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Endocrine 1 > Abnormal Growth in Peds > Flashcards

Abnormal Growth in Peds Flashcards

1
Q

What factors are evaluated in Auxology?

A

Compare growth patterns with norms
Changes ifn height-wt-head circ
Genetic potential
Normal vs Pathological dev.

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2
Q

What is the normal growth pattern?

A

Predictable Progression
Pulsatile
Seasonal

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3
Q

What are the measurements that are factored into Auxology?

A

Weight-length-head circ
Growth Charts
-WHO children

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4
Q

What needs to be considered when taking a history in Auxology?

A 
Weight-lenght-head circ at birth
Prenatal history
interval growth points
past medical history
Dietary history
Devt History
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5
Q

What factors are considered in body proportions?

A

Upper seg to lower seg
Increased in turner syndrome, rickets and achondroplasia
Dec in marfan Synd
Arm span to height

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6
Q

What constitutes over/underweight in BMI?

A

Overweight = 85th-95th percentile
Obese= >95th %ile
Underweight

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7
Q

What constitutes Failure to thrive?

A

Weight

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8
Q

What is the most common underlying cause of Failure to thrive?

A 
Insufficient Nurition
Inad Intake 
Inad Abs
Inc Urinary/intesinal loss
Inc Requirements
Ineffective Utilization
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9
Q

What is the difference between Wasting vs Stunting

A

Wasting: ###
Stunting: Normal at birth: Weight reduced but not height. later height lags, last head circ.

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10
Q

What Diagnostic Tests are used to evaluate Failure to thrive?

A 
Labs: CBC, Urinalysis, BUN/Cr, Lead, LFTs
Albumin/ALk phos, Ca and Phos if severe
Imaging: Upper GI series 
Swallowing function
Radionucleotide gastric emptying scans
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11
Q

What are the 5 Questions used in Eval of Tall Stature?

A 
Height abn for Pop? 
>97.7th
Growth abn rapid? 
-H/Ag dev up 2 major height %ile
Growth within range of Fam?
-Mid-parental ht
Evidence of Accel Growth?
-Adv Bone Age?
Dysmorphic Features found?
-Disorders or Syndromes?
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12
Q

How is mid parental height Calculated?

A

Girl: ((Fath-5in)+ Moth Ht)/2
Boy ((Mother+5in)+ Fath Ht)/2
Target Mid parental ht +/- 2 SD

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13
Q

What is the most common Cause of large for gestational age infants?

A

Maternal DM

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14
Q

What are more common Diseases of overgrowth in infancy?

A

Cerebral Gigantism

Beckwith-Wiedman Synd

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15
Q

What are the Endocrine Disorders that can cause Growth abnormalities?

A 
Precocious Puberty
GH excess
Hypothyroidism
Sex Hormone Deficiency or Insensitivity
Familial Glucocorticoid Def
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16
Q

What are causes of Precocious Puberty?

A 
Central GDPP
-HT or Pit
Peripheral GDIP
-Congenital Adrenal HP
-Testicular or Ovarian tumors
-McCune Albright synd
17
Q

What are features of kids with Precocious Puberty?

A

More in girls
Advanced Bone age
Early Epiphyseal closure
Tall child but short as adult

18
Q

What are chaicteristics of a Pt with GH Excess?

A 
Rare and Genetic
Height >3-4 SD
Normal Bone age
Elevated IGF-1, IGFBP-3, Abn MRI
Tx- Surgery, Rad or Meds
19
Q

What are features of Hyperthyroidism?

A 
Clinically similar to adults 
Diffuse Goiter
Adv bone age
Low TSH, High T3 and T4
Tx normalizes growth
20
Q

What are the features of Sex hormone Deficiency or Insensitivity?

A 
Def of Test or Estrogen
Permanent Hypogonadism
Delayed Skeletal maturation
EunuchoidProportions
-long legs
-Red UL segment ratio
Low sitting height
21
Q

What are the features of Familial Glucocorticoid Deficiency

A 
Rare
1^ adrenal insuff
High ACTH and Low Cort
-excessive adrenal androgens
Hypoglycemia, seizures, and hyperpigmentation
22
Q

What are the non-endocrine disorders that lead to Abnormal growth?

A 
Exogenous Obesity
Melanocortin-4 receptor mutation
Klinefelter Synd
47XYY synd
Marfan
Homocysteineuria
23
Q

What are features of Exogenous Obesity?

A

Tall, early onset pubery
Low GH prod
BMI >95th percentile
Genetic and Endo Obesity usually short

24
Q

What are features of Melanocortin 4 receptor Mutation?

A

Most common Monogenic cause of Obesity
Hyperphagia, Hyperinsulinemia
Preserved Repro Function

25
Q

What are features of Klinefelter Synd?

A 
2 or more X chromosomes in Males
Long legs, short trunk
Small Testes, gynecomastia
Mental disability
Rx = Testosterone
26
Q

What are features of 47 XYY Synd?

A

Problems with language and motor
Large teeth, tremor, incoordination
ADHD and Autism
No Rx Required for tall stature

27
Q

What are features of Marfan Synd?

A 
AD 
Arachnodactyly
Joint Hyperextension
Scoliosis, Pectus Excavatum
Lense Subluxation
Heart Valve Abn
Normal Bone age
28
Q

What are features of Homocysteinuria?

A

Marfanoid Features
Intellectual Disability
High Homocystein levels
Risk for Thrombotic Events

29
Q

What are features of Von Recklinghausen Dis?

A

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Endocrine 1 (15 decks)

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