11. Growth and Endocrine Conditions Flashcards
(35 cards)
What factors influence height?
Age Sex Race Nutrition Parental heights Puberty General health Growth disorders Emotional well being Social-economic status
What are the three phases of child growth?
Infantile-10/15cm per year
Childhood - 5/7cm per year
Pubertal- girls 11-15, boys 14-18
How d you measure a babies height up to 2 years of age?
Put them in between a plate. Measure length, I.e. baby is lying down
What other measurements do we do in under 2’s
Head circumference
How do you measure a child 2 years and shoves height?
Height stand- shoes and socks off stand up straight
Sitting height- May indicate body disproportions
What special growth charts can be used?
Condition specific growth charts for those with disabilities
What simple tools can be used to assess if growth is on track?
Chart parental height and work out child’s estimated height
Bone age- radiograph interpretated by radiographer
What would you like to assess on history and examination?
Birth weight and gestation PMH FH/SH/ schooling Systematic enquiry Dysmorphic features Systemic examination including pubertal assessment
In summary what are the assessment tools you use
Height/length/head circumference Growth charts and plotting MPH and target centiles Growth velocity Bone age Pubertal assessment
What are some indications for referral to the growth clinic?
Extremely short or tall stature Height be,low tartget height Abnormal height velocity History of chronic disease Obvious dysmorphic syndromes Early/late puberty
What are the common categories of short statures?
Familial- runs in the family, completely normal
Constitutional- short fro now but will catch up later on
SGA/IUGR- interested at these ones- if they don’t catch up, further investigate
What are the pathological causes of short stature?
Undernitrition Chronic illness (JCA, IBD, coeliac) Iatrogenic (steroids) Psychological and social Hormonal (GHD, hypothyroidism) Syndromes (turner, P-W)
Why would you do a FBC and ferritin Test in a child with small stature!
General health
Coeliacs
LFT’s, U&E’s
Renal and liver disease
Calcium metabolism problem?
Coeliac serology
Coeliac
IGF-1
Hormonal disorders
Karyotyoe
Turner’s syndrome
What is an IGF-1 Test?
A growth hormone stimulation test aimed to see if arginine and insulin affect growth
What is. Typical presentation of thyroid deficiency in children?
Gained weight and lost height
What are the presentations of turners syndrome?
Webber neck, wide carrying angle,
Do a karotype test to confirm
What is pari vili syndrome
Picked up at birth
What is noonans syndrome ?
Genetic disorder of childhood, come dine with me
What is achondroplasia
Diagnosed antenatal your just after birth
Short legs, long limbs
No treatments apart from leg lengthening when older
How do assess puberty?
Use tanners method: B breasts 1-5 G genitalia 1-5 PH pubic hair 1-5 AH axillary hair 1-3 T testicles 2-20ml (oligometer) SO- e.g. stat,ent as B3 PH3 or G2 PH2 6/6
