Growth (5/19) Flashcards Preview

Endorine > Growth (5/19) > Flashcards

Flashcards in Growth (5/19) Deck (26):
1

What happens to children with constitutional delay?

Lag 2-4 years behind average for age and sex in ht, pubertal dev and bone age. USually a fam hx of the same. By mid to late teens, catch up and reach final height in normal range

-plateau in height and then rapidly grow

2

What do we measure as a proxy for GH?

IGF-1-IGFBP-3

3

What are some processes that affect normal growth?

-GI diseases
-Small gestational age
-Systemic disorders
-Psychosocial deprivation
-Genetic disorders
-Endocrine disorders

4

What GI disease affect normal growth?

Malnut, malabsorption, inflamma bowel dis, celiac dis

5

Describe small gestational age's effect on growth

Most SGA kids catch up height by age 2, but 10-15% do not

6

What systemic disorders affect normal growth?

-pulmonary, immunological, cardiac, hematological, medication related

7

What genetic disease affect normal growth?

-Turners
-Downs
-skeletal dysplasia etc

8

What endocrine disease affect normal growth?

-Hypothyroidism
-excessive steroids
-GH def

9

What are ways to conduct a growth eval?

-Bone age determination by xray
-Dental dev
-Blood analysis

10

Describe Xray results

Normal bone age and short for age=genetically short. Delayed bone age=constitutional delay or disease, advanced bone age=precocious puberty

11

What blood analysis do you do for growth?

-CBC
-ESR
-Celiac screen
-Chemistry
-Karyotype (girls)
-GFs
-TSH, free T4

12

What do you look at to diagnose GH def?

-Hx of risk factors (pit truama, tumor, genetcis etc)
-Poor growth velocity
-Delayed bone age
-Low IGF1, IGFBP-3
-Failed GH provocative testing
-MRI of pit/hypothalamus

13

Boys vs girls in utero

-FSH and LH levels are high, males have higher androgen levels

14

Boys vs girls in infancy

No dif in androgen/estrogen levels between males and females because the hypothalamus is suppressed

15

Boys vs girls in puberty

-GnRH release results in sex steroid production. Males have more testosterone and females more estrogen

16

At what ages do we do a workup for abnomral pub?

Boys: 14
Girls: 13

17

What is precocious puberty?

Early puberty

18

What are the causes of precocious puberty?

Central: idiopathic, CNS pathology, hamartoma (abnormal cells)

Peripheral: ovarian cysts, McCune albright syndrome, exogenous hormones

19

What are some neonatal puberty issues?

Breast enlargement, galactorrhea, uterine bleeding, genitalia concerns

20

What are some infant puberty issues?

Breast dev (benign premature thelarche)
Small phallus

21

What do androgens do in early pub dev?

Pubic hair, body odor, voice, acne, growth

22

What do estrogens do in early pub dev?

Breast dev, growth

23

What are the androgens?

DHEAS, androstenedione, testosterone

24

What age do african americans and caucasian get breasts?

Mean 8.9 (AA) mean 10 (C)

25

How do we treat precocous pub?

Lupron, histrelin implant, no luron, andrgeon blockers

26

What is congenital hypothyroidism?

Def in thyroid hormone present at birth that, if untreated, can lead to growth failure and permanent mental retardation. Seen in 1/4,000 births and now e have a newborn screening test. Excellent prognosis