Pine trees that are too tall or too short do not do as well as pine trees that are average in height. The short trees do not get as much light as tall or average trees. The tall trees are more likely to break off in storms. Tell how this is an example of stabilizing selection.
Sample Solution
cause of weight gain. Majority of parents of obese children feel that their childâs weight gain is due to pathology and are oblivious to their life-style. A detailed dietary history with calculation of caloric intake would help convince them about the need for life style changes. 2) Anthropometry: Obtain a weight, height, calculate BMI and measure waist circumference (WC) if possible. Plot these measurements on respective charts for age and gender for the Indian population. BMI chart will classify the child as over-weight/obese and demonstrate the duration and rapidity of weight gain. Reduced height velocity suggests an endocrine problem whereas in exogenous obesity linear growth is normal. Waist Circumference (WC) is a good indicator of central adiposity and is a better predictor of metabolic syndrome (24,25), cardiovascular disease risk factors (26) and insulin resistance in children than BMI. A cut-off of 70th WC percentile is suggested to screen children for risk of MS in our population. WC is measured with the child standing using a non-stretchable tape applied horizontally just above the upper lateral border of the right ileum(27). Measurement is made at the end of a normal expiration and recorded to the nearest 0.1cm. Age- and sex-specific reference curves for WC for 2-18 year old Indian children are available by Khadilkar et al (18). 3) Clinical Examination: This includes assessment of vital signs especially measurement of Blood pressure with an appropriate size cuff. Look for dysmorphic features that would suggest a genetic syndrome. Cushingoid facies, hyperpigmented stretch striae and hypertension suggest cushingâs or exogenous steroid exposure. A hump on the back of neck and stretch striae may also be present in children with simple obesity. Dry skin or enlarged thyroid gland may suggest hypothyroidism and presence of acanthosis nigricans is an indicator of insulin resistance. Acne and hirsutism in girls could be due to PCOD. Shortening of 4th and 5th metacarpal should raise the suspicion of pseudohypoparathyroidism. Look for gynecomastia in males. Genital examination for Tanner staging & evaluation of early puberty should be done. Undescended testes in males could be associated with syndromic obesity.>
cause of weight gain. Majority of parents of obese children feel that their childâs weight gain is due to pathology and are oblivious to their life-style. A detailed dietary history with calculation of caloric intake would help convince them about the need for life style changes. 2) Anthropometry: Obtain a weight, height, calculate BMI and measure waist circumference (WC) if possible. Plot these measurements on respective charts for age and gender for the Indian population. BMI chart will classify the child as over-weight/obese and demonstrate the duration and rapidity of weight gain. Reduced height velocity suggests an endocrine problem whereas in exogenous obesity linear growth is normal. Waist Circumference (WC) is a good indicator of central adiposity and is a better predictor of metabolic syndrome (24,25), cardiovascular disease risk factors (26) and insulin resistance in children than BMI. A cut-off of 70th WC percentile is suggested to screen children for risk of MS in our population. WC is measured with the child standing using a non-stretchable tape applied horizontally just above the upper lateral border of the right ileum(27). Measurement is made at the end of a normal expiration and recorded to the nearest 0.1cm. Age- and sex-specific reference curves for WC for 2-18 year old Indian children are available by Khadilkar et al (18). 3) Clinical Examination: This includes assessment of vital signs especially measurement of Blood pressure with an appropriate size cuff. Look for dysmorphic features that would suggest a genetic syndrome. Cushingoid facies, hyperpigmented stretch striae and hypertension suggest cushingâs or exogenous steroid exposure. A hump on the back of neck and stretch striae may also be present in children with simple obesity. Dry skin or enlarged thyroid gland may suggest hypothyroidism and presence of acanthosis nigricans is an indicator of insulin resistance. Acne and hirsutism in girls could be due to PCOD. Shortening of 4th and 5th metacarpal should raise the suspicion of pseudohypoparathyroidism. Look for gynecomastia in males. Genital examination for Tanner staging & evaluation of early puberty should be done. Undescended testes in males could be associated with syndromic obesity.>
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