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Child Health > Growth Charts > Flashcards

Growth Charts Flashcards

1
Q

if there is unsymmetrical distribution would you call the middle line the mean

A

no median

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2
Q

what is standard deviation

A

measure of variability

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3
Q

what is the Z score

A

the standard deviation score- the number of SD a result is from the mean

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4
Q

how many standard deviations will create a 95% reference rate

A

2sd

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5
Q

If there are 100 people measured, how many are within 1 SD from the middle line?

A

68 (34.1% on both sides of the line)

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6
Q

how far apart a centile lines spaced on a growth chart

A

2 or 3

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7
Q

what do you need to tell whether a child is growing normally

A

several plots on a growth chart (shows if normal progression- can be within normal ranges but not growing at normal rate)

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8
Q

how does height velocity change between the phases of growth

A

very fast in infant stage (nutrition led), slows in
child stage (growth hormone led)
increases again in pubertal stage (sex steroid led)

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9
Q

what can being overweight can in development

A

precocious puberty

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10
Q

what is normal growth

A

child whose measurements and rate of growth are within the normal range compared with children of their age

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11
Q

what has happened to growth charts in recent years

A

shift to the right- increases in weight (severe obesity may be distorting charts),
height also increasing

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12
Q

how should babies be weighed

A

without clothes or nappy

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13
Q

how should you measure head circumference

A

where head circumference is widest- take 3 and average, don’t go over ears

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14
Q

when should you measure length

A

only before 2 years if concerned - will vary a lot because of e.g. mood

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15
Q

when should you start measuring height

A

from 2 years

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16
Q

how should you measure height

A

no shoes, on expiration, don’t try and stretch up

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17
Q

how do you plot a growth chart

A

record measurement, date in ink, plot in pencil, don’t join dots, (age in weeks for first 6-12 months)

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18
Q

what does a child on the x centile mean

A

childs measurements are exactly on the centile line or within a 1/4 of a space

if they are not this then said to be between x and y centile

19
Q

when should growth charts be concerning

A

if progression crosses two centiles, or if out of normal ranges

20
Q

what is the average age of onset of puberty

A

girls 11 years

boys 6 years

21
Q

what are the gonadotrophins

A

FSH and LH

22
Q

what causes the onset of puberty

A

when the secretion of gonadotrophin releasing hormone (GnRH) by the hypothalamus, which is largely but not entirely suppressed during childhood, increases so that pulsatile secretion of luteinizing hormone (LH) increases, resulting in sufficient sex steroid production to result in the secondary sexual development

23
Q

what does LH cause in boys

A

stimulates the Leydig cells to produce testosterone which induces the features of secondary sexual development

24
Q

what does FSH do in boys

A

binds to receptors on the Sertoli cells, enhancing spermatogenesis.

25
Q

what moderates LH secretion in boys

A

testosterone

26
Q

what in boys exerts negative feedback on FSH

A

inhibin B secreted by sertoli cells

27
Q

what is hCG and what does it do

A

Human chorionic gonadotrophin (hCG) has similar structure and action to LH

28
Q

what does LH stimulate in girls

A

proliferation of follicular and thecal cells

during the follicular phase of the menstrual cycle induces androgen secretion by theca cells

29
Q

what is the role of FSH in girls

A

induces proliferation of granulosa cells; increases expression of LH receptors on granulosa cells; enhances aromatase activity so that androstenedione is converted to oestradiol and increases progesterone production

30
Q

what is the role of oestradiol

A

acts on FSH receptors on the granulosa cells to cause proliferation of the follicular cells in addition to inducing secondary sexual development

31
Q

how are growth hormones affected by puberty

A

In both sexes GH and insulin-like growth factor (IGF-I) secretion are enhanced because of increased levels of sex steroids and insulin. Insulin secretion rises and is accompanied by an increase in insulin resistance

32
Q

why can obesity can precocious puberty

A

as adipose tissue secrets leptin

33
Q

puberty before what age is precocious

A

<8 years for girls

<9 years for boys

34
Q

puberty not occurring by what ages is delayed

A

13 for girls

14 for boys

35
Q

how do you stage puberty in girls

A

breast development, pubic and axillary hair, odour, menarche

36
Q

when do girls usually reach their peak height velocity

A

12 years, breast stage 2-3

37
Q

when do boys reach their peak height velocity

A

average 14 years

38
Q

what is the average difference between men and women

A

14 cm

39
Q

why are boys taller

A

have delayed and higher peak height velocity, boys taller in pre puberty

40
Q

what is mid parental height

A

height between parent heights, 9/10 children will be within +/- of this centile

41
Q

what investigatinos can be done into growth problems

A

bloods- gonadotrophins, growth factors, testosterone/oestradiol. thyroid, karyotype

bone age (x ray or carpal bones in the wrist)

dynamic function tests (pituitary problems)

MRI (pituitary tumour), USS uterus (endometrial thickening)

42
Q

what are the classifications of short stature

A

genetic
constitutional growth delay- late maturation
dysmorphic syndromes (turners and downs syndrome)
endocrine disorders (thyroid, GH deficiency)
chronic diseases
psychosocial deprivation

43
Q

how does growth affect life

A

bullying
psychosocial problems
short people earn less

Child Health (17 decks)

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