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20 Cards in this Set
- Front
- Back
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What are causes of congenital hypopituitarism/GH deficiency?
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Structural defects of pituitary
GH-1 gene deletion/mutation GH Resistance |
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What is the clinical presentation of congenital hypopituitarism?
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GH Deficiency:
Decreased growth velocity Weight gain (increased adipocytes) MICROPENIS |
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Dimpling and frontal bossing are signs of _____.
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Congenital hypopituitarism/GH deficiency
(Frontal Bossing = prominent forehead; no nasal bridge) (Dimpling = fatty depositions) |
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Diagnostic criteria for congenital hypopituitarism?
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Delayed bone age (growth plates open for longer than they should be)
Decreased IGF-1 Decreased IGFBP3 |
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Who should be screened for congenital hypopituitarism?
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Infants: low glucose, pit deficiencies
Children: abnormal growth, abnormal head imaging |
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What are the effects of hypothyroidism on growth and development?
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Severe growth delay
Delayed skeletal maturation Delayed puberty |
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Under what circumstances can Cushing's be acquired in children?
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Iatrogenic cortisol (inhibits IGF action, decreases GH secretion)
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Diagnose:
Normal growth velocity Short stature |
Familial short stature
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Which genetic syndromes are likely to cause short stature?
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Turner (missing/abnormal X chromosome)
Down Syndrome Any syndrome really |
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What is the effect of love on growth?
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If lack love-->psychosocial dwarfism
Decreased GH secondary to neglect (indistinguishable from acquired causes) |
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A sex steroid spurt is required for _____
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Growth Spurt
(Some have delayed spurt--"late bloomers") |
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How can growth spurts be jumpstarted in "late bloomers"?
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Testosterone injections
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What are causes of delayed bone age?
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GH deficiency
Hypothyroidism Chronic illness Constitutional Delay |
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What is constitutional growth delay?
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Temporary delay in the skeletal growth and thus height of a child with no other physical abnormalities causing the delay
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Poor milk intake, excessive time indoors, and obesity can result in __________.
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Vitamin D Deficiency (Rickett's!!)
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What hormonal changes can result in excessive growth?
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Excessive thyroid hormone
Increased steroids Increased insulin |
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Normal excess growth can be due to __________.
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Familial tall stature
Constitutional acceleration ("early bloomers") |
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What effect does exogenous obesity have on growth?
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Exogenous obesity:
Excess nutrition-->HIGH IGF-1 from liver =accelerated growth and weight gain |
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Patients with precocious puberty would have __________ bone age.
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Advanced
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Diagnostic test for gigantism.
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Before epiphyseal fusion:
Oral Glucose Tolerance Test If GH suppressed, then NOT gigantism If GH NOT SUPPRESSED, then GIGANTISM (When blood glucose levels fall, GHRH triggers the secretion of stored hGH) |
