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3rd Year - Paediatrics > 17. Paediatric Endocrinology and Diabetes > Flashcards

17. Paediatric Endocrinology and Diabetes Flashcards

1
Q

What Factors influence Height?

A
  1. Age / Skeletal Maturity (Bone Age) / Puberty
  2. Sex / Race / Parental Heights
  3. General Health - Nutrition / Chronic Disease
  4. Specific Growth Disorders
  5. Socio-Economic Status
  6. Emotional Well-Being
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2
Q

What are the Different Techniques for Measuring Height?

A
  1. Length
  2. Height
  3. Sitting Height
  4. Head Circumference
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3
Q

What needs to be looked for in a Paediatric History / Further Examination?

A
  1. Birth Weight and Gestation
  2. Past Medical History
  3. Family / Social History / Schooling
  4. Systemic Enquiry
  5. Dysmorphic Features
  6. Systemic Examination - including Pubertal Assessment
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4
Q

What are the Assessment Tools used to Assess Growth?

A
  1. Height / Length / Weight
  2. Growth Charts and Plotting
  3. Mean Parental Heights / Target Centiles
  4. Growth Velocity
  5. Bone Age
  6. Pubertal Assessment
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5
Q

What are the Indications for Growth Disorder Referral?

A
  1. Extreme Short / Tall Stature
  2. Height Below Target Height
  3. Abnormal Height Velocity
  4. History of Chronic Disease
  5. Obvious Dysmorphic Syndrome
  6. Early / Late Puberty
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6
Q

What are the Common Causes of Short Stature?

A
  1. Familial
  2. Constitutional
  3. Small for Gestational Age
  4. Intra-Uterine Growth Restriction
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7
Q

What are the Pathological Causes of Short Stature?

A
  1. Undernutrition
  2. Chronic Illness - JCA / IBD / Coeliac
  3. Iatrogenic - Streoids
  4. Psychological and Social
  5. Hormonal - GHD / Hypothyroidism
  6. Syndromes - Turners / Prader-Willi
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8
Q

What does a Full Blood Count and Ferritin look for?

A
  1. General Health
  2. Coeliac Disease
  3. Crohn’s Disease
  4. Juvenile Chronic Arthritis
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9
Q

What does a U&E’s / LFT’s / Ca / CRP look for?

A
  1. General Health
  2. Renal and Liver Disease
  3. Disorders of Ca Metabolism
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10
Q

What is Coeliac Serology and IgA looking for?

A

Coeliac Disease

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11
Q

What does a IGF-1 / TFT / Prolactin / Cortisol look for?

A

Hormone Disorders

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12
Q

What does a Karyotype Look for?

A

Turner’s Syndrome

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13
Q

What is included in the Tanner Method of Puberty Staging?

A
  1. Breast Development - 1 to 5
  2. Genital Development - 1 to 5
  3. Pubic Hair Development - 1 to 5
  4. Axillary Hair Development - 1 to 3
  5. Testis - 2ml to 20mls
  6. SO - e.g. Statement as B3 PH3 / G2 PH2 6/6
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14
Q

What is Early (a) / Delayed (b) Puberty for:

  1. Boys?
  2. Girls?
A
  1. a) Early Boys - < 9 years - Rare
  2. b) Late Boys - > 14 years - common,
  3. a) Early Girls - <8 years
  4. b) Late Girls - > 13 years - Rare
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15
Q

What are the Features of Constitutional Delay of Growth and Puberty (CDGP)?

A
  1. Boys Mainly
  2. Family History in Dad / Brothers
  3. Bone Age Delay
  4. Need to Exclude Organic Disease
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16
Q

What are Causes of Constitutional Delay of Growth and Puberty (CDGP)?

A
  1. Gonadal Dysgenesis - Turner (45X) / Klinefelter (47XXY)
  2. Chronic Disease - Crohn’s / Asthma
  3. Impaired Hypothalamic-Pituitary-Gonadal (HPG) Axis:
  4. a) Septo-Optic Dysplasia
  5. b) Craniopharyngioma
  6. c) Kallman’s Syndrome
  7. Peripheral - Cryptorchidism / Testicular Irradiation
17
Q

What is the cause of Early Breast Development?

A

Hypothalamic Activation:

  1. Infantile Thelarche
  2. Thelarche Variant - Premature Thelarche
  3. Central Precocious Puberty
18
Q

What is the cause of Early Secondary Sexual Characteristic Development?

A

Sex-Steroid Hormone Secretion:

  1. Exaggerated Adrenarche
  2. Precocious Pseudopuberty - Congenital Adrenal Hyperplasia
19
Q

What is the cause of Early Per-Vaginal Bleeding?

A

Premature Menarche

20
Q

What are the Features of Central Precocious Puberty?

A
  1. Pubertal Development - Breasts / Testicular
  2. Growth Spurt
  3. Advanced Bone Age
    Note - Need to Exclude a Pituitary Lesion
21
Q

What are the Features of Precocious Pseudopuberty?

A
  1. Abnormal Sex-Steroid Hormone Secretion
  2. Gonadotrophin Independent - Low / Prepubertal Levels of LH and FSH
  3. Clinical Picture - Secondary Sexual Characteristics
    Note - Need to Exclude Congenital Adrenal Hyperplasia
22
Q

What are the Features of Congenital Hypothyroidism?

A
  1. Caused by:
  2. a) Athyreosis / Hypoplastic / Ectopic
  3. b) Dyshormonogenic
  4. Newborn Screening
  5. Start Treatment within the First 2 Weeks
23
Q

What are the Features of Acquired Hypothyroidism?

A
  1. Autoimmune Thyroiditis - Most Common Cause
  2. Family History of Thyroid / Autoimmune Disorders
  3. Childhood Issues:
  4. a) Lack of Height Gain
  5. b) Pubertal Delay
  6. c) Poor School Performance
24
Q

What is assessed in an Obese Child?

A
  1. Weight
  2. Body Mass Index (BMI) - Kg/m^2
  3. Height
  4. Waist Circumference
  5. Skin Folds
  6. History and Examination
  7. Complications
25
Q

What should be looked for / at in an Obese Child?

A
  1. Diet / Physical Activity
  2. Family History
  3. Symptoms Suggestive of:
  4. a) Syndrome
  5. b) Hypothalamic-Pituitary Pathology
  6. c) Endocrinopathy
  7. d) Diabetes
  8. Drug History
26
Q

What are the Symptoms of Diabetic Ketoacidosis?

A
  1. Nausea and Vomiting
  2. Abdominal Pain
  3. Sweet Smelling, Ketotic Breath
  4. Drowsiness
  5. Rapid, Deep, Sighing Respiration
  6. Coma

3rd Year - Paediatrics (40 decks)

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