Growth, Puberty and Adolescence Flashcards
(25 cards)
What is the middle line called?
ADD picture
Median/mean/50th centile
What does the standard deviation measure?
Measure of variability
What is a Z-score?
No. of SDs from the mean
If 100 people are measured, how many are within 1 SD of the midline?
68
If 100 people are measured, how many are within 2 SD of the midline?
95
Define the height velocity?
No. of centimetres grown/year
When does a child show normal growth?
- Measurements within the normal range compared with children of the age
- Rate of growth is within the normal range compared with children of their age
If a child is growing normally, what does this mean?
Unlikely to have any major underlying problems
Changes in weight growth charts over the years?
Recently, there has been:
• A shift to the right, as more people are obese
• Longer tail, as people are becoming more severely obese
• Increasing severe obesity
• Similar upward trend with height
Instructions for measuring weight?
Babies should be weight without clothes/nappy
Children >2 years can be weighed in vest and pants but no shoes, footwear, dolls/teddies in hand
Instructions for measuring head circumference?
Taken where the head circumference is widest
Instructions for measuring length?
Measure length <2 years if concerned; measure without nappy/footwear
Problems with measuring length?
Commonly shows wide variation in the same child
Instructions for measuring height?
Measured from 2 years
Ensure heels. bottom, back and head touch apparatus with eyes/ears at 90 degrees
Do not stretch up and remove shoes
Measure on expiration
Most common error when plotting the chart?
Age errors:
• Weeks for 1st 6-12 months
• Calendar months thereafter
How to adjust age if premature (<37 weeks)?
E.g: if born at 36 weeks and measuring height and 1 year, plot it as though they were 11 months old
How to describe where a child is in relation to centiles?
If exactly on the centile line, or within 1/2 of a space of the centile line - on the centile line, e.g: on the 91 st centile
If not - between centiles, e.g: between the 75th-91st centile
How should falls/rises be described?
Multiples of centile spaces
Average age for a girl to enter puberty?
11 years old; 6 months later for boys
What is precocious puberty?
Early puberty; it is more common in girls
When is puberty delayed?
Absence of secondary sexual development in a girl aged 13 or a boy aged 14 years
It is more common in boys
Stages of puberty in girls?
Thenarche - breast budding
Adrenarche - body hair and odour
Menarche - periods begin (usually 2 years post-thelarche)
Ix for growth problems?
Gonadotrophins, growth hormone (IGF-1), testosterone/oestradiol, thyroid, karyotype, etc
Bone age
Dynamic function tests
MRI brain, USS uterus
6 different classifications of short stature causes?
- Genetic short stature (parents were also short) - they have normal bone age and there is no underlying endocrine abnormality
- Constitutional growth delay - late maturation causing short stature, usually with an unknown cause
- Dysmorphic syndromes
- Endocrine disorders
- Chronic disease
- Psychosocial deprivation
