Growth and Stature Flashcards

(30 cards)

1
Q

What are the three phases of postnatal growth

A

The infantile phase
The childhood phase
The pubertal phase

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2
Q

What are the characteristic features of infantile phase

A

Rapid but decelerating growth during he first 2 years of life

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3
Q

What is the overall growth in the infantile phase

A

30-35cm

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4
Q

What are the characteristic features of the childhood phase

A

Growth at a relatively constant velocity of 5-7cm per year

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5
Q

What is the most significant endocrine factor for growth in the childhood phase

A

Growth hormone

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6
Q

What is characteristic of the pubertal phase

A

a groth spurt of 8-14cm per year due to synergistic effects of increasing gonadal steroid and GH secretion

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7
Q

What ceases first, spinal growth or limb growth

A

Limb growth

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8
Q

What can be used to estimate a child’s adult height

A

The mid-parental height

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9
Q

What is mid-parental height useful for

A

assessing genetic influences on height

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10
Q

What is bone age a measure of

A

skeletal maturity

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11
Q

How is bone age obtained

A

by assessing the appearance and shape of the bones of the hand and wrist from a radiograph

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12
Q

What is short stature

A

defined as a height 2 standard deviation or more below the mean height for children of that gender and chronological age

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13
Q

What are some causes of short stature

A

Low birth weight and illnesses in infancy
familial
constitutional delay of growth and puberty
endocrine abnormalities (thyroid disease, Cushing’s, vitamin D deficiency or resistance)
Dysmorphic syndromes associated with abnormal skeletal growth (Turner’s syndrome, Down’s syndrome, achondroplasia)
Chronic ilness, malnutrition
Psychosocial problems
Idiopathic

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14
Q

What do children with familial short stature have

A

short parent(s) with a history of normal puberty

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15
Q

Why does the height of the child begin to drift from the growth curve

A

The onset of pubertal growth spurt is delayed

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16
Q

Describe the physical examination and biochemical investigations for constitutional delay of growth and puberty (CDGP)

A

Both are normal

17
Q

What happens to the growth velocity for children with abnormalities in the endocrine control

A

Reduced growth velocity and they are usually overweight for their height

18
Q

What is the most common endocrine cause of short stature

A

GH deficiency

19
Q

What might GH deficiency be associated with

A

other pituitary hormone deficiencies

20
Q

What does GH stimulate in children

A

Epiphyseal prechondrocyte differentiation and linear bone growth in children
Gh also stimulates skeletal growth through stimulation of the hepatic synthesis and secretion of insulin-like growth factor-1

21
Q

What is linked to Cushing’s syndrome in children

A

Glucocorticoid therapy for asthma, IBD or immunological renal disease

22
Q

During a clinical examination, what should be looked for

A
Reduced growth velocity 
Underweight/ overweight 
pubertal development 
Dysmorphic features 
Features of chronic illness
Features of endocrine abnormalities
23
Q

If a child is found to be hypothyroid, what should be postponed until thyroxine has been adequately replaced

A

testing of GH

24
Q

How is GH administered

A

daily subcut injections

25
What are some adverse effects of GH injections
benign intracranial hypertension carpal tunnel syndrome pancreatitis increase in growth and pigmentation of naevi
26
What is the goal of GH deficiency
To achieve IGF-1 levels of about 1 standard deviation above the mean for age/ Tanner stage of pubertal development
27
Describe the treatment in Turner's syndrome
slightly higher doses of GH because they have a degree of GH resistance
28
Describe the relationship between obesity and overall GH production
Obesity may be accompanied by an early onset of puberty and modest overgrowth Obese children often have diminished overall GH production but high normal serum IGF-1 and GH binding proteins, resulting in tall stature for age prior to puberty
29
If an oral glucose tolernce test is carried out, what will it show in children with GH secreting adenomas
failure of GH suppression in these children
30
When is treatment encouraged for tall stature
extreme cases