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Endocrine > 189. Growth and development > Flashcards

189. Growth and development Flashcards

(45 cards)

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1
Q

Causes:

  • Cushing’s Disease: pituitary ACTH hypersecretion
  • Cortisol secreting tumor
  • CRH secreting tumor
  • Exogenous (high dose steroids)

Suppress GH and IGF-1 action at the growth plate
- slow linear growth with weight gain acceleration

A

Glucocorticoid excess

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2
Q

In hypothyroidism:

- in addition to typical symptoms you will also see profound growth deceleration/failure and __ puberty

A

Delayed

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3
Q

Most important in the first few months (up to about 9 months) when it comes to postnatal growth

A

Nutrition

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4
Q

Secretion affected by:

  • thyroid hormone
  • estrogen
  • glucocorticoids
  • androgens
  • IGF-1
A

GH

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5
Q

Newborns with congenital hypothyroidism or growth hormone deficiency are usually __ at birth

A

Normal size

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6
Q

Disorders of the GH-IGF axis

Other endocrine disorders:

  • Cushing’s
  • Hypothyroidism

Malnutrition

IUGR

Chronic diseases

Psychosocial disorders

A

Secondary Growth Disorders

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7
Q

Growth hormone action:

  • Increases lipolysis
  • Decreases lipogenesis

Make __ into lean tissue

A

Adipose tissue

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8
Q

Hormone that leads to:

  • bone growth directly (2 routes)
  • Inhibition of IGF-1 negative feedback pathway
  • increase secretion of GH from pituitary
A

Estrogen

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9
Q

At midgestation, fetus grows how much per week?

A

2.5 cm

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10
Q

Growth hormone action at the level of __:

  • increases AA transport
  • Increases nitrogen retention
  • Increases lean tissue
  • Increases energy expenditure
A

Muscle

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11
Q

Hypothalamic dysfunction –> impaired GHRH release

  • congenital malformations
  • trauma
  • inflammation
  • CNS tumors
  • cranial irradiation
A

GH deficiency

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12
Q

Binding of what molecule to its receptor at the bone level leads to growth

Synthesized in the liver

A

IGF-1

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13
Q

In secondary growth disorders:
- linear growth is __ throughout

Skeletal age (bone age) __ chronologic age

A

Slow

<

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14
Q

Endocrine regulators of growth
- local production critical for normal intrauterine growth

Prenatal role in humans not completely delineated
- mice with knockouts have birth weights 60% of normal

A

IGF-1 and IGF-2

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15
Q

Definition:

  • more than 2 standard deviations below for sex and age
  • 3% of all children
  • does not automatically imply pathology
A

Short stature

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16
Q

Critical mediator of growth
- rises significantly during puberty

Largely responsible for stimulating muscle and cartilage growth

A

IGF-1

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17
Q

Children grow in a remarkably __ manner

Any deviation from this pattern should raise concern

A

Predictable

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18
Q

Secreted in a pulsatile manner, greatest amplitude overnight

Regulated by:

  • GHRH (+)
  • somatostatin (-)

Secretion affected by:

  • exercise
  • sleep patterns
  • food intake: ghrelin
  • age and pubertal status
  • body composition
  • emotional factors
  • various other neurotransmitters
A

GH

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19
Q

Peak growth rates occur during the __ __ of life and during puberty

  • 0-12 months: 25 cm/yr
  • 12-24 months: 12.5 cm/yr
  • 2 yrs - puberty: 6-8 cm/yr
  • pubertal peak: 9-10 cm/yr
20
Q

The major endocrine regulator of fetal growth

- infants of diabetic mothers are born large bc glucose crosses placenta

21
Q

3 phases of growth

Study These Flashcards
A
  1. Fetal (in utero)
  2. Infancy and childhood
  3. Adolescence
22
Q

Girls: ((Dad’s height - 5 inches) + mom’s height)/2

Boys: (Dad’s height + (mom’s height + 5 inches))/2

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A

Mid parental height

23
Q

Idiopathic short stature:

Genetic or familial short stature is cases in which bone age __ chronological age

Constitutional delay of growth and puberty (late bloomers) is cases in which bone age __ chronological age

24
Q

What kind of growth chart do you use for 2-20 year olds?

25
In primary growth abnormalities: - linear growth rate can be: - -> __ , but below the typically growth curve - -> __ , but then slows down Skeletal age (bone age) __ Chronologic age
Normal | =
26
IGF won't get transported through blood effectively without __
IGFBP
27
Direct effect on epiphyseal cartilage - chondrocyte proliferation - epiphyseal fusion Permissive effect on growth hormone secretion - increases GH release
Thyroid hormone
28
Endocrine causes of short stature (3 types)
Hypothyroidism Glucocorticoid excess IGF deficiency
29
What kind of growth chart do you use for 0-2 year olds?
WHO
30
Main source of nutrition and oxygen to the fetus Abnormal implantation, vascular insufficiency, infarction can compromise supply of oxygen and nutrients to the fetus
Placenta
31
Growth hormone action: - Promotes epiphyseal growth - GH stimulates differentiation of prechondrocytes and local expression of IGF-1
Linear growth
32
Combination of hypothyroidism, precocious puberty, and ovarian cysts in girls
Van Wyk Grumbach syndrome
33
Infants with __ are born small for gestational age d/t insulin resistance
Leprechaunism
34
Some features of __: - round, cherubic face - truncal obesity - small hands/feet - neonatal hypoglycemia, prolonged jaundice, and/or micropenis - Hx of cranial irradiation or chemotherapy - Midline defects - High pitched voice
GH deficiency
35
What position is a 2+yo when you measure their height?
Standing up
36
Puberty is regulated by the __ axis Sex steroids, estrogen, and testosterone produce the physical changes of puberty and promote the growth spurt
HPG (hypothalamic-pituitary-gonadal)
37
aka Intrinsic Growth Plate Abnormalities Osteochondrodysplasias Chromosomal abnormalities - Down's Syndrome - Turner Syndrome - Russel-Silver Syndrome
Primary Growth Abnormalities
38
Major endocrine regulators of growth in infancy and childhood
Thyroid hormone | Growth hormone
39
What position is a 0-2yo when you measure their height?
Supine
40
Growth hormone action: - increases osteoclast differentiation and activity - increases osteoblast activity - increases bone mass by endochondral bone formation
Bone metabolism
41
When checking bone age, you take an XR of the __ __
Left hand
42
Normal intrauterine growth is largely __ of the fetal pituitary gland hormones
independent
43
Deviation from a __ __ __ can be the first manifestation of a wide variety of disease processes
Normal growth pattern
44
Height < 3rd percentile Height significantly below genetic potential - just bc they're on the growth curve doesn't mean they are growing the way they should Abnormally slow growth rate Downwardly crossing percentile channels after 18 months - 2 years of age
Red flags for growth
45
Nutritional obesity has normal growth or accelerated from increased __ acting on IGF-1 receptors
Insulin

Endocrine (26 decks)

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