Endocrine Disorders And Centile Charts And Assessment Of Child Growth

Question 1

Why is assessment of child growth difficult

Answer 1

Children don’t grow linearly

Question 2

What should not be weighed with babies and children

Answer 2

Babies - clothes, nappy
Children - shoes, toys

Question 3

What is use to measure weight

Answer 3

Class iii clinical electronic scales

Question 4

What is used to measure head circumference and where should it be measured

Answer 4

Plastic or paper tape
Where head circumference widest

Question 5

What is used to measure length

Answer 5

Length board or mat

Question 6

What can be used to measure height

Answer 6

Rigid rule with t piece
Stadiometer

Question 7

At what age do you stop measuring length and start measuring height

Answer 7

2 yrs

Question 8

How long does it take 80% of infants to recover weight lost in first week

Answer 8

2wks old

Question 9

What does recovery of birthweight by 2 wks suggest

Answer 9

Effective feeding
Baby healthy

Question 10

What amount of weight loss needs careful assessment at any age

Answer 10

> 10%

Question 11

When are babies weighed after neonatal period

Answer 11

8 wks
12 wks
16 wks
1 yr

Question 12

What does a centile mean and how close does a child have to be to the line to be on a centile

Answer 12

Percentage expected to be below that line
Within 1/4 space of line

Question 13

What can cause abnormal growth

Answer 13

Chronic disease
Emotional instability
Unsecure family environment
Malnutrition
Overnutrition
Abnormal hormone/growth factor actions
Unhealthy growth plates

Question 14

What nutrition problem is indicated by weight deficit greater than length deficit

Answer 14

Malnutrition

Question 15

How does weight track in 1st yr

Answer 15

Usually within 1 centile space - often not on 1 particular centile

Question 16

How does head circumference track

Answer 16

Usually within 1 centile space

Question 17

What age can BMI be measured using centile

Answer 17

2yrs

Question 18

How is midparental height calculated

Answer 18

(Mothers height + fathers height/2) +7 cm for boy/ -7cm for girl

Question 19

What 4 aspects are used to evaluate short stature

Answer 19

Height v weight centile
When it started
Body proportions
Presenting signs

Question 20

Causes of disproportionate short stature

Answer 20

Achondroplasia
Hypochondroplasia
Leri Weill dyschonrosteosis
Rickets

Question 21

What causes leri Weill dyschonrosteosis

Answer 21

Short stature home box gene

Question 22

How does leri Weill dyschonrosteosis present

Answer 22

Mesomelic limb shortening
Reduced sub ischial length
Madelung deformity of forearm - bowing of radius, dorsal dislocation of ulna, premature epiphyseal function

Question 23

When does leri Weill dyschonrosteosis usually become apparent

Answer 23

Puberty

Question 24

Most important monogenic cause of short stature

Answer 24

SHOX haploinsufficiency

Question 25

Evaluations of proportional short stature

Answer 25

Psychosocial assessment Syndromes features karyotype Test for systemic disorders Test for endocrine disorders

Question 26

Why are all girls with short stature given karyotype analysis

Answer 26

Check for turners syndrome

Question 27

Turners syndrome presentation

Answer 27

Webbed neck Shield chest Widely spaced nipples Cubical vagus Lymphoedema of hand and ankles Shortening of 4th/5th metacarpal Knock knees Gonadal dysgenesis

Question 28

2nd line tests in proportionate short stature

Answer 28

IGF-1 IGFBP3 GH stimulation test MRI

Question 29

Treatments for short stature

Answer 29

Oxandrolone rhGH

Question 30

Familiar short stature

Answer 30

Child grows along their growth centile and final height is short but appropriate for family

Question 31

Constitutional growth delay

Answer 31

Appropriate final height but delay in skeletal maturity and onset of puberty, often with late growth spurt and continued growth older than most people

Question 32

Deficiency of which hormone can cause short stature

Answer 32

GH

Question 33

Where is GH produced, what stimulates and inhibits it’s secretion

Answer 33

Anterior pituitary Stim - GHRH inhibit - somatostatin

Question 34

What is the pattern of GH secretion

Answer 34

Pulsation in response to sleep, exercise, hypoglycaemia

Question 35

Growth hormone deficiency

Answer 35

Decreased growth velocity and delayed skeletal maturation in the absence of other explanations

Question 36

How is GH deficiency treated

Answer 36

GH replacement

Question 37

How does GH deficiency effect birth weight and length

Answer 37

Normal birth weight Slightly reduced birth length

Question 38

Why is GH deficiency often not recognised until 7-8yrs old

Answer 38

Other hormones mask deficiency - eg IGF1+2

Question 39

Oxandrolone

Answer 39

Androgen anabolic steroid

Question 40

What starts puberty

Answer 40

GnRH produced and stimulates pituitary to produce LH and FSH

Question 41

What stages are used to describe puberty

Answer 41

Tanner stages 1-5

Question 42

Precocious puberty

Answer 42

Girls reaching tanner stage 2 before age 8 Boys reaching tanner stage 2 before age 9

Question 43

Most common cause of precocious puberty

Answer 43

Premature GnRH production

Question 44

How is precocious puberty treated

Answer 44

GnRH to overstimulate pituitary and stop gonadotropin production

Question 45

At what tanner stage does precocious puberty become irreversible to treatment

Answer 45

Stage 3

Question 46

Delayed puberty

Answer 46

Onset of puberty after 14 yrs

Question 47

Conditions commonly occurring with delayed puberty

Answer 47

Chronic disease Cryptorchidism Anosmia Anorexia Radio/chemo