Common Growth Disorders: Etiology, Clinical Presentation, and Management

Question 1

In children, which hormonal abnormality is frequently linked to short stature?

Accepted Answer

Growth hormone deficiency

Answer

Excessive thyroid hormone

Answer

Adrenal gland underactivity

Question 2

A 4-year-old child has short stature and a deficiency in growth hormone. What is the most likely underlying cause?

Accepted Answer

Congenital pituitary defect

Answer

Trauma to the head

Answer

Hypothyroidism

Answer

Chronic malnutrition

Question 3

Which of the following is a defining characteristic of precocious puberty?

Accepted Answer

Early development of secondary sexual characteristics

Answer

Delayed maturation of bones

Answer

Above-average height for age

Answer

Delayed onset of menarche

Question 4

In children, what is the first-line treatment for growth hormone deficiency?

Accepted Answer

Replacement therapy with growth hormone

Answer

Administration of thyroxine

Answer

Caloric supplementation

Answer

Hormonal contraceptives

Question 5

A child with failure to thrive is being evaluated for psychosocial deprivation. Which of the following findings is most suggestive of this diagnosis?

Accepted Answer

Inadequate parenting skills

Answer

Presence of an organic disease

Answer

Normal growth trajectory

Answer

Genetic disorder

Question 6

Which laboratory test is essential for evaluating growth hormone deficiency?

Accepted Answer

Insulin-like growth factor-1 (IGF-1)

Answer

Thyroid hormone profile

Answer

Complete blood count

Answer

Urinalysis

Question 7

In children with growth hormone deficiency, what is the primary goal of growth hormone replacement therapy?

Accepted Answer

To increase height

Answer

To improve bone density

Answer

To enhance cognitive function

Answer

To prevent psychosocial problems

Question 8

A 12-year-old girl presents with delayed puberty. Which of the following clinical findings suggests an underlying organic cause?

Accepted Answer

Delayed bone maturation

Answer

Tanner stage 1 breast development

Answer

Normal growth pattern

Answer

Lack of secondary sexual hair

Question 9

A six-year-old boy presents with short stature. Which of the following is the most likely cause?

Accepted Answer

Constitutional growth delay

Answer

Growth hormone deficiency

Answer

Turner syndrome

Answer

McCune-Albright syndrome

Question 10

What is the first-line treatment for children with growth hormone deficiency?

Accepted Answer

Growth hormone replacement therapy

Answer

Testosterone therapy

Answer

Anabolic steroids

Answer

Dietary supplements

Question 11

A three-year-old girl presents with failure to thrive. Her parents report that she has a poor appetite and frequent vomiting. Which of the following is the most likely underlying medical condition?

Accepted Answer

Gastroesophageal reflux disease (GERD)

Answer

Celiac disease

Answer

Pyelonephritis

Answer

Asthma

Question 12

Which hormone is the primary regulator of puberty in boys?

Accepted Answer

Gonadotropin-releasing hormone (GnRH)

Answer

Follicle-stimulating hormone (FSH)

Answer

Luteinizing hormone (LH)

Answer

Testosterone

Question 13

What is the recommended initial test to screen for growth hormone deficiency?

Accepted Answer

Insulin-like growth factor-1 (IGF-1) level

Answer

Growth hormone stimulation test

Answer

Magnetic resonance imaging (MRI) of the pituitary gland

Answer

Bone age X-ray

Question 14

Which of the following is NOT a potential cause of short stature in Turner syndrome?

Accepted Answer

Precocious puberty

Answer

Deletion of the X chromosome

Answer

Growth hormone deficiency

Answer

Renal agenesis

Question 15

In the management of short stature, discuss the role of growth hormone therapy. Specifically, consider its indications, potential benefits, and limitations.

Accepted Answer

Growth hormone therapy can significantly improve adult height in children with growth hormone deficiency.

Answer

Growth hormone therapy is indicated for all children with short stature.

Answer

Growth hormone therapy has no potential side effects.

Question 16

In pediatric patients with growth disorders, how can genetic testing inform clinical management?

Accepted Answer

Identifies specific genes, guiding treatment strategies

Answer

Confirms the diagnosis in all cases

Answer

Used exclusively to diagnose rare growth disorders

Question 17

Which of the following causes of failure to thrive in children is **not** related to inadequate nutrition?

Accepted Answer

Maternal depression

Answer

Organic disease

Question 18

Which of the following medications is used to treat precocious puberty in girls?

Accepted Answer

Leuprolide

Answer

Estrogen

Answer

Testosterone

Question 19

A 9-year-old boy presents with accelerated growth and bone maturation. Which of the following is the **most likely** diagnosis?

Accepted Answer

Precocious puberty

Answer

Constitutional tall stature

Question 20

Which of the following hormones is **primarily** responsible for stimulating linear growth?

