Growth in childhood Flashcards

1
Q

How do you measure height and plot centile charts?

A
  • Equipment should be accurate and maintained properly
  • Position child properly to get accurate height (read instructions on growth chart)
  • Remove things that interfere w/measuring - shoes off, hair out of the way
  • Calculate age + plot correctly on chart
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2
Q

What is the difference between height velocity and cumulative height?

A

Cumulative height = how tall child is now (total of all growth from conception)

Height velocity = how fast a child is growing in cm per year

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3
Q

How do children grow?

A
  • Fastest phase of growth after birth = first 2 years
  • Children move up + down through centiles at this phase
  • Most children move into a centile position by 2/3yrs
  • Normal children grow fast enough to keep on same centile thr childhood
  • Phase of fast growth at puberty (pubertal growth spurt) - timing depends of age at which child enters puberty
  • Skeleton matures as child grows, epiphyses fuse at end of puberty, growth stops
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4
Q

What are the common causes of abnormal growth?

A

Short stature:

  • Poor nutrition
  • Chronic disease
  • Endocrine causes - GH deficiency, thyroid hormone deficiency
  • Genetic disorders affecting bone growth - achondroplasia, Turner’s, Down’s
  • Psychological distress + neglect

Tall stature:

  • Syndromes of overgrowth - Marfan syndrome, Soto syndrome
  • GH excess from pituitary tumour
  • Precocious puberty
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5
Q

How do hormones affect growth?

A
  • Hypothalamic GHRH (increases)+ somatostatin (inhibits) GH secretion
  • Growth hormone from anterior pituitary has some growth effect
  • GH stimulates IGF1 release
  • IGF1 circulates bound to IGF1 binding proteins + stimulates growth in all tissues
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6
Q

What are the main factors linked to increasing obesity?

A
  • Higher energy intake vs energy expenditure
  • In some cultures, overweight has traditionally been seen as a desirable feature indicating wealth + high status
  • In different areas, feature of poverty/affluence
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7
Q

Why is increasing obesity a concern?

A
  • More likely to get T2DM, cardiovascular disease, some cancers, orthopaedic problems
  • Some ethnic groups have less “tolerance” of obesity - more likely to get complications, e.g. T2DM at lower BMI
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8
Q

What influences cumulative growth?

A
  1. Events before birth - poor foetal growth, low birth weight, prematurity
  2. Medical issues in childhood - malnutrition, chronic disease, endocrine problems inc. GH deficiency
  3. Genetic factors - height of family + inherited disorders of growth
  4. Randomness - not every child of same parents will be same height; multiple genes randomly distributed at conception influence
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