What this deck covers
Short Stature and Growth Hormone in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.
Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.
The 18 cases, in order
- Small, but is he slowing
- Comparing her with her parents
- A late starter in a late family
- The one to rule out in a girl
- Proving the pituitary is short
- A blood test before the big one
- Wandering eyes and slow growth
- Bumping into things
- Odd wrists in mother and daughter
- Short limbs, normal trunk
- Born small and stayed small
- Losing weight as well as height
- Growth stopped and something hurts
- A different house, a different chart
- Can she just have the injections
- A limp on the injections
- Headaches after starting treatment
- What the wrist film adds
Diagnoses and management options tested
Across the 18 cases you are asked to choose between options such as: An error in measurement that should be repeated, She has a growth hormone deficiency, Constitutional delay of growth and puberty, Coeliac disease, A skeletal survey, A morning cortisol, Septo-optic dysplasia, Coeliac serology and a stool sample, A nutritional deficiency of long standing, Growth hormone deficiency, Growth hormone deficiency of late childhood onset, Coeliac serology with a total IgA, A skeletal dysplasia of late onset, A late response to thyroid treatment.
Clinical pearls from this deck
- Short is a position. Slow is a process. Only the second one is a problem.
- Measure the parents. A child short for the population may be exactly right for her family.
- Ask when the father started shaving. It outperforms most of the blood tests you might send.
- Karyotype every short girl. The features are subtle often enough that looking is not sufficient.
- A random growth hormone level is low in normal children. Never send one to make this diagnosis.
- A low IGF-1 has many causes. A normal one is the useful result, because it spares a test.
Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.
More from this system: all Endocrinology Board Questions case decks · pediatric reference values.
