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ENDOCRINE SYSTEM > Growth Disorders > Flashcards

Growth Disorders Flashcards

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1
Q

Pathological wt

A
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2
Q

Pathological wt

A
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3
Q

height that is 2 standard
deviations below the mean height for age and sex (less
than the third percentile) OR

More than 2 standard deviations below the mid-parental
height OR

A growth velocity disorder is defined as an abnormally
slow growth rate, which may manifest as height
deceleration across 2 major percentil3 lines on the growth
chart

A

Short stature

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4
Q

Midparental height

A
  • Male: Mothers height + 5 + Fathers height / 2

* Female: Fathers height – 5 + Mothers height / 2

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5
Q

Typical Constitutional Growth delay

A
  • Normal at birth
  • Then grows normally 4-6 months
  • Then growth accelaration
  • By 2-3 years = slows
  • Then grows at normal rate (but still short stature)
  • @ puberty: late puberty
  • but will later on, catch up normal (50th percentile)
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6
Q

1st sign: testicular enlargement

A

9-14 years old

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7
Q

1st sign: breast development

A

8-13 years old

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8
Q

thelarche to menarche

A

about 2 years

menstruation at 9 years, thelarche at 6 years, then precocious puberty

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9
Q

Birth ht

A

50 cm

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10
Q

1st year

A

GR: 25cm per year
Ht: 75cm

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11
Q

2nd year

A

GR: 12-15cm per year
Ht: 87-88cm

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12
Q

3rd year

A

GR: ½ ofd 2nd year (6-7
cm)
Ht: 94-95cm

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13
Q

After 3rd year

A

Growth rate: 5-6 cm per year

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14
Q

6th year

A

110 cm

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15
Q

FORMULA ht

A

Age in years x 5 + 80 = cm

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16
Q

FORMULA (weight):

A

age in months + 11 = lbs

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17
Q

full term infant wt

A

> /= 2.5 kilos

if less uterine growth retardation

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18
Q

1st wk wt

A

may decrease by 5-10% of BW

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19
Q

2nd wk BW

A

regain lost wt

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20
Q

expected wt gain thereafter

A

+30g per day (1 mo = 900g) or 1 lb/2 weeks

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21
Q

after 3 months of age

A

wt gain is expected to slow down = -1 lb/2wks

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22
Q

after 1 yr

A

2 kilos per yr

ex: @Y = 12 kiols; 3Y 14 etc.

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23
Q

HEAD CIRCUMFERENCE:

Age Growth = Rate

1st year of life = Increases by 12 cm
1st 4 months = 1.5 cm/month
2nd 4 months = 1.0 cm/month
3rd 4 months = 0.5 cm/month

2nd year of life = Increases by 2 cm

A

indication of cerebration or brain

development

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24
Q

Short stature (how to ID) 1st thing to recognize:

