Yasser is falling behind

Description

Mind Map on Yasser is falling behind, created by amna mohd on 09/11/2017.
amna mohd
Mind Map by amna mohd, updated more than 1 year ago
amna mohd
Created by amna mohd almost 7 years ago
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Resource summary

Yasser is falling behind
  1. Short Stature
    1. Causes
      1. Bone or skeletal disorders
        1. Rickets
          1. Achondroplasia
          2. Chronic diseases
            1. Asthma
              1. Celiac disease
                1. Congenital heart disease
                  1. Cushing disease
                    1. Diabetes
                      1. Hypothyroidism
                      2. Genetic conditions
                        1. Down syndrome
                          1. Noonan syndrome
                            1. Russell-Silver syndrome
                              1. Turner syndrome
                                1. Williams syndrome
                                2. Other reasons
                                  1. Growth hormone deficiency
                                    1. Pathophysiology
                                      1. Causes
                                        1. Deficiency of anterior pituitary secretion (panhypopituitarism)
                                          1. Failure of somatomedin receptor or GHR response.
                                            1. Lack of somatomedin C secretion by liver
                                              1. Hypothalamic dysfunction (decreased GHRH)
                                                1. Secretion of inactive growth hormone.
                                                2. Effects
                                                  1. Physical parts of the body develop in a reduced rate, but in appropriate proportion
                                                    1. With panhypopituitary dwarfism --> no puberty or adult sexual functions
                                                    2. Diagnosis
                                                      1. History taking
                                                        1. GHD Criteria
                                                          1. Clinical presentation
                                                            1. Delayed growth
                                                              1. Increased fat
                                                                1. Short stature
                                                                  1. High pitched voice
                                                                    1. Micropenis
                                                                  2. Milestones of development
                                                                  3. Physical Examination
                                                                    1. Growth Chart
                                                                      1. Height & Weight measurements
                                                                        1. Calculating the expected height
                                                                          1. 1. Add the mother's height and the father's height in either inches or centimeters.
                                                                            1. 2. Add 5 inches (13 centimeters) for boys or subtract 5 inches (13 centimeters) for girls.
                                                                              1. 3. Divide by two
                                                                              2. Expectations
                                                                                1. Turner syndrome
                                                                                  1. Down syndrome
                                                                                    1. Achondroplasia (dwarfism)
                                                                                      1. Rickets
                                                                                        1. Signs of hypopituitarism
                                                                                      2. Investigations
                                                                                        1. Blood Tests for Growth Hormone Deficiency
                                                                                          1. Binding protein levels (IGF-I and IGFBP-3).
                                                                                            1. Growth hormone stimulation test
                                                                                              1. GHRH-arginine test
                                                                                                1. Insulin tolerance test (ITT)
                                                                                              2. Other Exams and Tests
                                                                                                1. DXA scan
                                                                                                  1. MRI of the brain
                                                                                                    1. X-ray of the hand
                                                                                                      1. X-ray of the head
                                                                                                  2. Management plan
                                                                                                    1. Pharmacological Therapy
                                                                                                      1. Recombinant GH
                                                                                                        1. Administered IM or SC
                                                                                                          1. Adverse Effects
                                                                                                            1. Injection-site pain or arthralgias
                                                                                                              1. Idiopathic intracranial hypertension
                                                                                                                1. Hyperglycemia may develop
                                                                                                                  1. GH may promote the growth of various types of neoplasms and increase tumor recurrence rates.
                                                                                                                2. Recombinant Insulin-Like Growth Factor-1
                                                                                                                  1. Patients should be monitored very closely for hypoglycemia
                                                                                                                  2. Growth Hormone-Releasing Hormone
                                                                                                                    1. Sermorelin is administered daily by subcutaneous injection
                                                                                                                3. Prognosis:
                                                                                                                  1. Child will grow 1 to 2 inches within the first 6 months of starting treatment
                                                                                                                4. Intrauterine infections
                                                                                                              2. Risk Factors
                                                                                                                1. Large familiar group
                                                                                                                  1. Underweight during pregnancy
                                                                                                                    1. Malnutrition
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