Post Contents List
- 1 DISORDERS OF GROWTH AND DEVELOPMENT
- 2 Growth GHD CausesGram-Positive Streptococci Bacterial Infections Causes Diagnosis Treatment. Read more ... » may be :
- 3 Growth Classic Stage Theories
- 4 Growth GHD CLINICAL PRESENTATION —
- 5 Physical Exam Growth GHD
- 6 •Children with GHD:
- 7 •Adults:
- 8 Associated Conditions
- 9 Treatment
- 10 Growth GHD Adult GH deficiency
- 11 Growth GHD Treatment ,
- 12 Acromegaly
- 13 Growth and Development Disorders Diagnosis
- 14 Differential Diagnosis
- 15 Lab diagnosis:
- 16 Treatment
DISORDERS OF GROWTH AND DEVELOPMENT
Growth is dependent on GH, IGF, sex steroids, thyroid hormones, paracrine growth factors and cytokines.
Growth also requires caloric energy, amino acids, vitamins and trace metals.
Short stature results due to intrinsic and extrinsic factors which impair growth.
Growth GHD CausesGram-Positive Streptococci Bacterial Infections Causes Diagnosis Treatment. Read more ... » may be :
- Most common cause of GHD in children is idiopathic.
- Most common cause of GHD in adults is a pituitaryAldosteronism Clinical features Causes and Treatment. Read more ... » adenoma or treatmentGram-Positive Streptococci Bacterial Infections Causes Diagnosis Treatment. Read more ... » of the adenoma with surgery or radiotherapy:
- · Hormonal disorders
- · Systemic disorders
- · Genetic disorders
- · Hereditary disorders
- GH deficiency causes short stature, increased fat, high pitched voice, hypoglycemia, micropenis.
Growth Classic Stage Theories
|INFANCY (0–1 YR)||TODDLERHOOD (2–3 YR)||PRESCHOOL (3–6 YR)||SCHOOL AGE (6–12 YR)||ADOLESCENCE (12–20 YR)|
|Erikson:psychosocial||Basic trust vs mistrust||Autonomy vs shameand doubt||Initiative vs guilt||Industry vs inferiority||Identity vs role diffusion|
|Piaget:cognitive||Sensorimotor||Sensorimotor||Preoperational||Concrete operations||Formal operations|
rewards (stages 1 and 2)
|Conventional:conformity (stage 3)||Conventional:law and order (stage 4)||Postconventional:moral principles|
Growth GHD CLINICAL PRESENTATION —
- GHD can be divided into congenital and acquired forms.
- A variety of congenital genetic causes of GHD:
- GH secretagogue receptor gene defects
- GH gene defects
- Transcription factor defects (PIT-1, PROP-1, LHX3/4, HESX-1, and PITX-2)
- GHRH receptor gene defects
- GH receptor/postreceptor defects
- Prader-Willi syndromeMetabolic,Insulin Resistance Syndrome X Causes Symptoms. Read more ... »
- The single most important clinicalGram-Positive Streptococci Bacterial Infections Causes Diagnosis Treatment. Read more ... » manifestation of GHD of all causes is growth failure, and careful documentation of growth rate is critical to making the correct diagnosisGram-Positive Streptococci Bacterial Infections Causes Diagnosis Treatment. Read more ... ».
Physical Exam Growth GHD
•Children with GHD:
- Most common presentation is short stature
- Assess pubertal status using Tanner staging systemGram-Positive Streptococci Bacterial Infections Causes Diagnosis Treatment. Read more ... ».
- Severe GHD children have maxillary hypoplasia and forehead prominence; kewpie doll appearance.
- Accurately measure height and weight.
- Newborns may present with hypoglycemia, jaundiceCauses of jaundice with diagnosis and bio markers. Read more ... », or micropenis.
- Decreased lean body mass
- Poor bone density
- SarcoidosisSarcoidosis Causes Diagnosis Symptoms and Treatment. Read more ... »
- Sheehan syndrome
- is replacement with GH 0.05 mg/kg/day subcutaneously for growth of 10 cm/year.
