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Year 2- Endocrine System > Growth, Puberty and Paediatric Problems > Flashcards

Growth, Puberty and Paediatric Problems Flashcards

1
Q

What do you use to measure height in children?

A

Wall stadiometer

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2
Q

What is measured in children under the age of two instead of height?

A

Length

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3
Q

When is measuring sitting height useful?

A

In children you suspect have a short spine or short limbs

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4
Q

What measurement is taken in children of the head?

A

Head circumference

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5
Q

Around which part of the head do you take measurement of a child’s head circumference?

WARNING COMMON EXAM QUESTION but idk if it’s in like an OSCE situation haha

A

Around the forehead for maximal circumference

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6
Q

How can bone age be assessed in children?

A

X-ray of left wrist and compare to a standardised one using Tana Whitehouse 20 bones.
Each bone is given a score and added together to give bone age

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7
Q

If a child has delayed bone age, what does this sugget?

A

That they will be a late developer

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8
Q

What is used for the staging of puberty?

A

Tanner method

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9
Q

What is measured in the Tanner method, used to stage puberty?

A

Breast development
Genital development
Pubic hair
Axillary hair

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10
Q

What is meant by stage 1 o the Tanner method for staging puberty?

A

No evidence of puberty

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11
Q

What is meant by stage 2 of the Tanner method for staging puberty?

A

The beginning of puberty

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12
Q

What is used to determine testicular maturation?

A

Prader Orichdometer

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13
Q

List some factors which influence height.

A

Age
Sex
Race
Nutrition
Parental heights
Puberty
Skeletal maturity
General health
Socio-economic status

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14
Q

What are the first three stages of grwoth?

A

Infantile
Childhood
Puberty

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15
Q

Who goes through puberty first- girls or boys?

A

Girls

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16
Q

What is the average age a girl goes through puberty?

A

10-1-.5

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17
Q

What is the average age a boy goes through puberty?

A

11-12

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18
Q

Which hormones lay dormant pre-puberty and then release during puberty?

A

Gonadotropins e.g. LH and FSH

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19
Q

At which point of the day during puberty does most LH and FSH get released?

A

During the night

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20
Q

Which hormone stimulates the hypothalamus to produce LH and FSH?

A

GnRH

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21
Q

What happens first during puberty in girls?

A

The breasts begin to bud (B2)

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22
Q

Menarche?

A

First period/menstruation

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23
Q

What is the earliest sign of puberty in a boy?

A

Testicular enlargement (T2)

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24
Q

If a child is obese, do they go through puberty more quickly or slowly than a thinner child?

A

More quickly

-> obesity triggers puberty earlier

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25
Q

List some of the indications leading to referral of a growth disorder?

A

Extreme tall or short centiles
Height below target height
Abnormal height velocity
History of chronic disease
Obvious dysmorphic syndrome
Early/late puberty

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26
Q

What is meant by familial short stature?

A

Short parents having a short child

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27
Q

What is meant by constitutional delay of growth and puberty?

A

Children that grow at a normal steady pace but as their peers go into puberty, they do not

28
Q

What is the bone age like in those with constitutional delay of growth and puberty?

A

Delayed bone age

29
Q

How is constitutional delay of growth and puberty managed?

A

Short course of testosterone which induces puberty and a growth spurt

30
Q

If a child is small for their age at about 3-4yrs, what treatment can be offered?

A

Growth hormone treatment

31
Q

What are some of the pathological causes of short stature?

A

Undernutrition
Chronic illness
Iatrogenic (steroids)
Psychological and social
Hormonal
Syndromes e.g. Turner’s syndrome

32
Q

Which thyroid related disorder can lead to child stopping growing?

A

Acquired hypothyroidism

33
Q

Turner syndrome involves short stature. What are some of the other features?

A

Webbed/short neck
Spaced nipples
Infantile proportions with short limbs

34
Q

Who does Turner’s syndrome affect?

