Endo: Peds: 5 Growth

Front 1

when measuring growth, what factor is most important

Back 1

change over time (comparison of how big they were then and now)

Front 2

utah growth study determined that endocrine caused how many growth problems

Back 2

5% had an endocrine cause for their short stature.

Front 3

short stature definition

Back 3

standing height more than 2 SD below the mean for gender.

Front 4

how do you compare growth patterns

Back 4

Gender specific reference charts have been published for weight and height for most developed countries, most ethnic subpopulations, and the most common genetic disorders.

Front 5

common causes of short stature

Back 5

Primary Growth Disorders
Chronic Disease—including genetic and undernutrition
Familial Short Stature
Constitutional Delay of Growth and Development

Front 6

before you get a zillion tests for short statures, what is most important

Back 6

a good history, growth patterns, ROS (to rule out chronic disease), assess how the kid feels about their height

Front 7

what do you examine in a kid to monitor their growth patterns

Back 7

Height and weight
US/LS ratio
Inspect mucous membranes
Examine the midface
Test visual fields (if you pit has a tumor it can affect vision)
Palpate the thyroid
Cardiopulmonary exam
Look for other dysmorphisms

Front 8

measurement of the head and limbs ratio

Back 8

Anthropometric Measurments

Front 9

know the bone age!! her favorite test

Back 9

AP X-Ray of the left hand and wrist
Determines epiphyseal maturation by comparing to the published standard
Linked more closely with sexual maturity rating rather than chronological age

Front 10

causes for delayed bone growth

Back 10

constitutional growth delay, chronic illness, malnutrition, endocrinopathy (thyroid disease, GH def), psychosocial deprevation

Front 11

The most common cause of short children is short parents.
Inheritability of height is 70-80%.
Growth velocity is normal.
Pubertal growth spurts are normal in timing and magnitude.
Bone age=Chronological age

Back 11

familial short stature

Front 12

bone age is delayed 2-4 years, bone age consistant with height and SMR rather than age, the late bloomers

Back 12

constitutional growth delay

Front 13

A 12 year old boy is on the 5th percentile for height and the 10th for weight. Both his parents are below average for height. what can you expect

Back 13

pubertal growth spurt will occur on time, puberty will not be delayed

Front 14

where is GH synthesized

Back 14

anterior pit

Front 15

function of GH

Back 15

fatty acid release for adipose, insulin resistance, regulates blood glucose, bone thickness, soft tissue growth, protein synthesis

Front 16

when does GH get secreted most often

Back 16

during sleep: stage III, IV (non-rem)

Front 17

why is GH released in a pulsatile fashion

Back 17

the alternation between GHRH and somatostation

Front 18

why do you grow during puberty

Back 18

the increase in androgens increase the release of GH

Front 19

what does GH release to cause growth

Back 19

IGF-1 and 2 from the liver

Front 20

Short stature, poor linear growth, delayed bone age

Back 20

growth hormone deficiency

Front 21

Low levels of IGF-1 and IGFBP-3 suggest

Back 21

GH deficiency

Front 22

why can you not check GH to determine growth hormone deficiency

Back 22

its pusatile release makes it hard to distinguish a low part of the cycle and deficiency

Front 23

what are acquired growth hormone deficiencies

Back 23

radiation, malignancy, menigitis, histocytosis, trauma (ie: head trauma to hypothalamus)

Front 24

side effect of GH tx

Back 24

increase development of malignancy

Front 25

who does not get GH tx

Back 25

Kids with past malignancies & scoliosis kids

Front 26

side effects of GH tx

Back 26

Insulin resistance
Mild sodium and water retention
Transient lowering of thyroxine levels
Increased development of malignancies
Scoliosis
Gynecomastia
Slipped capital femoral epiphysis

Front 27

if you have too much GH, what can happen

Back 27

Prepuberty: gigantism
Postpuberty: acromegaly—bony and soft tissue overgrowth

Front 28

Disorder affecting linear bone growth

Back 28

osteochondroplasia (such as achondroplasia, hypochondroplasia, diastrophic dysplasia)

Front 29

AD, short limbs, long trunk, midfacies, FGFR 3 mutation (what does this mutation cause)

Back 29

the mutation affects the collagen deposition on bones - achondroplasia

Front 30

the sulfate transporter is affected and affected cartilage deposition in bones

Back 30

diatrophic dysplagia

Front 31

chromosomal defects causing short stature

Back 31

down syndrome, turner syndrome

Front 32

turner syndrome characteristics (what characteristic are you looking for to make you diagnosis)?

Back 32

Short Stature (key to dx)
Webbed neck
Increased carrying angle (elbow angle)
Peripheral edema
Ovarian failure
Mosaic form may not present until puberty
Short adolescent females with amenorrhea should all have a karyotype done

Front 33

if you have a female with short stature, amenorrhea, age 15-16, what should you do

Back 33

get a karyotype (you are thinking she has turner syndrome)

Front 34

can you treat turner syndrome with GH tx?

Back 34

YES

Front 35

IUGR stand for

Back 35

intrauterine growth retardation

Front 36

causes of IUGR

Back 36

primodial growth failure, placental abnormalities causing poor vascularization, maternal disease (mom has HTN, mom on drugs, mom malnurished)

Front 37

Below normal linear growth rate, increased weight gain, and delayed bone age

Back 37

hypothyroidism

Front 38

Absence of distal femoral epiphysis
Epiphyseal dysgenesis

Back 38

congenital hypothyroidism

Front 39

PEDS endocrine growth disorders

Back 39

hypothyroidism, cushing, GH axis disrupted

Front 40

what does excess cortisol levels cause?

Back 40

cushing syndrome

Front 41

what is the disorder if a kid presents below normal linear growth, with delayed bone age, and round face, obesity, skin ulcers

Back 41

cushing syndrome

Front 42

how do you tx a cushing pt

Back 42

remove the extra cortisol whether is exogenous or endogenous

Front 43

related to abuse and neglect, disturbed eating and sleeping pattern, delayed bone age

Back 43

transient pit hormone deficiency, psychosocial dwarfism

Front 44

transient pituitary homrone deficiency

Back 44

psychosocial dwarfism

Front 45

A 14 y.o. is concerned because he’s shorter than his classmates. On exam he has the sexual maturity rating of a 12 year old. His dad says he had a similar problem, but grew out of it by the time he reached college. what do you expect to see on an x-ray?

Back 45

delayed bone age this is constitutional growth delay

Front 46

Which of the following is the key to diagnosis of Turner Syndrome?

Back 46

short stature

Front 47

what is the US/LS ratio for a new born ? 2 year old? 10 year old? adult?

Back 47

1.7 vs 1.4 vs. 1.0 vs 0.9