Chronic Disease and Psychosocial Deprivation ✅

Question 1

What is the importance of chronic disease when considering impaired growth?

Answer 1

Chronic disease of many systems may lead to impaired growth

Question 2

By what mechanism do chronic diseases cause impaired growth?

Answer 2

Negative energy balance

Question 3

What can cause a negative energy balance in chronic disease?

Answer 3

• Inadequate calorie intake
• Malabsorption
• Excess calorie requirement
• Hypoxia
• Electrolyte abnormalities
• Inflammatory cytokines
• Steroid treatment
• Acquired partial resistance to GH

Question 4

What can cause an acquired partial resistance to GH?

Answer 4

• Renal failure

- Crohn’s disease delayed onset of puberty

Question 5

What does treatment to improve growth impairment caused by chronic disease require?

Answer 5

Attention to the underlying mechanism before considering other options such as GH therapy

Question 6

How can adverse psychosocial factors lead to poor growth?

Answer 6

• Impairment in fetal growth
• Inadequate diet
• Increased illness
• Emotional deprivation and abuse

Question 7

Give 2 psychosocial factors that can impair fetal growth

Answer 7

• Maternal smoking

- Alcohol consumption

Question 8

What psychosocial factors might increased illnesses be linked to?

Answer 8

Parental smoking

Question 9

How can emotional deprivation/abuse lead to growth failure?

Answer 9

By producing hypothalamically-mediated suppression of pituitary GH secretion

Question 10

What does appropriate treatment for growth failure caused by emotional deprivation or abuse require?

Answer 10

Interventions to prevent further abuse and ensure child is raised in appropriate environment