A

Females

35
Q

Which syndrome can affect both boys and girls and involves short stature?

A

Prader-Willi syndrome

36
Q

What treatment benefits those with Turner’s syndrome or Prader-Willi syndrome?

A

Growth hormone treatment

37
Q

What is another feature of Prader-Willi syndrome?

A

Obesity

38
Q

Name the most important stages of puberty for boys and girls.

A

Boys- T3-4
Girls- B2

39
Q

When is puberty considered to be early in boys?

A

If <9

40
Q

When is puberty considered to be delayed in boys?

A

> 14

->more common than early puberty in boys.

41
Q

When is puberty considered to be early in girl?

A

<8yrs

42
Q

When is puberty considered to be delayed in girls?

A

> 13yrs

-> in girls, puberty is more likely to be early than delayed

43
Q

Does CDGP (constitutional delay of growth and puberty) mainly affect girls or boys?

A

Boys

44
Q

What is the chromosome type of Turner’s syndrome, a condition which can delay puberty?

A

45X

45
Q

What is the chromosome type of Kilneflter syndrome, a condition which can delay puberty?

A

47XXY

46
Q

Name two chronic diseases which can cause delayed puberty.

A

Asthma
Crohn’s

47
Q

What are some of the signs of central precocious puberty?

A

Pubertal development
Growth spurt
Advanced bone age

48
Q

If you suspect a patient to have precocious puberty, what should you do?

A

Refer them

Pituitary imaging is often done in these patients

49
Q

What happens in precocious pseudopuberty?

A

Early puberty which is not really puberty but an activation of another load of LH and FSH.
Secondary pubic characteristics occur e.g. pubic and axillary hair

50
Q

If a baby has ambiguous genitalia, what should you do?

A

Do not guess the sex- tell parents it’s not clear
MDT approach
Examination of gonads and internal organs
Karyotype

51
Q

Which life threatening condition do you want to rule out if a baby is born with ambiguous genitalia?

A

Congenital adrenal hyperplasia

52
Q

What are some of the causes of congenital hpothyroidism?

A

Athyreosis/hypoplastic/ectopic
Dyshormonogenic

53
Q

What happens in congenital hypotthyroidism?

A

Child is born without a thyroid gland/ functioning thyroid gland

54
Q

What has helped to reduce pretty much all cases of congenital hypothyroidism?

A

Newborn screening via the heel prick

55
Q

What is the most common cause of acquired hypothyroidism?

A

Autoimmune thyroiditis- Hashimoto’s

56
Q

What are some of the issues acquired hypothyroidism can cause in childhood?

A

Lack of height gain
Pubertal delay
Poor school performance

57
Q

What is used to assess obesity?

A

Weight/height
BMI
Waist circumference
Skin folds

58
Q

If someone is short and obese, what should be highlighted?

A

This is abnormal

59
Q

How do children with hypothyroidism present?

A

Goitres
Paler
Flat facials

60
Q

What are some of the causes of childhood obesity?

A

Simple obesity
Drugs
Syndromes
Endocrine disorders
Hypothalamic damage

61
Q

List some drugs which can cause weight gain, potentially leading to childhood obesity

A

Insulin
Steroids
Antithyroid drugs
Sodium valproate

62
Q

List some syndromes which can cause a child to develop obesity.

A

Prader-Willi syndrome
Laurence-Moon-Biedl syndrome
Pseudohypoparathyroidism type 1
Down’s syndrome

63
Q

List some of the endocrine disorders which can cause obesity.

A

Hypothyroidism
GH deficiency
Hypothalamic lesion

64
Q

What are some of the treatments for childhood obesity?

A

Diet
Exercise
Psychological input
Drugs??

65
Q

How do endocrine disorders cause childhood obesity?

A

Growth failure

66
Q

How do hypothalamic causes cause childhood obesity?

A

Loss of appetite control

67
Q
A

Year 2- Endocrine System (27 decks)

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