achilles
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between 7 and 8 yrs your patient has grown 4.5 cms in height. his mother however remains concerned and asks you to do furthur relevant investigations. his height is below and parallel to 5th percentile. which of the following would you undertake ?
1) GH secretion using insulin induced hypoglycemia
2)CT scan of the head
3)TSH
4)24 hr urine cortisol
5) none of the above
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| determine
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5?
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| babli
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TSH.
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| Rasul
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Guys, explan to me this question. I'd go for 1, but my endocrinology's no good, I'm not sure about answer
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| AAAAA
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5
THIS BRINGS HOME AN EXCELLENT POINT.
IF YOU CAN UNDERSTAND THE CONCEPT, THEN YOU WILL BUST ALL ALL ALL ALL ALL THE EXAM.
THIS MEANS YOU CAN BUST NEUROSURGERY , CARDIOTHORACIC SURGERY EXAM
THE QUESTION ASKS YOU WHEN TO INTERVENE AND WHEN NOT
Boys don't start their "growth spur" until may be 12, 13-17 years old
Girls start at around 9-11, 12 years old
So girls are taller than boys at around 10, 11 years old.
Boys are OK at around 7 and 8 due to CONSITUTIONAL GROWTH RETARDATION--it is normal---> Don't do anything-----> they will catch up at 13 years old
Wait , don't work up the patients.
Ask how tall is the father now and at 7 or 8 and the mother too.
In ped, 1 out of 5 questions DON'T DO anythings
Asymmetric breast in girls--->fine
Breast enlargement in boys around 13-----> fine
Boys at 7,8-----> fine absolutely fine Most boys grow at 13-17 not at 7, 8
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| AAAAA
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Girls have irregular period around 14-16----> Normal Perfectly normal
Girls have painful period---->Motrin only minimal intervention,
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| babli
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thanks AAAA.
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| achilles
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this is an exam question(MCC) i dont have the answer but i went for 5 myself.
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" it's not whether you get knocked down, it's whether you get up"
" i have miles to go before i sleep "
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