Normal and Abnormal Growth Clinical

  1. Midparental height, aka _____ height. For boys, add ____inches or ____ cm to ___’s height. Plus _____’s height and divided by 2.
    • Target
    • 5 inches
    • 13cm
    • Mother
    • Fathers
    • (basically, add mom and dad height in inches together, + 5 inches /2) for girls: same but -5 instead of +5
  2. This imagining modality can evaluate a child’s bone age:
    X ray
  3. Short stature is ____ SD from the average height
    Greater than 2
  4. Growth curve for a child that falls under the category of familial short stature:
    Starts lower than average and end lower than average
  5. Growth curve for a child that falls under the constitutional delay short stature category:
    • Starts lower than average but ends normal
    • Like Luke!
  6. Pathologic short statures is ______ SD below the mean for chronologic age
    Greater than 3.5 SD
  7. Growth rate for pathologic short statures is ______ below the mean for chronologic age
    Greater 2 SD
  8. Pathologic short stature is when height is _____ below the target height when corrected for midparental height
    Greater than 2 SD
  9. Pathologic short stature is defined as:
    • Height >3.5 SD below the mean for chronologic age
    • Growth rate > 2 SD below the mean for chronologic age
    • Height >2 SD below the target height when corrected for midparental height
  10. T/F: Chronic diseases like renal dz, asthma, CF, cardiac, celiac, AIDS and cancer can cause abnormal short stature growth pattern
  11. GH deficiency, cortisol excess, hypothyroidism are examples of ______ cause of _____ growth pattern for short stature
    • Endocrine
    • Abnormal
  12. Turner syndrome, noonan syndrome and achondroplasia are abnormal growth pattern for ____ stature
  13. Short stature genetic causes:
    • Turner syndrome
    • Noonan syndrome
    • Achondroplasia
  14. Short stature endocrine causes:
    • GH deficiency
    • Cortisol excess
    • Hypothyroidism
  15. 15 year old girl whose height falls 3 SD below the average, comes in with lack of breast development (so what, neither did i), spaced nipples, webbed neck, shortened 4th metatarsals and left-sided heart disease, likely ______
    Turner syndrome
  16. A short patient comes in with facial dysmorphism and downward slanted eyes and low-set ears, likely _______. What are some other features that he may display?
    • Noonan syndrome
    • Short webbed neck
    • Chest deformity, pulmonary stenosis, hypertrophic cardiomyopathy
    • Intellectual disability
  17. A very short person comes in with a prominent forehead, short arms and thighs, what is the genetic mutation that occurred in this person?
    • FGFR3 mutation
    • This describes achondroplasia
  18. Growth hormone therapy can be used for these conditions:
    • GH deficiency
    • Prader-Wili syndrome
    • SHOX deficiency
    • Turner Syndrome
    • Noonan syndrome
  19. T/f: doses for adults on growth hormone therapy is higher than for children
    False; doses for adults are lower than for children per kg of lean body mass
  20. What are adverse effects of growth hormone therapy?
    • Pseudotumor cerebri (increased ICP
    • Arthalgia
    • Myalgia
  21. Tall stature is defined as condition in which the height of an individual is ____ above the corresponding mean height for a normal subject of the same age and sex
  22. Bone age = _____
    Chronologic age
  23. Tall stature from normal constitutional growth display _____ bone age
  24. Final height of “early bloomers” is ______
    Normal adult range
  25. When there is growth hormone excess causing abnormal tall stature, think _____
    • Pituitary origin: Multiple endocrine neoplasia
    • Extrapituitary: GHRH excess, ectopic/ peripheral GH
  26. Gigantism is excess of which hormone?
    Growth hormone
  27. Excess GH before fusion of epiphyseal growth plates is ____
  28. McCune Albright Syndrome (MAS), Multiple endocrine neoplasia type 1 (MEN 1), Carney complex are ______ excess, resulting in ___ stature
    • GH
    • Tall
  29. Excess GH after epiphyseal plates closed is ____
  30. T/F: Acromegaly is excess GH resulting in linear bone growth
    False; acromegaly is after growth plate has fused, so bone grow laterally to the sides.
