Eckert: Growth Flashcards
(39 cards)
Mid-parental height
Females
Males
MH + (PH-13)/2
(MH+13) + PH/2
Generally children’s heights will be within (blank) standard deviations of MPH
1.5
What three things do growth charts measure?
height, weight, OFC
If weight is more affected than height, what are some problems that come to mind?
GI, nutritional, renal, metabolic, CF
If height is more affected than weight, what are some of the problems that come to mind?
generally constitutional, endocrine/syndromic, renal, metabolic
When the head circumference is most affected, what can this indicate?
neurologic/genetic problem
endocrine unlikely
When does bone age become reliable?
3 years
Wall mounted stadiometer Fixed platform Heels to the wall, chin up and supported Measure 3 times and average Be sure to plot appropriately depending on disorders, race, etc.
Important components for growth evaluation
Most helpful for determining height potential
bone age
When growth velocity is normal and bone age combined with height yield a normal predicted height, what is most likely occuring?
most likely is constitutional delay of growth and puberty
Incidence of constitutional delay of growth and puberty
males: 1/7500
females: 1/50,000
Kids must be growing (blank) cm/year to imply normal growth velocity
5-7cm
What age defines delayed puberty in males and females?
> 14yrs
Puberty generally starts when bone age is (blank) in females and (blank) in males
10; 12
What kinds of things should be considered if growth velocity is abnormal and height prediction is out of keeping with genetics?
mediciations (ADD, steroids, others)
GI issues (celiac, nutrition)
hypothyroidism, GH deficiency, adrenal insufficiency/hyperplasia
syndromes - Turner, Cushings
If there’s a short girl, what should you do?
karyotype
Tests that can be performed if bone growth, etc is inappropriate?
CMP CBC TSH IGF-1 IGF-BP-3 karyotype celiac panel LH/FSH estradiol/testosterone
What should be done if hormone deficiency is found?
MRI of pituitary
What's this pituitary hormone deficiency? Most common isolated deficiency IGF-1, BP-3 low Growth velocity slow Bone age delay Hypoglycemia, fatigue, slow mentation
GH deficiency
Hx neonatal hypoglycemia, jaundice, microphallus
Poor growth, delayed puberty
Fatigue, constipation, polyuria, polydipsia
Developmental Delay
+/- Appetite, sleeping issues
Diabetes insipidus
hypopituitarism
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
How common is Turner syndrome?
1/2500 live births
Consider this is ANY short female
Turner syndrome
Major signs of Turner syndrome
short stature cardiac abnormalities renal abnormalities hypothyroidism celiac disease diabetes
