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Flashcards in Growth Charts Deck (43):
1

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

no median

2

what is standard deviation

measure of variability

3

what is the Z score

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

4

how many standard deviations will create a 95% reference rate

2sd

5

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

68 (34.1% on both sides of the line)

6

how far apart a centile lines spaced on a growth chart

2 or 3

7

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

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

8

how does height velocity change between the phases of growth

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

9

what can being overweight can in development

precocious puberty

10

what is normal growth

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

11

what has happened to growth charts in recent years

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

12

how should babies be weighed

without clothes or nappy

13

how should you measure head circumference

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

14

when should you measure length

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

15

when should you start measuring height

from 2 years

16

how should you measure height

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

17

how do you plot a growth chart

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

18

what does a child on the x centile mean

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

when should growth charts be concerning

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

20

what is the average age of onset of puberty

girls 11 years
boys 6 years

21

what are the gonadotrophins

FSH and LH

22

what causes the onset of puberty

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

what does LH cause in boys

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

24

what does FSH do in boys

binds to receptors on the Sertoli cells, enhancing spermatogenesis.

25

what moderates LH secretion in boys

testosterone

26

what in boys exerts negative feedback on FSH

inhibin B secreted by sertoli cells

27

what is hCG and what does it do

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

28

what does LH stimulate in girls

proliferation of follicular and thecal cells

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

29

what is the role of FSH in girls

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

what is the role of oestradiol

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

31

how are growth hormones affected by puberty

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

why can obesity can precocious puberty

as adipose tissue secrets leptin

33

puberty before what age is precocious

<8 years for girls
<9 years for boys

34

puberty not occurring by what ages is delayed

13 for girls
14 for boys

35

how do you stage puberty in girls

breast development, pubic and axillary hair, odour, menarche

36

when do girls usually reach their peak height velocity

12 years, breast stage 2-3

37

when do boys reach their peak height velocity

average 14 years

38

what is the average difference between men and women

14 cm

39

why are boys taller

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

40

what is mid parental height

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

41

what investigatinos can be done into growth problems

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

what are the classifications of short stature

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

43

how does growth affect life

bullying
psychosocial problems
short people earn less