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*Diabetes & Endocrinology > Growth and Development > Flashcards

Growth and Development Flashcards

(Paediatric endocrinology and diabetes) (56 cards)

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1
Q

Name some protocols for accurate height measurement of a child

A
  • Shoes n socks off
  • Heels together, legs straight, shoulders released
  • Heels, buttocks, scapulae against wall
  • ‘breathe in and stand tall’
  • Height to last complete mm
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2
Q

How is height measured in children under 2 years, or when something is preventing you from measuring height?

A

Length is measured instead

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3
Q

When is sitting height measured?

A

When the body is disproportionate e.g. in people with skeletal dysplasia

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4
Q

Who is head circumference measuring routine in?

A

Children <2 years

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5
Q

How is head circumference measured?

A

Tape round forehead and occipital prominence

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6
Q

What does ‘make every contact count’ refer to?

A

Every time a child visits the GP or hospital, they should be measured; important to track growth to flag up any problems

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7
Q

Name a few different growth charts

A

Mid-parental height and target height
Condition-specific charts e.g. for Downs, Turners
BMI

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8
Q

How is bone age measured?

A

Radiographs usually of left wrist, hand and fingers

Measured from epiphyseal plates

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9
Q

Name the 5 components of puberty staging in the Tanner method

A 
B = 1 to 5
G = 1 to 5
PH = 1 to 5
AH = 1 to 3
T = 2ml to 20ml
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10
Q

What do the stages of the Tanner method roughly mean in relation to stages of puberty?

A

Stage 1 = prepubertal
Stage 3 = early puberty
Stage 5 = adult

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11
Q

What is the tool used for testicular maturation measurement?

A

Prader orchidometer

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12
Q

Name 6 features of history and further examination when investigating growth and development

A
  • birth weight + gestation
  • PMH
  • fam history/social history/schooling
  • systematic enquiry
  • dysmorphic features
  • systemic examination
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13
Q

What factors influence height?

A 
Age
Sex
Race
Nutrition 
Parental heights
Puberty 
Skeletal maturity (Bone age)
General health 
Chronic disease
Specific growth disorders
Socio-economic status
Emotional well-being
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14
Q

Which gender enters puberty earlier?

A

Female

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15
Q

For which gender does puberty last longer?

A

Male

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16
Q

What is the earliest objective sign of puberty in females?

A

Breast budding (Tanner stage B2)

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17
Q

What is the earliest objective sign of puberty in males?

A

Testicular enlargement (Tanner stage G2 + T3-4ml)

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18
Q

Give 6 indications for referral about a possible growth disorder

A
  • extreme short/tall stature (off centiles)
  • height below target height
  • abnormal height velocity (crossing centiles)
  • history of chronic disease
  • obvious dysmorphic syndrome
  • early/late puberty
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19
Q

What is the common link between obesity and growth?

A

Obese children are generally taller; short obese children are worrying

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20
Q

Give 3 common causes for short stature

A

Familial
Constitutional
SGA/IUGR

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21
Q

Give some pathological causes for short stature (6)?

A 
Undernutrition 
Chronic illness (JCA, IBD, Coeliac)
Iatrogenic (steroids)
Psychological + social
Hormonal (GHD, hypothyroidism)
Syndromes (Turner, P-W, Noonans, achondroplasia)
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22
Q

What is considered early and late puberty in boys?

A

EARLY < 9 yrs

LATE > 14 yrs

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23
Q

What is considered early and late puberty in girls?

Study These Flashcards
A

EARLY < 8 yrs

LATE > 13 yrs

24
Q

What is CDGP?