  31. T/F: GH excess that begins in adulthood, after complete epiphyseal fusion, has no effect on stature
  32. Non-GH excess cause of tall stature:
    • Congenital adrenal hyperplasia (CAH)
    • Precocious puberty
  33. Penile enlargement with pubic hair but prepubertal testes seen in a boy is _____
    Congenital adrenal hyperplasia
  34. Stature at time of diagnosis of Congenital Adrenal Hyperplasia is _____, and final height is ____
    • Tall
    • Short; because post-treatment because epiphyseal plates closed
    • (like in precocious puberty)
  35. Abdominal CT of congenital adrenal hyperplasia shows ______
    Bilateral adrenal hyperplasia
  36. Bone age of a 9 year old boy with congenital adrenal hyperplasia would be ______
    Like 15; basically bone maturity is greater than chronologic age
  37. Elevated urinary 17-ketosteroid levels, elevated serum 17-hydroxyprogesteron is indicative ____
    Congenital adrenal hyperplasia
  38. Precocious puberty is onset of secondary sexual development before age _____ in girls, and ___ in boys
    • 8 in girls
    • 9 in boys
  39. Precocious puberty stature at the time of diagnosis is ____, and final height stature is ____
    • Tall short
    • (like in congenital adrenal hyperplasia)
  40. T/F: Congenital adrenal hyperplasia and precocious puberty both are tall stature at time of diagnosis and short final height; so these two are in both short and tall stature schemes
  41. Genetic causes of abnormal tall stature:
    • Marfan
    • Klinefelter
  42. Marfan and Klinefelter leads to ____ Stature
  43. Very tall prepubertal boys with small testes, gynecomastia, marked lack of insight, poor judgement and impaired ability is likely _____, and this is due to chromosomal abnormality____.
    • Klinefelter
    • XXY
  44. Chronic diseases can cause _____ stature
  45. Highest rate of growth in boys is ages ______, and In girls is ______
    • Boys ages 13-14
    • Girls ages 11-12
  46. T/F: growth charts provides information is growth over time and it also gives info about the rate of growth
    • False; it only gives information on growth over time, but not the rate of growth
    • Rate of growth shown in growth velocity curve
  47. How is the growth velocity curve computed?
    Taking the rate of growth between each growth point and plotting it against age
  48. Use the CDC growth chart for age _______, and use the WHO growth chart for age _____.
    • CDC greater than 2 years
    • WHO less than 2 years (because WHO growth charats only provide information on children up to 5)
  49. Children over three years height should be measured while _____
    Standing, must be able to stand without assistance.
  50. For ages 2-3 years, children’s height measurement depends on_____
    The child’s ability to stand erect for the time it takes to be measured
  51. T/F: children under 2 years of age, height is measured with parents holding them up on their feet
    False; they should be measured supine (measure length, not height) on a measuring board
  52. Three phases of post natal growth are:
    • Infantile phase (rapid but decelerating growth in first 2 years)
    • Childhood phase (relatively constant velocity)
    • Pubertal phase (growth spurt of 8-14 cm per year)
  53. Total growth in the infantile post natal growth phase is ______, and this happen in the _____ years of life
    • 30-35 cm
    • First 2 years
  54. A rapid but decelerating growth describe which phase of the post natal growth phase?
  55. Childhood phase growth is ______ velocity of _____ cm per year
    • Constant
    • 5-7 cm
  56. A “pre-pubertal dip” describes which phase of the post natal growth phase?
    Childhood phase
  57. Pubertal phase consists of growth spurts of ______ cm per year
  58. Infants should be measured ____ clothes to the nearest _____ kg or _____ oz
    • Without but a clean diaper
    • 0.01 kg or half oz
Card Set
Normal and Abnormal Growth Clinical
Endo Exam 1