HISTORY TAKING IN PEDIATRIC ENDOCRINE DISEASE - PowerPoint PPT Presentation

Loading...

PPT – HISTORY TAKING IN PEDIATRIC ENDOCRINE DISEASE PowerPoint presentation | free to download - id: 3f22ca-NTViN



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

HISTORY TAKING IN PEDIATRIC ENDOCRINE DISEASE

Description:

HISTORY TAKING IN PEDIATRIC ENDOCRINE DISEASE DEFINITION The term short stature describes height that is in the third percentile as compared to the average height for ... – PowerPoint PPT presentation

Number of Views:113
Avg rating:3.0/5.0
Slides: 25
Provided by: HORI2
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: HISTORY TAKING IN PEDIATRIC ENDOCRINE DISEASE


1
HISTORY TAKING IN PEDIATRIC ENDOCRINE DISEASE
2
DEFINITION
SHORT STATURE
  • The term short stature describes height that is
    in the third percentile as compared to the
    average height for a persons age, sex, and
    racial group

3
(No Transcript)
4
(No Transcript)
5
Causes
  • Normal variants
  • Non-endocrine causes
  • Endocrine causes

6
CAUSES OF SHORT STATURE
  • Nonendocrine Causes
  • Constitutional short stature
  • Genetic short stature
  • Intrauterine growth retardation and SGA
  • Syndrome of short stature
  • Turners syndrome and its variants
  • Noonans syndrome (Pseudo-Turners syndrome)
  • Prader-Willi syndrome
  • Laurence-Moon and Bardet-Biedl syndrome
  • Other autosomal abnormalities dysmorphic synd
  • Chronic disease
  • - Cardiac disorder
  • Left to right shunt
  • Congestive heart failure
  • - Pulmonary disorders
  • Cystic fibrosis
  • Asthma
  • - Gastrointestinal disorders
  • Malabsorption (eg, celiac disease)
  • Endocrine disorders
  • GH deficiency and variants
  • - Congenital GH deficiency
  • - With midline defects
  • - With other pituitary hormone deficiencies
  • - Isolated GH deficiency
  • - Pituitary agenesis
  • - Acquired GH deficiency
  • Hypothalamic-pituitary tumors
  • Histiocytosis X
  • Central nervous system infections
  • Head injuries
  • GH deficiency following cranial irradiation
  • Central nervous system vascular accidents
  • Hydrocephalus
  • Empty sella syndrome
  • - Abnormalities of GH action
  • GH insensitivity (Larons dwarfism)
  • Primary IGF-1 deficiency

7
Normal variants
  • Familial (genetic) short stature and
    constitutional short stature are common
    variations of normal.
  • Individuals with familial short stature have a
    normal growth rate even though it is below the
    5th percentile
  • They do not have skeletal delay, puberty and
    pubertal growth spurt occur at the usual
    chronological age, and final height is
    appropriate for mid-parental target height

8
Normal variants
  • Those with constitutional short stature have
    growth deceleration in the first two years of
    life, with normal growth velocity being achieved
    by age three and continuing throughout childhood
  • Onset of puberty is usually delayed
  • Adult height is in the normal range but varies
    according to parental height

9
Non-endocrine causes
  • Non-endocrine causes of short stature are
    commoner than endocrine causes
  • Patients with non-endocrine disease tend to have
    normal body proportions
  • Chronic malnutrition is the commonest cause of
    poor growth globally
  • inflammatory bowel disease, coeliac disease, or
    anorexia nervosa
  • Short stature is also commonly associated with
    renal disease, and conditions associated with
    hypoxia or hypoxaemia, such as congenital heart
    disease, pulmonary disease, and
    haemoglobinopathies
  • Psychosocial deprivation often causes short
    stature. Placing the child in a different
    environment results in growth catching up.

10
Endocrine causes
  • Growth hormone deficiency or insufficiency is an
    uncommon cause of short stature
  • Prevalence of the condition 1 in 4000
  • Classic GH deficiency short stature, increased
    fat mass leading to a chubby appearance with
    immature facial, immature high-pitched voice, and
    delay in skeletal maturation.
  • The calvarium seems to be relatively overgrown
    (delayed closure of fontanelles), with prominence
    of the frontal bone

11
Endocrine causes
  • The impairment of growth in Cushing's syndrome is
    predominantly the result of a direct effect at
    the growth plate. The commonest cause is
    iatrogenic (treatment with glucocorticoids), with
    endogenous glucocorticoid excess (Cushing's
    syndrome dependent on the pituitary and adrenal
    glands) being much rarer.

12
Causes
  • Several factors contribute to short stature,
    including
  • Genetic factors (eg, skeletal dysplasias, Turner
    syndrome, Downs syndrome, Silver Russell
    syndrome)
  • Endocrine disorders (eg, hypothyroidism, growth
    hormone deficiency)
  • Delayed puberty (causes temporary short stature,
    but normal height is eventually achieved)
  • Early puberty
  • Malnourishment (on a global scale, this is the
    most common cause of growth failure and is
    generally associated with poverty)
  • Chronic diseases
  • Congenital heart disease
  • Kidney diseases
  • Asthma
  • Sickle cell anemia
  • Gastrointestinal disorders (eg, inflammatory
    bowel disease)
  • Lung conditions ( cystic fibrosis, severe asthma,
    chronic obstructive pulmonary disease)
  •  

13
HISTORY TAKING
  • Initiating the session
  • - Greeting, Introduce, obtain patients name,
    sex, date of birth, and
  • Address
  • Identifying the reason for the consultation
  • - Chief complain
  • - Explanation about hystory taking
  • 3. Gathering information
  • - History of present illness - Pregnancy
  • - Birth History - History of Development
  • - Family History - History of Disease
  • - Medications - Diet
  • - Accidents - Social
  • 4. Closing

14
History of present illness
  • The onset
  • Other symptom(s)

15
Pregnancy
  • Nutritional status
  • Toxic or medication exposure
  • Gestational age

16
Birth History
  • Delivery
  • APGAR score
  • Birth weight length

17
History of Development
  • Age of milestone sitting, walking, speaking
    words
  • Educational achievement

18
Family History
  • Family member with short stature
  • Consanguinity
  • Height and weight of siblings
  • Height and weight of parents
  • Puberty

19
History of Disease
  • Gastrointestinal
  • Lung
  • Heart
  • Kidney disease
  • Anemia

20
Medications
  • Corticosteroids

21
DIET
  • Adequate food (quantity)
  • Quality (healthful)

22
Accidents
  • Head

23
SOCIAL
  • Home interaction
  • School interrelationship with schoolmates

24
TERIMA KASIH
About PowerShow.com