Growth and puberty Flashcards
(24 cards)
what are factors that can influence q child’s growth
genetic potential nutritional intake endocrine rgulation comorbidities emootional health
how do you assess growth in the UK
measure height (>2yo) OR length (<2yo) + weight + head circumference (in infants)
Plot on UK-WHO chart
Different charts for girls, boys, trisomy 21
when do you correct growth for prematurity until
until 2 yo
when do you start tracking centiles for babies
from birth
what about centiles will concern you in a baby
if the baby crosses 2 or more centile iness
how much of their birthweight is it normal for babies to lose in their first 10 days of life
10% max
what is the order of development of puberty in girls
thelarche (breast development) > adrenarche (pubic hair) > menarche (menstruation)
what do you call breast development
thelarche (mnemonic: tette)
what do you call pubic hair development
adrenarche (Axillary, pubic hair growth)
when i the average age for menarche
12.5 years
what is the rage of age for puberty in females, and the average age
8-13 yo
average: 11
when does puberty develop in males compared to females
18 months after females
what is precocious pubry
secondary sex characteristics developing at <8 years in girls and <9 years in boys
what are causees of precocious puberty
Central (GnRH dependent)
- idiopathic
- familial
- CNS tumour (e.g. optic glioma with NF1)
- developmental abnormality
- encephalitis, brain abscess
- hydrocephalus
Peripheral (GnRH independent)
- increased androgen secretion (CAH, leidig cell adenoma)
- gonadotrophin secreting tumour
- Ovarian cyst
- McCune-Albright syndrome
- iatrogenic / exogenous sex hormones
What are causes of global developmental delay
Antenatal:
- GENETIC (Downs, NF, Fragile X, Duchenne muscular dystrophy, TS)
- METABOLIC/ENDO (hypothyroid, PKU, MCAD)
- Toxin: drugs, alcohol
Perinatal/PN:
- infection
- trauma/ischaemia> cerebral palsy
- neglect
what are causes of specific delay - gross motor
spina bifida
cerebral palsy
what are causes of specific delay - fine motor and vision
retinoblastoma
retinopathy of premturity
what are causes of specific delay - speech and language
hearing problems (otitis media with effusion, deafness)
what are causes of specific delay - social
autism
Fragile X
What is the broad initial mx if you are suspecting NAI
- Gather information from other professionals who may know the child
- Check if the child is on the child protection register
- Contact senior / lad pediatrictian in child protection
- Take photographs if necessary
Document everything carefully
What do you do if suspecting NAI
Inform parents of what is happening
but do NOT accuse anybody of harming the child
Who do you refer to if suspecting child abuse
- Refer to SOCIAL SERVICES ALL cases of suspected abuse or neglect
- Refer to police if allegations of rape/sexual assault, severely injured child from abuse, perpetrator is threatening to remove the child from the hospoital where the child is believed to be in danger
delayed puberty in boys
no testicular development by 14
delayed puberty in girls
no telarche by 13/ no menarche by 15
