Growth & Development

Question 1

What are the 4 stages of growth?

Answer 1

Foetal, Infancy, Childhood, Puberty

Question 2

What affects foetal growth?

Answer 2

Mother’s Genetics
Mother’s Health (e.g. hypertension)
Placental nutrition and function
Smoking/Drinking

Question 3

Which is the most rapid phase of growth?

Answer 3

Foetal

Question 4

What is foetal rate of growth?

Answer 4

about 10cm a month. Peaking at 13-18 weeks gestation

Question 5

What is the most important factor in infant growth?

Answer 5

Nutrition

Question 6

Describe infant growth

Answer 6

Linear growth.
Initially rapid about 25cm in 1st year
Then declines

Question 7

Describe childhood growth

Answer 7

Relatively steady
Adult like proportions form (loose the toddler like top heavy stage)
Boy and girls = same
4-7cm a year

Question 8

What is most important factor for growth in childhood?

Answer 8

Hormones - pituitary gland makes growth hormone - the main regulator of linear growth. IGF-1 and thyroid hormone also involved

Question 9

What is a dysmorphic feature?

Answer 9

A difference to the ‘normal’ body structure

Question 10

What are the features of Turner syndrome?

Answer 10

Short stature
Low Hairline
Neck Webbing
Broad Chest
Short 4/5 metacarpals 
Inner ear problems
Co-arctation of the aorta
Gonandal Dysgenesis

Question 11

What is genetic problem of Turner syndrome?

Answer 11

Monosomy of X

Question 12

Features of Down Syndrome

Answer 12

Upslanting palpebral fissure
Flat face
Hypotonia
Hypertelorism
Protruding Tongue
Epicanthic folds
Skin fold on neck

Question 13

What does hypertelorism mean?

Answer 13

Eyes far apart

Question 14

What does epicanthic fold mean?

Answer 14

Skin fold covering inner corner of eye

Question 15

Describe Silver Russell Syndrome

Answer 15

IUGR/SGA
Frequent asymmetry e.g. leg length
Relative macrocephaly - gives distinctive facial type (upside down triangle)
Cafe au lait spots
Cliniodactyly of 5th finger

Question 16

Describe Noonan Syndrome

Answer 16

Autosomal dominant
Short stature
Pectus carinatum
Cryptorchidism
Low hairline/neck webbing
Ptosis
Hypertelorism
Low Set Ears

Question 17

What are endocrine causes of short stature?

Answer 17

Hypothyroidism
GH deficiency/resistance
Cushings syndrome
Parathyroid/Vitamin D disorder

Question 18

What are physical causes of short stature?

Answer 18

Dysmorphic syndromes (turner, Noonan, silver Russell, dwarfism) 
Skeletal Dysplasia
Chronic disease 
Malnutrition
Renal Failure
IUGR
small for gestational age
 prematurity

Question 19

What is adrenarche?

Answer 19

Androgen dependent changes e.g BO, pubic hair and acne

Question 20

What is therlarche?

Answer 20

Breast development

Question 21

What is puberty?

Answer 21

Secondary characteristics (e.g low voice) and reproductive capacity

Question 22

What is menarche

Answer 22

Menstruation starts

Question 23

When is normal puberty in girls?

Answer 23

After age of 8years - mean 10 years

Question 24

When is normal puberty in boys?

Answer 24

After age of 9 - mean age 12.

Question 25

What are the boy stages of pubertal development?

Answer 25

Testicular growth – Penis, pubic and axillary hair growth – height – voice depends & facial hair

Question 26

What are girl stages of pubertal development?

Answer 26

Breast
Height
Pubic and axillary hair
Menarche