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Endocrine Week 4 2017/18 > 3: Paediatric aspects of diabetes and endocrinology > Flashcards

3: Paediatric aspects of diabetes and endocrinology Flashcards

1
Q

What type of diabetes is common in children?

A

Type 1 diabetes

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2
Q

In what emergency situation can children be newly diagnosed with Type 1 diabetes?

A

DKA

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3
Q

Type 1 diabetes in children has a strong ___ component.

A

genetic

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4
Q

What sort of precipitating event can trigger Type 1 diabetes in children?

A

Viral illness

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5
Q

In the pre-diabetes change, what biochemical abnormality can be detected in children?

A

Production of islet cell autoantibodies

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6
Q

What are the signs of hyperglycaemia in children?

A

Four Ts

tired

thirsty

toilet (bedwetting)

thin (weight loss)

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7
Q

What are major signs of DKA in children?

A

Vomiting

Abdominal pain

Kussmaul breathing +/- pear drop breath

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8
Q

A fasting blood glucose of over ___ mmol/L is diagnostic of Type 1 diabetes.

A

7 mmol/L

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9
Q

A random blood glucose of over __ mmol/L is diagnostic of diabetes.

A

11.0 mmol/L

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10
Q

Apart from symptoms, what do you need to diagnose a child with DKA?

A

pH < 7.3

Ketonuria

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11
Q

What is a fatal complication of DKA in children?

A

Cerebral oedema

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12
Q

What is the most common symptom of new onset diabetes in children?

A

Bedwetting

(noctural enuresis)

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13
Q

What tests would you perform on a child who you suspect has diabetes?

A

Random blood glucose

Urinalysis

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14
Q

As cerebral oedema is a fatal complication of DKA in children, what must be administered carefully?

A

Fluids

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15
Q

In DKA, fluids and insulin are administered based on the ___ of the child.

A

weight

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16
Q

In DKA of patients under 18 years, when is insulin given?

A

1 hour after fluids

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17
Q

A goal of diabetes treatment in children is ensuring they have normal ___ and development and their education isn’t disrupted.

A

normal growth and development

normal education

18
Q

What are the HbA1c targets in children?

A

< 48 mmol/mol in first year after diagnosis

< 58 mmol/mol thereafter

Obviously the lower the better

19
Q

What microvascular screens are done for children in diabetes clinics?

A

BP

Retinal screening

Urinalysis

20
Q

What are the blood glucose targets

a) before meals
b) 2hrs after meals
c) at bedtime?

A

a) Before meals: 4-7 mmol/L

b) After meals: 5-9 mmol/L

c) Bedtime: 4-7 mmol/L

21
Q

What type of insulin therapy are children with Type 1 diabetes offered?

A

CSII

(insulin pump)

22
Q

What new technology avoids the use of skin prick tests to measure blood glucose?

A

Glucose sensor

23
Q

What thyroid abnormalities may babies be born with?

A

Dysplastic, absent or abnormal-site thyroids

24
Q

Congenital thyroid diseases may also be caused by problems with the ___ gland.

A

pituitary gland

25
Q

What are some signs of congenital thyroid disease?

A

Delayed jaundice

Poor feeding, normal weight gain

Hypotonia (reduced muscle strength)

Skin and hair changes

26
Q

Which general test is carried out on Day 5 after birth to diagnose a variety of diseases in babies?

A

Guthrie test

27
Q

Where can ectopic thyroid be found?

A

Sublingual

28
Q

What is the result of untreated hypothyroidism in babies?

29
Q

What are some signs of hypothyroidism in children?

A

Slow growth, delayed puberty

Poor general health

Learning difficulties

30
Q

What will a thyroid function test look like in a hypothyroid child?

A

High TSH

Low T3/T4

31
Q

How is paediatric hypothyroidism treated?

A

Levothyroxine

32
Q

What are some signs of hyperthyroidism in children?

A

Behavioural problems, sleep disturbance

Goitre

Face, eye signs

Tachycardia, palpitations

Early puberty

33
Q

What will a thyroid function test look like in a hyperthyroid child?

A

Low TSH

High T3/T4

34
Q

How is paediatric hyperthyroidism treated?

A

Beta blocker for autonomic symptoms

Anti-thyroid drugs - e.g carbimazole

+/- Radio-iodine, surgery

35
Q

What is the most common primary cause of underactive adrenal glands in children?

A

Congenital adrenal hyperplasia

36
Q

What is the most common secondary cause of underactive adrenal glands in children?

A

Pituitary disease

High dose steroid therapy

37
Q

What is overproduction of steroids by the adrenal glands caused by?

A

Cushing’s disease / syndrome

38
Q

Children with adrenal problems will present with overly ___ features.

A

masculinised

39
Q

Problems with the hypothalamic-pituitary-gonadal axis e.g in congenital adrenal hyperplasia can produce ___ genitalia in children.

40
Q

What are some causes of ambiguous genitalia in children?

A

Congenital adrenal hyperplasia

Genetic disease

Congenital defects

41
Q

How is the sex confirmed when a baby has ambiguous genitalia?

A

Karyotyping

Endocrine Week 4 2017/18 (10 decks)

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