growth puberty and adolescence Flashcards
What is the middle line called?
Called the median
What does the standard deviation measure?
It is the measure of variability
What centile is the median?
The median is the 50th centile
What is the Z-score?
The Z-score is the number of standard deviations from the mean
if the population heart rate is 100 and the standard deviation is 10, your z-score if you are 90 is 1
If there are 100 people measured, how many are within 1 SD from the middle line? How many are within 2SD from the middle line?
68% will fall within 1 standard deviation
95% will fall within two standard deviations
99.7 (basically 100) % will fall within three standard deviations
How far are centile lines spaced apart in relevance to standard deviations?
Centile lines are spaced 2/3rds of a standard deviation apart
At what age is there the transit from UK-WHO to UK90 data on growth charts?
At age 4 year old
What centile shows overwight children on BMI charts? What BMI is this? What centile shows obese (very overweiht) and what BMI?
Overweight is 91st centile
Greater than BMI of 25 (to 30)
Obese is 98th centile
Greater than BMI of 30
What centile shows severely obese and which shows morbidly/extremely obese?
Severely obese is the 99.6th centile
Extremely/morbidly is 3.33SD from the norm
What scales should be used for measuring the weight of a child?
Class III electronic scales in metric
How should head circumference be measured?
Measured where head is widest - do not include ears
Use a disposable measuring tape and take the average of 3 measures
What does a child’s heads circumference inidcate?
Indicates excessive or limited growth of a child
From the age of 2 years, what is the correct tool for measuring height in a child?
Use a rigid rule with Tpiece or a stadiometer
Pic shows a stadiometer
What should you ensure is touching the apparatus in measuring height to take an accurate measure?
Ensure heels, bottom, back and head are touching apparatus
In centile terminology, when plotting a point, If the point is exactly on line X or within 1/4 of line X, what centile line is it said to be on? If the centile line is more than 1/4 from centile line X, (ie say line X is the 75th centile and the dot is between the 75th and 91 st centile), what is the dot saidd to be on?
Exactly or within or quarter of centile line then said to be on that line
More than 1/4 from the line then said to be betwwen centile X and centile Y
What is the average age for a girl to enter puberty? (what about boys)
Average age is 11 years old
Boys is 6months later
What are the gonadotrophins?
Lutienising hormone and Follicle Stimulating Hormone (LH and FSH)
What do LH and FSH stimulate in boys?
LH stimulates the Leydig cells to produce tesosterone (testosterone has a negative feedback role on LH secretion)
FSH stimulates the sertoli cells to help with spermatogenesis
What hormone produced by the sertoli cells acts on the FSH secretors to reduce secretion?
Inhibin B (produced in males)
What is the earliest sign of puberty in boys? What stages is used to determine age of a child?
Earliest sign of puberty in boys is testicular volume increase
Tanner stages are used
What is thelarche? (usually first sign of puberty in girls)
Breast budding
How long after thelarche does menarche begin?
Menarche - periods begin usally 2 years after thelarche (range is 1-5)
What is precocious puberty defined as? (age for boys and girls)
Precocious puberty is normal pubertal development occurring abnormally early (less than 8 years for girls and 9 years for boys)
What is secondary sexual devlopment? Give examples of some characteristics
This is the developmental of characteristics that distingusihes between sexes however are not involved in reproduction
Pubic hair Breast tissue development in females
Facial hair and adam’s apple in males
What is pubertal delay defined as? MORE common in boys or girls?
The absence of secondary sexual characteristics in a girl by age 13 and a boy by age 14
More common in boys
Do boys or girls reach Peak Height Velocity PHV first? Whose peak height velocity is greater?
Boys have delayed PHV
Boys PHV > girls
If there is a growth problem, what tests should be carried out?
Gonadotrophins
Growth hormone
Testosterone/oestradiol
Thyroid karyotype
Bone age
MRI brain
How is bone age measured?
Measured by carrying out an X-ray of the carpals on the left hand
What is genetic short stature vs constitutional growth delay?
Genetic short stature – healthy, well child who has inherited short stature from parents. No underlying endocrine abnormality and normal bone age.
Constitutional growth delay – late maturation causing short stature.
Cause usually unknown. May be genetic short stature component. Tends to present around puberty with delayed onset. Children have delayed maturation and delayed bone age. Can be very stressful.