Growth GHD Adult GH deficiency
- is caused by hypothalamicHypothalamic, Pituitary And Other Sellar Masses. Read more ... » or pituitary damage of area secreting GH. Later there may be FSH / ~H, TSHACTH and TSH DEFICIENCY Diagnosis with Treatment. Read more ... » and ACTHACTH and TSH DEFICIENCY Diagnosis with Treatment. Read more ... » deficiency also.
- There is lean body with fat abdomen, and increased waist size, hyperlipidemia, hypertensionThyrotoxic crisis or Thyroid storm. Read more ... »,’ left ventricular dysfunction.
Growth GHD Treatment ,
- Replacement of GH 1.25 mg/day. Women require higher levels then men.
- Liquid solutions for SC injection: These are available in multidose pen devices.
- Encapsulated GH in glycolide microspheres for deep SC administration.
- Either 1.5 mg/kg body weight once a month or 0.75 mg/kg twice a month.
- Daily therapy is more effective than 3-times-a-week therapy. The recommended dose is 0.04 mg/kg/d for children
- This is due to increased secretion of growth hormoneAnterior Pituitary Hormones and Disorders. Read more ... » due to pituitary adenoma, extrapituitary tumors, hypothalamic tumors, pancreatic islet cell tumorArbuda or Cancer Ayurvedic Review. Read more ... », adrenal and thyroidThyrotoxic crisis or Thyroid storm. Read more ... » tumors, pheochromocytomaDIAGNOSIS and Investigations OF SECONDARY HYPERTENSION. Read more ... ».
- It is diagnosed at the age of 10 years or more. There is frontal bossing (prominent forehead), increased hand and foot size, wide thick jaw, space between incisor teeth, thick heal pads, coarse facial features, large nose, muscle weakness, oily skin, cardiomegaly, thick tongue etc. Patient looks abnormally huge.
- There is premature coronary heartCardiac Arrhythmias Definitions Mechanisms and Methods for Detecting Arrhythmias. Read more ... » diseaseGram-Positive Streptococci Bacterial Infections Causes Diagnosis Treatment. Read more ... », cardiomyopathy, arrhythmiasCOMPLICATIONS OF Acute Myocardial Infarction (AMI) AND TREATMENT -2. Read more ... » and death. These patients have obstructive sleep apneaSleep Disorders Types Diagnose Of Sleep Disorders. Read more ... », diabetes mellitusOphthalmologic Complications of DM (Diabetes Mellitus). Read more ... », colonic malignancy.
Growth and Development Disorders Diagnosis
- Down syndrome
- Idiopathic short stature
- Noonan syndrome
- Prader-Willi syndrome
- RenalDiabetic Nephropathy and Renal complications of DM (Diabetes Mellitus). Read more ... » failure
- Russell- Silver syndrome
- Small size for gestational age in newborns
- Turner syndrome
- IGF-I (insulinHyperglycemic Hyperosmolar State (HHS) Acute Complication Of DM. Read more ... »-like growth factor) level is elevated.
- There is failure of GH suppression in response to glucose load (75 g glucoseGlycogen Storage Diseases von Gierke disease, Andersen's disease, McArdle's disease. Read more ... »).
- Thyroid-stimulating hormone (TSH) (hypothyroidismThyroid Disorders Examination and Laboratory tests. Read more ... » should be excluded as a cause)
- Serum electrolytes (low bicarbonate levels may indicate renal tubular acidosisTubular Diseases of the Kidney Types Clinical Features Diagnosis with Treatment. Read more ... »)
- IGF-1, IGFBP-3
- Multiple GH levels
- Surgical resection (transsphenoidal) Somatostatin analogues-Octreotide acetate
- Bromocriptine, a dopamine agonist may suppress GH
- Stereotactic ablation by gamma knife.