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35 Cards in this Set
- Front
- Back
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What are determinants of normal growth?
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Nutrition
Genes Home environment Hormones |
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If someone is undernourished, what is the pattern of their growth?
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First you'll have a drop in weight, then a drop in height
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What is the growth pattern in an obese person?
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Faster growth
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What are the hormones that affect growth?
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Thyroid hormone
GH Sex hormones Also, excess of hormones (ex. corticosteroids) |
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What are the two patterns of abnormal growth?
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Short stature
Low growth velocity |
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What's the definition of short stature?
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Height less than the 3rd percentile
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What's the definition of low growth velocity?
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Downward shifting on the percentile curves.
Growth velocity less than the 3rd percentile |
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What is a part of the evaluation for growth defect?
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A good history
ROS Meds Birth history FH SH Family growth/pubertal hx |
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If a girl has both cardiac and renal defects in the setting of growth deficiency, what should you think of?
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Turner syndrome
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What are the abnormalities in turner syndrome?
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Cardiac defects
Renal defects Short stature |
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What are some elements in a history that point to a pituitary problem in the setting of abnormal growth?
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Headaches
Vision problems Wetting the bed (enuresis) |
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What is a pulmonary-related problem that can cause stunted growth?
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CF
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What are some GI-related concerns that can cause problems with growth? What are some relevant symptoms?
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Celiac disease
IBD Symptoms: abdominal pain, diarrhea |
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What are some meds that can cause abnormal growth?
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Oral steroids!
Stimulants such as ritalin |
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How do stimulants cause poor growth?
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They're also appetite suppressants
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What are some symptoms of GH deficiency?
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Neonatal jaundice
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What's the definition of small for gestational age?
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Birth weight or length 2 SD below the mean for gestational age.
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How many SGA kids don't achieve catch-up growth?
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only 10%
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What's the formula for mid-parental height?
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How do you arrive at a diagnosis of familial short stature?
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After you've exhausted all of the other possibilities; it's a diagnosis of exclusion
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How many times should you measure height in office?
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3 times, take the average
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What's the difference between length and height?
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You're longer than you are taller: gravity.
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What is upper/lower segment ratio?
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Measure of the symmetry of the body:
Lower segment: symphysis pubis to floor Upper segment: height - lower segment |
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What are some conditions that cause abnormalities in upper/lower segment ratio?
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Dysplasia
Achondroplasia Turner syndrome |
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What's the most important variable measured when thinking about pediatric growth?
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Velocity!
Over 6-12 month period |
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If someone has a normal growth velocity, what condition are they unlikely to have?
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GH deficiency
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When does the growth spurt happen in girls? Boys?
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Girls: earlier; tanner 2-3
Boys: later; tanner 3-4 |
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If you're underweight for your height, what do you think about? Overweight?
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Underweight: Systemic illness
Overweight: hormone abnormalities |
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What are some labs that you run in a kid with abnormal development?
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CBC, ESR, BUN, LFTs
Free T4, TSH IGF-1, IGFBP3 Anti-endomysial Ab, IgA (Celiac) Karyotype for girls (turners) |
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What happens in the GH/IGF-I axis?
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If someone has a low IGF-1 AND a low IGFBP3, what do you think?
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GH deficiency
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If someone has a low IGF-1, NL IGFBP3, what do you think?
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Malnutrition
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Where does IGF-1 work?
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Long bones
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What's a radiologic test for assessing age?
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Bone age!
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If someone has a history of growth problems and CNS system, what test should you order?
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Head MRI.
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