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Endocrine System > Lecture 5 & 6 Growth and Develop and Endocrine Problems in Childhood > Flashcards

Lecture 5 & 6 Growth and Develop and Endocrine Problems in Childhood Flashcards

1
Q

Name measurement techniques performed to asses a Childs growth and development

A

Height
Length
Sitting Height
Head circumference

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2
Q

Name charts used for measuring and plotting data in assessing growth and development

A 
RCPCH UK 2-18 growth chart
Birth centiles
Parent height comparator
Mid parental gentile scale
Predicted adult height scale
Target height
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3
Q

How is the potential height if a child calculated

A

add together the father’s height and the mother’s height divide this by two
add 7cm to the total
this gives the mid parental centile

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4
Q

B1

A

Prepubertal

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5
Q

B2

A

Brest bud

Enlargement of areola

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6
Q

B3

A

Further enlargement of breast and areola

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7
Q

B4

A

Areola and papilla form a secondary mound

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8
Q

B5

A

Mature stage

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9
Q

G1

A

Prepubertal

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10
Q

G2

A

Enlargement of scrotum and testes

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11
Q

G3

A

Enlargement of penis length and further growth of testes

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12
Q

G4

A

Increased size of penis with growth in breadth and development of glands

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13
Q

G5

A

Adult genitalia

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14
Q

PH1

A

Prepubertal

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15
Q

PH2

A

Sparse growth of long hair, slightly pigment

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16
Q

PH3

A

Darker, coarser and more curled hair, sparsely spreading over junction of pubes

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17
Q

PH4

A

Hair adult in type, but covering smaller area than adult, no spread to medial surface of thighs

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18
Q

PH5

A

Adult hair in type and quantity

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19
Q

T 1-3ml

A

Prepubertal

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20
Q

T4ml +

21
Q

T12-25ml

22
Q

Small testes are an indicator of what

A

primary or secondary hypogonadism

23
Q

Factors influencing height

A
  • Age
  • Sex
  • Race
  • Nutrition
  • Parental Heights
  • Puberty
  • Skeletal maturity
  • General Health
  • Chronic disease
  • Specific growth disorders
  • Socio-economic status
  • Emotional well-being
24
Q

Describe normal growth in the infinite stage

A

 Rapid period of growth 0-2 years

 Depends in factors such as nutrition and IGF1 & IGF2

25
Describe the normal growth during childhood
 Long phase of growth from 2-12 years  Slower, slightly decelerating curve  More dependent on growth hormone and thyroxine
26
Describe the normal growth during the pubertal stage
 From around 12 to final height |  Dependent in the sex steroid hormone (testosterone and oestrogen)
27
What are the most important pubertal stages in girls and boys
• Breast budding (Tanner stage B2) in a girl • Testicular enlargement (Tanner stage G2-T 3-4ml) in boy Earliest sign of puberty
28
Indicator for growth disorder referral
* Extreme short or tall (off centiles) * Height below target height * Abnormal height velocity (crossing centiles) * History of chronic disease * Obvious dysmorphic syndrome * Early/late puberty
29
Common causes of short stature
* Familial * Constitutional- temporary delay in the skeletal growth * SGA/IUGR
30
Pathological causes of short stature
``` • Undernutrition • Chronic illness • Iatrogenic (steroids) • Physiological and Social • Hormonal (GHD, hypothyroidism) • Syndrome  Turner  Prader-Willi  Noonan’s  Achondroplasia ```
31
Constitutional delay of growth and puberty mainly occurs in
Boys | People with FH in dad or brother
32
Other causes of delayed puberty
* Gonadal dysgenesis (Turner 45X, Klinefelter 47 XXY) * Chronic disease (Crohn’s, asthma) * Impaired HPG axis (hypothalamic-pituitary-gonadal)- septo-optic dysplasia, craniopharyngioma, Kallman’s syndrome * Peripheral (cryptorchidism, testicular irradiation)
33
Management of new born with ambiguous genitalia
 Do not guess the sex  MDT approach (paed. endo, surg., neonatologist, geneticist, psychologist)  Exam: gonads/internal organs  Karyotype  Exclude congenital adrenal hyperplasia- risk of adrenal crisis in first 2 weeks of
34
Causes of congenital hypothyroidism
 Athyreosis ( absence or functional deficiency of the thyroid gland) /hypoplastic (incomplete development)/ectopic (not located in its usual position)  Dyshormonogenic
35
Whats the most common cause of acquired hypothyroidism
autoimmune thyroiditis (Hashimoto’s)
36
What childhood issues an arise with acquired hypothyroidism
 Lack of height gain  Pubertal delay  Poor school performance
37
What BMI is classified as obese
BMI> 97.5th centile or SD >2
38
What BMI is classified as overweight
BMI >85th centile or SD >1.04
39
How is Obesity assessed
* Weight * BMI * Height * Waist circumference * Skin folds * History and examination * Complications
40
Name complications of obesity
* Metabolic syndrome * Fatty liver disease * Gallstones * PCOS * Nutritional deficiencies * Thromboembolic disease * Pancreatitis * Central hypoventilation * Obstructive sleep apnoea * GORD * Orthopaedic problems * Stress incontinence * Injuries * Psychological * LVH * Atherosclerotic CVD * Right sided heart failure
41
Drugs that causes obesity
Insulin Steroids Antithyroid drugs Sodium valproate
42
Syndromes that are linked to obesity
 Prader Willi  Laurence-Moon-Biedl syndrome  Pseduohypoparathyroidism type 1  Down’s syndrome
43
Endocrine disorders linked to obesity
```  Hypothyroidism  Growth Hormone deficiency  Glucocortiocoid excess  Hypothalmic lesion (tumour/trauma/infection)  Androgen excess  Insulinoma  Insulin resistance syndromes  Leptin deficiency  Growth failure ```
44
Symptoms of Type 1 diabetes in children
Thirst Weight Loss Tired Using the Toilet more
45
Symptoms of type 1 diabetes in children under 5
* Heavier than usual nappies * Blurred vision * Candidiasis (oral, vulval) * Constipation * Recurring skin infections * Irritability, behaviour change
46
Steps involved in making an early diagnosis for children with suspected diabetes
THINK symptoms Test immediately Telephone
47
if finger prick capillary glucose test is >11mmol/l the patient is
Diabetic
48
if finger prick capillary glucose test is <11mmol/l the patient is
not diabetic and there is another cause of the symptoms
49
Symptoms fo DKA
* Nausea & Vomiting * Abdominal pain * Sweet smelling ketotic breath * Drowsiness * Rapid, deep sighing respiration * Coma

Endocrine System (26 decks)

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