Accepted Answer

Insulin-like growth factor-1 (IGF-1)

Answer

Thyroid hormone

Question 21

A 12-year-old girl presents with a complaint of short stature. Her height is below the 5th percentile for age and gender. Which of the following is the most common cause of short stature?

Accepted Answer

Constitutional growth delay, a condition where growth is delayed but eventually catches up

Answer

Growth hormone deficiency, a condition where the pituitary gland does not produce enough growth hormone

Answer

Turner syndrome, a genetic disorder that affects females and can cause short stature

Answer

Hypothyroidism, a condition where the thyroid gland does not produce enough thyroid hormone

Question 22

Which of the following is the first-line treatment for children with growth hormone deficiency?

Accepted Answer

Recombinant growth hormone therapy, which involves injections of synthetic growth hormone

Answer

Thyroid hormone replacement, if growth hormone deficiency is caused by an underlying thyroid condition

Answer

Testosterone therapy, for boys with growth hormone deficiency and delayed puberty

Answer

Estrogen therapy, for girls with growth hormone deficiency and delayed puberty

Question 23

For a 5-year-old boy with short stature, which of the following is the most appropriate next step in the evaluation?

Accepted Answer

Growth curve analysis to track growth patterns and identify any deviations

Answer

Hormonal evaluation to check for growth hormone or thyroid hormone deficiencies

Answer

Genetic testing to rule out underlying genetic disorders

Answer

Radiographic evaluation, such as an X-ray, to assess bone age and growth plates

Question 24

Gonadotropin-releasing hormone (GnRH) analogs are the recommended first-line treatment for which of the following?

Accepted Answer

Idiopathic precocious puberty

Answer

Growth hormone deficiency

Answer

Turner syndrome

Answer

Cystic fibrosis

Question 25

A 10-year-old girl presents with rapid growth, advanced bone age, and breast development. Which of the following is the most likely underlying cause?

Accepted Answer

Central precocious puberty

Answer

McCune-Albright syndrome

Answer

Peripheral precocious puberty

Answer

Adrenal hyperplasia

Question 26

What is the most common cause of short stature in children?

Accepted Answer

Idiopathic short stature

Answer

Turner syndrome

Answer

Growth hormone deficiency

Answer

Cystic fibrosis

Question 27

Which of the following is a potential psychosocial impact of growth disorders in children and adolescents?

Accepted Answer

Low self-esteem

Accepted Answer

Social isolation

Accepted Answer

Increased risk of depression

Answer

Improved academic performance

Question 28

The most common cause of failure to thrive in infants is:

Accepted Answer

Gastrointestinal disorders

Answer

Congenital heart disease

Answer

Endocrine disorders

Answer

Neurological disorders

Question 29

The treatment of choice for growth hormone deficiency is:

Accepted Answer

Recombinant human growth hormone

Answer

Synthroid

Answer

Testosterone

Answer

Insulin

Question 30

Which is the most common cause of precocious puberty in girls?

Accepted Answer

Idiopathic

Answer

McCune-Albright syndrome

Answer

Congenital adrenal hyperplasia

Answer

Pituitary adenoma

Question 31

The first-line treatment for precocious puberty in boys is:

Accepted Answer

Leuprolide acetate

Answer

Tamoxifen

Answer

Cyproterone acetate

Answer

Anastrozole

Question 32

The recommended growth chart used for monitoring children in the United States is:

Accepted Answer

Centers for Disease Control and Prevention growth chart

Answer

World Health Organization growth chart

Answer

Tanner-Whitehouse growth chart

Answer

National Health and Nutrition Examination Survey growth chart

Question 33

The most useful laboratory test in diagnosing growth hormone deficiency is:

Accepted Answer

Insulin-like growth factor-1 (IGF-1)

Answer

Growth hormone stimulation test

Answer

Thyroid function tests

Answer

Complete blood count

Question 34

A child whose height falls below the 3rd percentile and exhibits a growth rate of less than 5 cm per year is considered to have:

Accepted Answer

Short stature

Answer

Failure to thrive

Answer

Growth hormone deficiency

Answer

Constitutional growth delay

Question 35

The first-line therapy for idiopathic growth hormone deficiency is:

Accepted Answer

Oral growth hormone replacement therapy

Answer

Subcutaneous insulin-like growth factor-1

Answer

Testosterone therapy

Answer

Estrogen therapy

Question 36

Which laboratory test is most helpful in diagnosing celiac disease?

