Review Note
Last Update: 06/09/2024 03:17 PM
Current Deck: SLS Cards::10. Pediatric growth and nutrition
New Card (Unpublished)Currently Published Content
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Commit #107510
What follow-up is needed and what red flags would you look out for in delayed puberty?
Back
Commit #107510
Generally, no breast development by age 13 OR no testicular enlargement by age 14 is a red flag and needs further investigation.
Specific red flags
Specific red flags
- Growth concerns
- Drop in percentiles for height
- Short stature (beyond expected based on parental)
- Systemic symptoms
- Fatigue
- Unexplained weight loss
- Polyuria, polydipsia --> suggests diabetes
- Neurological symptoms
- Headaches
- Vision problems/ changes --> suggests pituitary tumor
- Seizures
- Psychosocial issues
- Emotional distress
- Behavior changes
- Signs of hypothyroidism
- Fatigue, weight gain, cold interolerance, dry skin, constipation
- Signs of hyperthyroidism
- Tremors, weight loss, heat intolerance, sweating, tachycardia
- Signs of Turner syndrome
- Chromosome XO
- Short stature, lack of breast development, shield chest + widely spaced nipples. Webbed nack, cubitus valgus, shortened 4th metatarsals.
- Important due to heart defects, e.g. aortic valve abnormalities (e.g. bicupid), coarctation, aortic arch defects.
- Signs of anorexia nervosa/ bulimia
- 5Q eating disorder questionnaire (1. are you satisfied with your eating patterns, 2. do you ever eat in secret, 3. does your weight affect the way you feel about yourself, 4. have any members of your family suffered with an eating disorer, 5. do you currently suffer with or have ever suffered in the past with an eating disorder)
- Signs of significant asthma
- Use of glucocorticoids could be potential exacerbator/ cause for delay.
- Signs of adrenal insufficiecy
- Hyperpigmentation
- Salt craving, low BP, muscle weakness
- Chronic illness
- Crohns, celiac