Growth Faltering

Question 1

what are the four drivers of normal growth

Answer 1

hormones
nutrition
genes
a good environment

Question 2

what are the five different types of cell in the anterior pituitary

Answer 2

somatotrophs
thyrotrophs
gonadotrophs
lactotrophs
corticotrophs

Question 3

what do somatotrophs secrete

Answer 3

GH

Question 4

what does GH stimulate secretion of

Answer 4

insulin-like growth factors

Question 5

what do thyrotrophs secrete

Answer 5

TSH

Question 6

what do corticotrophs secrete

Answer 6

ACTH (and MSH)

Question 7

what are the different actions of hGH between childhood and adulthood

Answer 7

in childhood:
increases the growth rate in skeleton nad skeletal muscles
in adulthood:
maintains muscle and bone mass and promotes healing

Question 8

prepubertally what are the primary hormones for growth

Answer 8

Gh and TSH

Question 9

what are the four phases of growth

Answer 9

foetal
infantile
childhood
pubertal

Question 10

during which phase does most of the growing occur

Answer 10

childhood (40%)

Question 11

during childhood when does most growth occur

Answer 11

at night as deep sleep promotes secretion of GH

Question 12

in boys what causes fusion of the epiphyseal plates

Answer 12

testosterone is converted to oestrogen in some tissues causing fusion of hte plates

Question 13

what is the most influential factor in the first two phases of growth

Answer 13

nutrition

Question 14

how does PTH work in the bone

Answer 14

at physiological levels it stimulates OB to make bone

at increased levels OC is stimulated therefore slowing growth

Question 15

how is asymmetrical growth restriction started

Answer 15

by comprimised nutritional delivery at a certain stage of pregnancy (usually last trimester)

Question 16

what is asymmetric growth restriciton

Answer 16

a restriction of weight followed by lenght

head size is not usually affected

Question 17

what is symmetrical growth restriction

Answer 17

the head is proportional to the rest of the body

the foetus is generally small indicating it has developed more slowly

Question 18

give three causes of asymmetric growth restriction

Answer 18

chronic high blood pressure
severe malnutrition
genetic mutations (Ehlers-Danlos syndrome)

Question 19

give four cuases of symmetric growth restriciton

Answer 19

early intrauterine infections (CMV, rubella, toxoplasmosis)
chormosomal abnormalities
anaemia
maternal substance misuse (alcohol)

Question 20

what defines a baby as small for gestational age

Answer 20

if the birthweight and length are below the 3rd centile

Question 21

impaired foetal and postnatal growth in term infants is related to a higher risk of what in later life

Answer 21

IHD
HTN
IGT and T2DM
increased risk of developmental and behavioural problems

Question 22

how can growth hormone deficiency manifest

Answer 22

short stature and a tendency to be overweight

Question 23

how can hypothyroidism affect growth

Answer 23

it results from a reduction of cartilage and bone formation resulting in short stature.
The child can also appear overweight