Accepted Answer

Serum IgA anti-tissue transglutaminase

Answer

Complete blood count

Answer

Serum thyroid function tests

Answer

Urine organic acids analysis

Question 37

A child with failure to thrive and a history of recurrent infections is at an increased risk for:

Accepted Answer

Immunodeficiency

Answer

Cardiac disease

Answer

Metabolic disorder

Answer

Neurological disorder

Question 38

The most prevalent cause of short stature in children is:

Accepted Answer

Constitutional growth delay

Answer

Growth hormone deficiency

Answer

Turner syndrome

Answer

Prader-Willi syndrome

Question 39

The growth chart utilized for assessing growth in children in the United States is the:

Accepted Answer

Centers for Disease Control and Prevention growth chart

Answer

World Health Organization growth chart

Answer

British growth chart

Answer

National Health Service growth chart

Question 40

What is a potential long-term impact of untreated growth disorders on the musculoskeletal system?

Accepted Answer

Scoliosis

Answer

Growth hormone deficiency

Answer

Improved bone density

Question 41

A 2-year-old boy presents with poor weight gain and failure to thrive despite a normal birth history and achievement of developmental milestones. Physical examination reveals a thin child with sparse hair and an enlarged liver (hepatomegaly). Which of the following is the most likely diagnosis?

Accepted Answer

Kwashiorkor

Answer

Cystic fibrosis

Answer

Iron deficiency anemia

Answer

Marasmus

Question 42

A 10-year-old girl presents with delayed puberty and her height is below the 5th percentile for her age. Physical examination reveals normal female physical characteristics.  Which of the following is the most likely cause of her short stature?

Accepted Answer

Constitutional delay of growth and puberty

Answer

Growth hormone deficiency

Answer

Turner syndrome

Answer

Hypothyroidism

Question 43

A 7-year-old boy is brought to the clinic by his parents concerned about his height. He is at the 10th percentile for height, but has been growing at a normal rate. His parents are both tall. Which of the following is the most appropriate next step in management?

Accepted Answer

Reassurance and continued monitoring

Answer

Genetic testing for skeletal dysplasias

Answer

Endocrine evaluation for hormonal deficiencies

Answer

Growth hormone therapy

Question 44

A 4-year-old girl presents with early breast development, pubic hair, and advanced bone age. Which of the following is the most likely diagnosis?

Accepted Answer

Precocious puberty

Answer

Adrenal tumor

Answer

Premature thelarche

Answer

Growth hormone excess

Question 45

A 3-year-old boy is evaluated for concerns about his growth. His weight is below the 5th percentile, and his height is at the 25th percentile. He has experienced recurrent respiratory infections and has a poor appetite. What is the most likely diagnosis?

Accepted Answer

Failure to thrive

Answer

Constitutional growth delay

Answer

Short stature

Answer

Precocious puberty

Question 46

A 10-year-old girl presents with a height below the 3rd percentile. Her pubertal development is normal, and she has no other significant medical history. What is the most likely cause of her short stature?

Accepted Answer

Idiopathic short stature

Answer

Growth hormone deficiency

Answer

Turner syndrome

Answer

Chronic kidney disease

Question 47

A 7-year-old boy presents with accelerated growth, advanced bone age, and early signs of puberty. Which of the following is the most likely diagnosis?

Accepted Answer

Precocious puberty

Answer

Constitutional delay of growth and puberty

Answer

Hypothyroidism

Answer

Growth hormone deficiency

Question 48

Which of the following is NOT a potential long-term complication associated with precocious puberty?

Accepted Answer

Increased risk of obesity

Answer

Early closure of growth plates

Answer

Short stature in adulthood

Answer

Advanced bone age

Question 49

A 4-year-old girl presents with recurrent urinary tract infections, failure to thrive, short stature, and low-set ears. Which of the following genetic syndromes is most likely?

Accepted Answer

Turner syndrome

Answer

Noonan syndrome

Answer

Klinefelter syndrome

Answer

Prader-Willi syndrome

Question 50

A 12-year-old boy presents with short stature and a history of delayed puberty. His family history includes other members with short stature. Which of the following is the most likely diagnosis?

Accepted Answer

Constitutional delay of growth and puberty

Answer

Growth hormone deficiency

Answer

Hypothyroidism

Answer

Chronic kidney disease

Question 51

What is the most appropriate initial investigation for a child suspected of having growth hormone deficiency?

Accepted Answer

Growth hormone stimulation test

Answer

Bone age assessment

Answer

Genetic testing

Answer

Thyroid function tests

Question 52

A 10-year-old girl with precocious puberty is being treated with a gonadotropin-releasing hormone (GnRH) analog. What is the primary mechanism of action of GnRH analogs in this case?

Accepted Answer

Suppression of gonadotropin secretion

Answer

Induction of puberty

Answer

Stimulation of growth hormone secretion

Answer

Direct inhibition of ovarian function

Question 53

Which of the following statements about the management of failure to thrive is FALSE?

Accepted Answer

Supplementation with vitamins and minerals is not necessary.

Answer

Nutritional counseling is essential.

Answer

Addressing underlying medical conditions is crucial.

Answer

Monitoring growth and development is important.