Growth in childhood Flashcards Preview

YR2: Reproduction, Ageing and Development > Growth in childhood > Flashcards

Flashcards in Growth in childhood Deck (22)
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1
Q

How do you measure height and plot centile charts?

A

Equipment should be accurate + maintained properly
Position child properly to get accurate height
Remove things that interfere w/measuring e.g. shoes off
Calculate age + plot correctly on chart

2
Q

What is the difference between height velocity and cumulative height?

A

Cumulative height = how tall child is now (total of all growth from conception)
Height velocity = how fast a child is growing in cm per year

3
Q

How do children grow?

A

Fastest phase of growth after birth, till 2 years
Children move up + down through centiles at this phase
Most children move into a centile position by 2/3yrs
Normal children grow fast enough to keep on same centile through childhood
Phase of fast growth at puberty (pubertal growth spurt) - timing depends of age of onset
Skeleton matures as child grows, epiphyses fuse at end of puberty, growth stops

4
Q

What are the common causes of short stature?

A

Poor nutrition
Chronic disease (chronic inflammation disrupts IGF1 action)
Endocrine causes: GH deficiency, thyroid hormone deficiency
Genetic disorders - achondroplasia, Turner’s, Down’s
Psychological distress + neglect

5
Q

Describe the endocrine control of growth

A

Hypothalamic GHRH (increases) + somatostatin (inhibits) GH secretion
GH from anterior pituitary has some growth effect
GH stimulates IGF1 release
IGF1 circulates bound to IGF1 binding proteins + stimulates growth in all tissues

6
Q

What are the main factors linked to increasing obesity?

A
Decreased exercise/ increased calorie consumptiont
Association with increased TV watching
Consumption of soft drinks
Parental obesity
Education + social factors
7
Q

List 7 complications and associated features of obesity

A
T2DM
CVD
Cancer
Orthopaedic problems
Psychological problems 
Respiratory difficulties 
PCOS
8
Q

What influences cumulative growth?

A
  1. Events before birth: poor foetal growth, low birth weight, prematurity
  2. Medical issues in childhood - malnutrition, chronic disease, endocrine problems inc. GH deficiency
  3. Genetic factors - height of family + inherited disorders of growth
  4. Randomness - not every child of same parents will be same height; multiple genes randomly distributed at conception influence
9
Q

Why measure growth?

A

Poor growth in infancy is associated with high childhood morbidity + mortality.

10
Q

What are the common causes of tall stature?

A

Syndromes of overgrowth -e.g. Marfan syndrome
GH excess from pituitary tumour
Precocious puberty
Tall parents

11
Q

What external factors can influence the pulsatile secretion of GH?

A

Nutrition
Sleep
Exercise
Stress

12
Q

What is the most rapid phase of growth? What can influence this?

A

Antenatal phase

Maternal health + placenta

13
Q

When is growth most dependent on nutrition? Thus when would you start to suspect GH deficiency?

A

Birth-9 months

Between 9-12 months as GH becomes the more dominant influence

14
Q

When do boys and girls have their pubertal growth spurt?

A

Boys: End of puberty
Girls: Start of puberty

15
Q

What happens in the final part of growth?

A

Bones mature + epiphyses fuse at the end of puberty.

The final part of growth occurs in the spine + final epiphyses to fuse are in the pelvis.

16
Q

What may resolve suspected short stature on a centile chart?

A

Plotting the mid-parental centile- may shift the graph up or down

17
Q

What tests should be performed if short stature is suspected?

A
FBC
CRP
Serum iron
Liver + kidney function 
Thyroid function 
Coeliac screen
IGF1 
Bone age
18
Q

What causes short stature with reduced growth velocity?

A

Endocrine Problems:
Hypothyroidism
GH deficiency
Steroid excess

19
Q

What causes short stature despite normal hormones?

A

Syndromes e.g. Turners, DS, Skeletal dysplasias

Significant illnesses- due to poor nutrition, inflammation + effects of drugs e.g. steroids

20
Q

List 3 syndromes associated with obesity

A

Cushings
Prader Willi
Lawrence-Moon-Biedl

21
Q

What are the genetic influences on weight?

A

Polygenic inheritance

Weight highly heritable trait

22
Q

List 5 monogenic obesity syndromes

A
Leptin deficiency
Leptin receptor deficiency
POMC deficiency
PC-1 deficiency
MC4R deficiency