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A

Constitutional Delay of Growth and Puberty

25
Who is CDGP most common in?
Boys; fam history in dad or brothers; bone age delay (need to exclude organic disease)
26
Give 4 causes of delayed puberty
Gonadal dysgenesis (Turner, Klinefelter) Chronic disease (Crohn's, asthma) Impaired HPG axis (septo-optic dysplasia, craniopharyngioma, Kallman's syndrome) Peripheral (cryptorchidism, testicular irradiation)
27
What is central precocious puberty?
Early pubertal development; breast development in girls and testicular enlargement in boys
28
Give a couple more features of CPP
Growth spurt | Advanced bone age
29
What is the cause of CPP in girls?
Usually idiopathic; do pituitary imaging
30
What is the cause of CPP in boys?
Look for underlying cause e.g. brain tumour, genetics
31
What is the treatment for CPP?
GnRH agonist (Gonadatrophin-releasing hormone agonist)
32
What is different between precocious pseudopuberty and CPP?
PP is gonadotrophin independent (low/prepubertal levels of LH and FSH)
33
Give some features of precocious pseudopuberty
Abnormal sex steroid hormone secretion Virilasing/feminasing Secondary sexual characteristics
34
What is the management for a newborn with ambiguous genitalia?
Do NOT guess sex of baby MDT approach Exam: USS? gonads/internal organs Karyotype
35
What is it important to exclude in newborns with ambiguous genitalia?
Congenital Adrenal Hyperplasia (risk of adrenal crisis in first 2 weeks)
36
Give 2 causes of congenital hypothyroidism
- Athyreosis/hypoplastic/ectopic | - Dyshormonogenic
37
When should treatment of congenital hypothyroidism commence?
Within first 2 weeks
38
What is the most common cause of acquire hypothyroidism?
Autoimmune (Hashimoto's) thyroiditis
39
What is the expected history in someone with acquired hypothyroidism?
Fam history of thyroid/autoimmune disorders | Childhood issues like lack of height gain, pubertal delay, poor school performance
40
What percentage of children aged 2-15 are overweight/obese?
31%
41
What centile is considered overweight?
BMI >85th centile
42
What centile is considered obese?
BMI >97.5th centile
43
What is important to keep in mind when looking at an obese child?
Obese + short = abnormal
44
Name a few complications of obesity
``` Metabolic syndrome Fatty liver disease Gallstones Thromboembolic disease Pancreatitis GRD Stress incontinence Orthopaedic problems Left ventricular hypertrophy RSHF etc ```
45
Name 5 causes of obesity
``` SIMPLE OBESITY (99%) Drugs Syndromes Endocrine disorders Hypothalamic damage ```
46
Name 4 drugs that can cause obesity
Insulin Steroids Anti-thyroid drugs Sodium valproate
47
Name 4 syndromes that can cause obesity
``` Prader Willi syndrome Laurence-Moon-Biedl syndrome Pseudohypoparathyroidism type 1 Down's syndrome (there will be obvious pointers towards syndrome anyway) ```
48
Name some treatments for obesity
Diet Exercise Psychological input Drugs (??)
49
What is the most common form of diabetes in children?
Type 1
50
Why is it important to diagnose children with diabetes early?
To prevent DKA (diabetic ketoacidosis) occurring
51
What are the THINK symptoms of diabetes (4 Ts)?
Thirsty Thinner Tired Using the toilet more
52
What is the immediate test for diabetes?
Finger prick capillary glucose test (result >11mol)
53
What is a 'red flag' symptoms of diabetes?
A return to bedwetting or day-wetting in a previously dry child
54
What are some other symptoms of diabetes in children under 5?
- heavier than usual nappies - blurred vision - candidiasis (oral, vulval) - constipation - recurring skin infections - irritability, behaviour change
55
What are some symptoms of DKA?
``` Nausea + vomiting Abdominal pain Sweet smelling, 'ketotic' breath Drowsiness Rapid, deep 'sighing' respiration Coma ```
56
What do you NOT request to diagnose DKA?
Returned urine specimen Fasting blood glucose Oral glucose tolerance test DO NOT WAIT for lab results

*Diabetes & Endocrinology (24 decks)

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