Growth and Nutrition Chapter 8 Examination and Findings M1-Tanner 1-4

M1 = Only the nipple is raised above the level of the breast M2 = Budding stage; bud-shaped elevation of the areola M3 = Breast and areola enlarged; no contour separation M4 = Increasing fat deposits; areola forms a secondary elevation above that of the breast

Normal variant in both males and females = May be accompanied by a lag of stature growth Deliberate consequence of puberty blockers in transgender youth = Usually occurs over a different time span

Tanner 1 = Preadolescent; only the nipple is raised above the level of the breast Tanner 2 = Budding stage; bud-shaped elevation of the areola Tanner 3 = First signs of enlargement; no contour separation Tanner 4 = Increased fat deposits; secondary mound above the breast

Causes delayed onset of puberty = May result in a different time span for pubertal changes Often a deliberate choice = Accompanied by a lag in stature growth

Tanner 1 = Testes, scrotum, and penis are the same size and shape as in the young child Tanner 2 = Enlargement of scrotum and testes; the skin of the scrotum becomes redder, thinner, and wrinkled Tanner 3 = Enlargement of the penis, especially in length; further enlargement of testes; descent of scrotum Tanner 4 = Continued enlargement of the penis and sculpturing of the glans; increased pigmentation of scrotum; sometimes described as 'not quite adult'

Acromegaly = A rare disease of excessive growth and distorted proportions caused by hypersecretion of growth hormone and insulin-like growth factor after closure of the epiphyses Causes of Acromegaly = Most common cause is a benign pituitary adenoma or other rare tumor; familial syndromes like multiple endocrine neoplasia type 1 and McCune-Albright syndrome Effects of Growth Hormone Excess = Slow skeletal growth and soft tissue enlargement Common Age Group for Acromegaly = Most common in middle-aged adults

42.4% = Obesity rate for men 43.3% = Obesity rate for women 40% = Obesity rate for both genders combined 45% = Obesity rate for individuals over 70 years old

LH and FSH = Suppression of sex hormone secretion Testosterone and Estrogen = Release of sex hormones Gonadotropin-releasing hormone (GnRH analogs) = Suppressing LH and FSH secretion Body's natural GnRH hormone = Synthetic form in puberty blockers

Decrease of facial and body hair growth in males = Male at birth identification Prevention of voice deepening in males = Male at birth identification Stoppage of breast development in females = Female at birth identification Delay or stoppage of menstruation in females = Female at birth identification

Puberty blockers affect acne development = Incorrect statement Puberty blockers affect body odor development = Incorrect statement Puberty blockers affect axillary and pubic hair development = Incorrect statement Puberty blockers affect primary and secondary sex characteristics = Correct statement

Limiting the growth of genitalia in males = Puberty suppression effect Stopping breast development in females = Puberty suppression effect Delaying or stopping voice deepening in males = Puberty suppression effect Preventing widening of the hips in females = Puberty suppression effect

P1—Tanner 1 = No growth of pubic hair P2—Tanner 2 = Initial, scarcely pigmented straight hair, especially along medial border of the labia P3—Tanner 3 = Sparse, dark, visibly pigmented, curly pubic hair on labia P4—Tanner 4 = Hair coarse and curly, abundant but less than adult

BMI 19.8-26.0 = 11.5 to 16 kg (25 to 35 lb) BMI 26.1-29.0 = 9 to 11.5 kg (20 to 25 lb) BMI 29.1-34.9 = 7 to 11.5 kg (15 to 25 lb) BMI >35 = 5 to 9 kg (11 to 20 lb)

Patient's prepregnancy BMI of 21.5 = Recommended weight gain: 11 kg Patient's prepregnancy BMI of 28.2 = Recommended weight gain: 10 kg Patient's prepregnancy BMI of 32.0 = Recommended weight gain: 8 kg Patient's prepregnancy BMI of 36.8 = Recommended weight gain: 6 kg

Tanner 5 = Lateral spreading; type and triangle spread of adult hair to medial surface of thighs Tanner 6 = Further extension laterally, upward, or dispersed (occurs in only 10% of women) Tanner 2 = Initial, scarcely pigmented straight hair, especially along medial border of the labia Tanner 3 = Sparse, dark, visibly pigmented, curly pubic hair on labia

25 - 29.9 = Overweight 30 - 34.9 = Obese 18.5 - 24.9 = Normal weight < 18.5 = Underweight

Weight (kg) / Height (m)^2 = BMI Calculation Height (cm) x 0.01 = Conversion of Height to meters Weight (lb) x 0.45 = Conversion of Weight to kilograms Height (in) x 0.0254 = Conversion of Height to meters

First trimester = 1.4 to 2.7 kg (3 to 6 lb) Second trimester = 0.23 to 0.45 kg (0.5 to 1 lb) per week Third trimester = Postpartum period =

Gestational hypertension, preeclampsia = Obese patients Gestational diabetes, cesarean delivery = Inadequate weight gain = High-birth-weight infant =

Appearance of pubic hair along midline, adult pattern of chest hair, facial hair growth fully developed. = Tanner stage 5 Initial enlargement of scrotum and testes; reddening and thinning of scrotum skin. = Prepubertal: no pubic hair, genitalia same as childhood. = Break voice, growth of penis length, testicular volume increases, slight reddening and changing texture of scrotum. =

Areola and papilla form secondary mound; no separation between contours of breast and areola. = Projection of papilla only; areola follows general contour of breast. = Elevation of papilla only. = Secondary mound forms but no separation between breast and areola; enlargement of areola and papilla forming secondary mound. = Tanner stage 4

Low-birth-weight infant risk = High-birth-weight infant risk = Difficult delivery risk = Optimal infant birth weight risk =

Underweight related to cancer diagnosis or treatment side effects = Underweight related to malnutrition or social issues affecting food access = Underweight related to muscle loss due to aging or chronic illness = Underweight related to medication side effects impacting appetite or metabolism =