A

1st: normal or pathologic
normal: familial short stature or constitutional delay

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25
Short stature (how to ID) if pathologic:
is it proportionate or disproportionate?
26
Short stature (how to ID) disproportionate
skeletal dysplasia | rickets
27
Short stature (how to ID) proportionate
prenatal or post
28
Short stature: Prenatal
IUGR (placental dses, infxns, teratogens) Dysmorphic syndromes Chromosomal dis
29
Short stature: Postnatal
``` Endoc dis Psychosocial dwarfism Malnutrition GI dses Cardiopulmo dses Chronic anemia Renal dis ```
30
FAMILIAL SHORT STATURE
* Annual Growth Rate Normal * Height at or Below 3rd Percentile * No Systemic or Endocrine Disease * Pubertal Growth Spurt at Normal Age * Skeletal Age Equal to Chronological Age * Ancestors Relatively Short
31
CONSTITUTIONAL DELAY IN GROWTH AND | PUBERTY: PHYSIOLOGICAL FEATURES
• Exeggerated “phase change” growth deceleration • Transient deficiencies in GH secretion, particularly prior to puberty • Severity of CDGP/ BA delay reflects duration of periods of impared GH secretion • Slowed tempo of growth à Ba delay à eventual pubertal delay • Prolonged school- age growth deceleration and enhanced susceptibility to exogenous growth suppression (e.g. ADHD meds, ICS)
32
At conception, the change of transmitting the | phenotype from affected parent to affected child is
1 in 2
33
• An unaffected individual not inheriting the | phenotype has
no risk of transmitting the phenotype to his or her own children (except with reduced penetrance or anticipation). In other words, there is no carried state.
34
height that is 2 standard deviations below the mean height for age and sex (less than the third percentile) OR More than 2 standard deviations below the mid-parental height OR A growth velocity disorder is defined as an abnormally slow growth rate, which may manifest as height deceleration across 2 major percentil3 lines on the growth chart
Short stature
35
Midparental height
* Male: Mothers height + 5 + Fathers height / 2 | * Female: Fathers height – 5 + Mothers height / 2
36
Typical Constitutional Growth delay
* Normal at birth * Then grows normally 4-6 months * Then growth accelaration * By 2-3 years = slows * Then grows at normal rate (but still short stature) * @ puberty: late puberty * but will later on, catch up normal (50th percentile)
37
1st sign: testicular enlargement
9-14 years old
38
1st sign: breast development
8-13 years old
39
thelarche to menarche
about 2 years menstruation at 9 years, thelarche at 6 years, then precocious puberty
40
Birth ht
50 cm
41
1st year
GR: 25cm per year Ht: 75cm
42
2nd year
GR: 12-15cm per year Ht: 87-88cm
43
3rd year
GR: ½ ofd 2nd year (6-7 cm) Ht: 94-95cm
44
After 3rd year
Growth rate: 5-6 cm per year
45
6th year
110 cm
46
FORMULA ht
Age in years x 5 + 80 = cm
47
FORMULA (weight):
age in months + 11 = lbs
48
full term infant wt
>/= 2.5 kilos | if less uterine growth retardation
49
1st wk wt
may decrease by 5-10% of BW
50
2nd wk BW
regain lost wt
51
expected wt gain thereafter
+30g per day (1 mo = 900g) or 1 lb/2 weeks
52
after 3 months of age
wt gain is expected to slow down = -1 lb/2wks
53
after 1 yr
2 kilos per yr | ex: @Y = 12 kiols; 3Y 14 etc.
54
HEAD CIRCUMFERENCE: Age Growth = Rate 1st year of life = Increases by 12 cm 1st 4 months = 1.5 cm/month 2nd 4 months = 1.0 cm/month 3rd 4 months = 0.5 cm/month 2nd year of life = Increases by 2 cm
indication of cerebration or brain | development
55
Short stature (how to ID) 1st thing to recognize:
1st: normal or pathologic normal: familial short stature or constitutional delay
56
Short stature (how to ID) if pathologic:
is it proportionate or disproportionate?
57
Short stature (how to ID) disproportionate
skeletal dysplasia | rickets
58
Short stature (how to ID) proportionate
prenatal or post
59
Short stature: Prenatal
IUGR (placental dses, infxns, teratogens) Dysmorphic syndromes Chromosomal dis
60
Short stature: Postnatal
``` Endoc dis Psychosocial dwarfism Malnutrition GI dses Cardiopulmo dses Chronic anemia Renal dis ```
61
FAMILIAL SHORT STATURE
* Annual Growth Rate Normal * Height at or Below 3rd Percentile * No Systemic or Endocrine Disease * Pubertal Growth Spurt at Normal Age * Skeletal Age Equal to Chronological Age * Ancestors Relatively Short
62
CONSTITUTIONAL DELAY IN GROWTH AND | PUBERTY: PHYSIOLOGICAL FEATURES
• Exeggerated “phase change” growth deceleration • Transient deficiencies in GH secretion, particularly prior to puberty • Severity of CDGP/ BA delay reflects duration of periods of impared GH secretion • Slowed tempo of growth à Ba delay à eventual pubertal delay • Prolonged school- age growth deceleration and enhanced susceptibility to exogenous growth suppression (e.g. ADHD meds, ICS)
63
At conception, the change of transmitting the | phenotype from affected parent to affected child is
1 in 2
64
• An unaffected individual not inheriting the | phenotype has
no risk of transmitting the phenotype to his or her own children (except with reduced penetrance or anticipation). In other words, there is no carried state.
65
Diagnosis of Turner syndrome should result in | comprehensive workup of all potential health issues
- caridac eval - renal ultrasound - middle ear ex and hearing test - scolio/kyphosia - hip dislocation - assess linear growth - eval of ovarian fxn and pubertal dev - TFTs - screening for celiac dse - eye ex - orthodontic eval - educational/psychosocial eval - bone mineral density - LFTs, FBG, lipids, CBC, Cr. BUN
66
DIFFERENTIAL DIAGNOSIS OF STATURAL OVERGROWTH
Fetal | Postnatal
67
Fetal
``` • Maternal diabetes mellitus • Cerebral gigantism • Beckwith-Wiedemann syndrome ```
68
Postnatal
``` • Familial tall stature • Cerebral gigantism • Beckwith-Wiedemann syndrome • Exogenous obesity • Excess GH secretion (pituitary gigantism) • Precocious Puberty • Margen syndrome • Homocystinuria • XYY • Hyperthyroidism • Androgen or estrogen deficiency: estrogen resistance (increased adult stature) ```

ENDOCRINE SYSTEM (6 decks)

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