L21: Childhood Growth

Question 1

What is measuring children important

Answer 1

• measurement allows to provide a sensitive indication of health in child related
• growth rates are well defined in healthy children with adequate nutrition

Question 2

What do changes in growth rate indicate

Answer 2

A health problem in the child

Question 3

What are the typical body portions of babies like

Answer 3

Large head
Small mandible
Short neck
Limbs short

Question 4

How can we measure

Answer 4

Arm span

Sitting height

Question 5

Name the conditions that involve alterations to the normal body proportions

Answer 5

Short trunk dysplasia 
Short limb dysplasia 
Rhizomelic dysplasia 
Mesomelic dysplasia 
Acromelic dysplasia
Asymmetry

Question 6

What is short trunk dysplasia

Answer 6

When the trunk does not grow much

Question 7

What is short limb dysplasia

Answer 7

When the both limbs do not grow much

Question 8

What is rhizomelic dysplasia

Answer 8

Arms and thighs do not grow well

Question 9

What is mesomelic dysplasia

Answer 9

Forearm and leg do not grow well

Question 10

What is acromelic

Answer 10

Hands and feet do not grow well

Question 11

What is asymmetry

Answer 11

Differences in one side/half of the body

Question 12

What chart do we use to compare the growth of a patient against white children

Answer 12

Growth charts

Question 13

What is the normal range of height between

Answer 13

3rd and 97th percentile

Question 14

What are the components of the infancy, childhood and puberty model

Answer 14

Infancy component
Childhood component
Puberty component

Question 15

What is the infancy component

Answer 15

This is driven by nutrition where there is a rapid decelerating growth in the first years

Question 16

What is the childhood component

Answer 16

Growth and thyroid hormone are important

Question 17

What is the puberty component

Answer 17

Pubertal hormone i.e oestrogen and testosterone are important which causes a growth spurt

Question 18

When does the growth spurt stop

Answer 18

When the fusion of epihyseal stop

Question 19

What hormone causes epihyseal fusion

Answer 19

Oestrogen

Question 20

How is oestrogen produced in males

Answer 20

Testosterone is converted to oestrogen by aromatase in adipose tissue

Question 21

Which gender is taller than the other

Answer 21

Males

Question 22

What is the first sign of puberty in females

Answer 22

Breast development

Question 23

What is the first sign of puberty in males

Answer 23

Increased in testicular volume

Question 24

What are the determinants of growth

Answer 24

Parental phenotype and genotype 
Quality and duration of pregnancy 
Nutrition 
Specific system and organ integrity 
Psycho-social environment 
Growth promoting hormones

Question 25

How can we estimate the growth of a male using the heights from parents

Answer 25

(Mothers height + fathers height + 12.5) / 2

Question 26

How are females height calculated using the heights from parents

Answer 26

(Mothers height + father’s height - 12.5)/ 2

Question 27

Where does growth occurs

Answer 27

At growth plates where chondrogenesis happens

Question 28

What factors affect the growth plate

Answer 28

Calcium Phosphate Nutrition

Question 29

Which factors can inhibit growth at the growth plate

Answer 29

Inflammatory cytokines Acidosis Toxins

Question 30

What are the ways in which we can classify growth retardation

Answer 30

1) primary growth plate abnormality 2) secondary growth disorders 3) idiopathic short stature

Question 31

What are categories of primary growth plate abnormalities that can occur

Answer 31

Osteochondrodyplasias (skeletal dysplasia) | chromosomal abnormalities

Question 32

What are osteochondrodysplasia

Answer 32

Genetic abnormalities of cartilage and bone growth that lead to abnormal size of the skeleton and disproportion of the long bones, spines, head.

Question 33

What are the chromosomal abnormalities that can occur

Answer 33

Turners syndrome (45,X)

Question 34

What doe secondary growth disorders include

Answer 34

Malnutrition Chronic disease Intra uterine growth retardation Endocrine disorders

Question 35

Give an example of a endocrine disorder that can cause growth retardation

Answer 35

GH and IGF-1 deficiency

Question 36

Describe the the growth hormone regulation axis

Answer 36

1) hypothalamus secreted GHRH to the anterior pituitary gland 2) anterior pituitary gland releases GH to the liver or GH stimulates directly the bone 3) liver produced IGF-1 that acts on the bone for growth 4) IGF-1 and GH inhibit the anterior pituitary and hypothalamus later on

Question 37

What are the causes of IGF deficiency

Answer 37

- GH deficiency due to hypothalamic dysfunction or pituitary GH deficiency - GH insensitivity: signalling cascade is disrupted or primary defects of IGF1 synthesis - IGF1 resistance- due to defects of IGF-1 receptors or post receptor defect

Question 38

How is IGF1 transported in the serum

Answer 38

Via: ALS IGF-BP3

Question 39

What are the 3 causes of idiopathic short stature

Answer 39

1) familial short stature 2) constitutional delay of growth and puberty with normal height prediction 3) overlap of familial and constitutional delay

Question 40

How can we asses patients with GH deficiency

Answer 40

Take an x-ray of their left hand and look for a delayed bone age

Question 41

What is psychosocial short startup

Answer 41

It is the emotional rejection inside a family so when the child is removed from the stressful environment they can grow