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Block 3 Week 7 > Eckert Endocrine Growth > Flashcards

Eckert Endocrine Growth Flashcards

(51 cards)

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1
Q

If you go into liver failure will you grow? whY?

A

no

you need IGF-1 and IGF-BPI to grow which is made in the liver

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2
Q

The direct effect of GH is negligible compared to IGF-1. T or F

A

T

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3
Q

In a prenatal child, what makes you grow the most?

A

IGF-I and nutrition/maternal factors

GH and T4 have minor effects

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4
Q

How much does a prenatal child grow a week?

A

1.2-2.5 cm/week with peak at midgestation

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5
Q

How much does an infant and toddler grow per year and what affects the growth the most?

A

15-25cm

nutrition and GH/T4

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6
Q

Between what years is rechanneling common?

A

Between birth and 3 years

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7
Q

What affects the growth the most in childhood?

How much does a child grow in a year?

A

Hormones, genetics, and nutrition

5-7 cm a year

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8
Q

What affects growth the most during puberty?

How much does a child grow in a year?

A

hormones

up to 15 cm/year

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9
Q

When you measure a baby how do you do it?

A

measure length in less than 2 year olds,

measure height after 2 year olds

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10
Q

How do you know a baby is growing irregularly?

A

if it is growing more than 2 SDs in variation from normal growth velocity

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11
Q

What hormones are involved in normal growth?

A

growth hormones, thyroid hormones, cortisol, pubertal hormones

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12
Q

What are factors involved in normal growth?

A 
hormones
nutrition
GI abnormalities
Genetics
Environment
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13
Q 
What are these important for:
FAS, drug exposure
ADD and meds
Steroids – inhaled and oral
“Stress”
A

environmental factors influencing normal growth

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14
Q

Not getting enough calories or getting the wrong calories can stunt growth, so can (blank) due to stress.

A

psychosocial dwarfism

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15
Q

Usually height is determined by genetics of (blank)

A

Same sex parent

I.e. tall dad, tall son

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16
Q

how do you predict height of males and females?

Is this a good predictor of height?

A

Females-> take Moms heigh + (fathers height-13)/2
Males-> take moms height add 13 plus dads height/2
Plot MPH in percentile
Yes

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17
Q

On a growth chart, if weight is more affected than height then what is the problem?

A

Problems with GI, nutrition, renal, metabolic, CF

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18
Q

On a growth chart, if height is more affected then weight then what is the problem?

A

Problem with endocrine/syndromic, renal, metabolic

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19
Q

What do growth charts tell you?

A

height, weight, and OFC (occipital frontal circumference)

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20
Q

Is head growth (OFC) affected by hormone deficiencies?

What is it most affected by?

A

no surprisingly

neurologic/genetic (most likely not endocrine)

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21
Q

When should you start evaluating growth by bone age and what is this useful for?

Study These Flashcards
A

not until 3 years

helpful for determining height potential

22
Q

How many times should you take a height measurement?

Study These Flashcards
A

3 times and then average

23
Q

If someone is small but growth velocity is normal for prepuberty and bone age combined with height yield a normal predicted height but the bone age is 2 years behind then the problem is most likely (blank)

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A

constitutional delay of growth and puberty

24
Q

Is consititutional delay more common in males or females?

25
Describe constitutional delay of growth and puberty
``` relative short stature normal predictive value normal growth velocity (pre-pubertal) delayed puberty (after 14 years) Bone age is 2 years behind or more i.e growing normally then flat line=delay of growth ```
26
What are some things that can cause short stature?
medications (ADD, steroids) Gi issues (celiac, nutrtition, IBD) Hypothyroidism, pituitary problems, adrenal problems, kallman syndrome
27
What syndromes can lead to short stature?
turner, noonan, russel-silver, cushings syndrome, kallman syndrome
28
If bone is different than actual age we can predict (blank)
hypothyroidism
29
What are these for: Bone Age*** CMP, CBC, TSH, fT4, IGF-1, IGF-BP-3,karyotype in girls, ESR, celiac panel (tTg IGA, total IgA), gonadotropins, estradiol/testosterone If indicated ACTH, cortisol, salivary cortisol If hormone deficiency present, MRI pituitary GH stimulation testing - controversial
Growth evaluation
30
If gonadotropins are high in females then what is most likely the cause?
turners syndrome
31
Is cushings syndrome prevalent in children?
no it is rare
32
``` What does this cause: Most common isolated deficiency IGF-1, BP-3 low Growth velocity slow Bone age delay Hypoglycemia, fatigue, slow mentation ```
growth hormone deficiency
33
If you aren't doing well nutritionally what will your IGF 1 and BP3 levels be like?
IGF1 will be low and your BP3 will be normal
34
If you have growth hormone deficiency what will your IGF 1 and BP3 levels be like?
both will be low
35
If an infant has hypoglycemia, then this is a sign they will have (blank)
growth hormone defiency
36
When growth velocity is normal and bone age combined with height yield a normal predicted height, most likely is (blank)
constitutional delay of growth and puberty
37
what can a single central incisor be indicative of in an infant?
GH deficiency
38
What does this indicate: Hx neonatal hypoglycemia, jaundice, microphallus Poor growth, delayed puberty Fatigue, constipation, polyuria, polydipsia Developmental Delay +/- Appetite, sleeping issues Diabetes insipidus May be associated with septo-optic dysplasia, midline defects, single central incisor Low free T4 (nl TSH), adrenal function tests, osmolality, low IGF-1, BP-3
hypopituitarism
39
If you have a short female, with some cardiac or kidney abnormalities, has hypothyroidism, celiacs, or diabetes, what should you think is the cause?
turner syndrome
40
Why do people with turner syndromes often have problems?
because autoimmune disorders are higher in these populations than normal
41
People with turner syndrome lack (blank) but you can give them some growth hormone to help with their lack of growth
estrogen
42
What is this indicative of: Short stature, macrocephaly, micrognathia (undersized jaw), asymmetric limbs, precocious puberty, scoliosis, Failure to thrive, hypoglycemia as infant.
Russell-Silver syndrome
43
How do you treat Russell-Silver Syndrome?
with growth hormone, high calorie foods, and appetite stimulus
44
What is this: “male Turner” right sided cardiac defects, neck webbing, hypogonadism This runs in the family
Noonas syndrome
45
What is this: | Failure to thrive, hypotonia as infant, excessive weight gain after 1st year of life
Prader-Willi Syndrome
46
What is this: rare, can be caused by steroid use, short stature, rapid weight gain, buffalo hump, striae, hypertension, delayed puberty
Cushings syndrome
47
How do you test for cushings syndrome?
salivary cortisol, AM cortisol, ACTH, 24 hours urine for free cortisol, dexamethasone suppression test
48
What should you do if you have patients with any of these: Unexplained neonatal hypoglycemia, jaundice, microphallus Early signs of hypopituitarism, including GHD Unexplained, abnormally slow or fast growth Persistent growth velocity 95th% for age Extreme short stature (>2.5 SD) (or extreme tall) Growth pattern and prognosis at variance with family Height projection differs significantly from MPH Detection of abnormal body proportion
Refer them!
49
Arm span should be within (blank) of your height, if it isnt, deenotes a growth problem
2 cm
50
If someone has high stature what could the caues be?
``` GH tumor Marfans Sotos syndrome Klinefelters hyperthryoidism obesity precocoious puberty ```
51
If you have flat-lined height at a certain point but increasing weight, what does this indicate?
indicates obesity

Block 3 Week 7 (8 decks)

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