ICR-Pediatric Growth Disorders Flashcards Preview

Female Repro > ICR-Pediatric Growth Disorders > Flashcards

Flashcards in ICR-Pediatric Growth Disorders Deck (27)
Loading flashcards...
1
Q

Greatest determinate of size during intrauterine life. What are the big growth factors during this time?

A

Maternal-placental-fetal unit. IGF1 & IFG2 are the major growth factors.

2
Q

Causes of intrauterine growth restriction

A

Abnormal placenta, crowding, infection, toxins and chromosomal abnormality

3
Q

When do you know that intrauterine growth restriction will affect a baby’s adult height?

A

If you don’t see catch up growth in the first year of life.

4
Q

Average growth rate during intrauterine life

A

26 inches per year

5
Q

Average growth rate during infancy

A

6-12 inches per year

6
Q

How common is rechanneling?

A

Maternal factors lessen over 12-18 months and channeling can be normal during this time. This is not normal after 3 years of age.

7
Q

Average growth rate during childhood? Major growth factors during this period?

A

2-3 inches per year. GH and thyroid hormone are critical during this period.

8
Q

How does obesity contribute to length growth?

A

You get linear growth. However, obese kids are not taller because they tend to advance their growth plates as well.

9
Q

How does hypercortisolism contribute to growth?

A

You see rapid weight gain with tapering of height

10
Q

Average onset age for puberty in girls

A

8-13. Breast development is first evident. Peak heigh velocity at Tanner 2-3.

11
Q

Average onset age for puberty in boys

A

9-14. Testicular volume increase is first evident. Peak height velocity at Tanner 4-5.

12
Q

Tanner staging

A

*

13
Q

Major growth factor in puberty

A

Sex steroids

14
Q

What bones begin growing 1st in puberty?

A

Distal (feet and hands) get big 1st.

15
Q

Weight 2 standard deviations below the mean for age

A

Failure to thrive. You can also consider genetic potential and crossing lines.

16
Q

Height 2 standard deviations below the mean for age

A

Short stature. You can also consider genetic potential and crossing lines.

17
Q

Mid-parental height prediction

A

This is about 75% accurate. The further apart the parents are in height, the less accurate the test is.

18
Q

Medications that affect childhood growth

A

Glucocorticoids (autoimmune or asthma) or stimulants (ADHD suppresses appetite).

19
Q

How might mid-line defects affect stature?

A

Pituitary is also midline and TSH or GH deficiency may cause short stature.

20
Q

Screening labs you might use for growth disorders

A

CBC, ESR, serum electrolytes, LFT’s, urinalysis, thyroid function (TSH, fT4) and bone age (compare growth plates to give picture of skeletal maturity)

21
Q

Secondary labs to do for assessing growth disorders

A

Karyotype (45X), IGF-1 (GH surrogate measurement), other pituitary hormones (GnRH, Estradiol, testosterone, cortisol), celiac panel, Cl- sweat test and MRI of brain and sella.

22
Q

What will the bone age be in kids with constitutional delay of puberty (late bloomers)?

A

Bone age is delayed. They hit puberty later so they have more room in their growth plates when everyone else is growing and growth plates are reducing.

23
Q

Important factors in determining constitutional delay of puberty?

A

Late maternal menarche or paternal height growth after high school. Also confirm that there is absence of chronic disease.

24
Q

What will the bone age be in kids with genetic short stature?

A

Bone age = chronological age. There is no delay in puberty and they have a normal growth rate and velocity, they may have just started at a lower percentile due to genetics.

25
Q

What is causing this growth failure?

A

Loss of height w/gain in weight = endocrine.

26
Q

What is causing this growth failure?

A

He’s already small, but crosses weight and height lines at puberty = nutrition or GI

27
Q

What is the most sensitive predictor of health in kids?

A

Growth