endo Flashcards

1
Q

markers in type 1 DM

A

islet cell antibodies, antibodies to glutamic acid decarboxylase, islet cells and insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

features type 1 DM

A

2 peaks- pre school and teenagers. children present - few weeks history of polyuria, polydipsia, weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

other features type 1 DM

A

enuresis, skin sepsis, candida, infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

late features type 1 DM

A

DKA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

features DKA

A

vomiting, dehydration, abdominal pain, Kussmauls breathing (hyperventilation),hypovolaemic shock, coma, death, drowsy, acetone breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

diagnosis type 1

A

random >11, glycosuria, ketonuria. fasting >7 or incr HbA1c

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

rapid acting insulin analogues

A

insulin lispro, glulisine, aspart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

long acting insulin analogues

A

detemir, glargine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

when should you give short acting regular insulin before meals

A

15-30 mins before meal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

why should you rotate injection sites with insulin

A

prevent lipohypertrophy or lipoatrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

onset rapid acting insulin

A

30-60m

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

onset long acting insulin

A

1-2h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the insulin regimens

A

basal bolus or continuous pump

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how does basal bolus work

A

3x daily short acting boluses, 1x long acting bolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what happens first in puberty for girls

A

breast development- 8.5-12.5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

when does pubic hair growth and rapid height spurt occur (female)

A

after breast development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

when does the menarche occur

A

2.5 years after puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what happens first in puberty for males

A

testicular enlargement >4ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what follows testicular enlargement

A

pubic haisr- 10-14 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

when does height spurt occur in males

A

testicular vol 12-15ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what causes closure of the growth plates

A

sex hormones- females have their height spurt earlier when have menarche so stop growing after that, whereas males continue growing for a while and then have their growth spurt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is short stature

A

height below 2nd centile or 0.4th (3rd)

23
Q

causes of short stature

A

familial, IUGR, extreme prem, constitutional delay of growth and puberty, endo- hypothyroid, decr GH, decr IGF1, steroid excess, nutritional deficiency, chronic illness, psychosocial deprivation, chromosomal

24
Q

GH treatment

A

biosynthetic GH, recombinant IGF1

25
Q

investigations in short stature

A

X ray wrist and hand for bone age, FBC (anaemia, crohns), creat and electrolytes, ca, po, alp, TSH, karyotype, endomysial and anti TTG (coeliac), CRP and ESR, IGF1, 0900 cortisol and dexamethasone suppression test

26
Q

causes of tall stature

A

obesity, hyperthyroid, excess sex steroids, excess adrenal androgen steroids, gigantism. marfans, klinefelter, maternal diabetes, primary hyperinsulinism, beckwith syndrome

27
Q

when does the posterior fontanelle close

A

8 weeks

28
Q

when does the anterior fontanelle close

A

12-18 months

29
Q

what is microcephaly

A

head circumference

30
Q

causes microcephaly

A

familial, autosomal recessive condition, congenital infection, after insult to the brain

31
Q

what is macrocephaly

A

> 98th centile head circumference

32
Q

causes macrocephaly

A

tall stature, familial, incr ICP, hydrocephalus, chronic subdural haematoma, tumour

33
Q

how old are you to be delayed puberty

A

14 years females, 15 years male

34
Q

causes of delayed puberty

A

constitutional delay in growth and puberty; low gonadotrophin release, high gonadotrophin release

35
Q

what can cause low gonadotrophin release

A

systemic- CF, crohns, anorexia, excess physical activity. hypothalamic- pituitary disorders-panhypopituitarism, tumour

36
Q

what can cause high gonadotrophin release

A

chromosomal, steroid hormone enzyme deficiencies, acquired damage- surgery, chemo,radio

37
Q

what are the two mechanisms for precocious puberty

A

gonadotropin dependent- premature activation of the axis. gonadotropin independent- excess sex steroids

38
Q

when is the growth spurt females

A

12 years

39
Q

when is the growth spurt males

A

14 years

40
Q

staging of breast development

A

BI- prepubertal; BII- breast bud; BIII- smooth contour; BIV- areola and papillae project above breast; BV- adult

41
Q

staging pubic hair growth male and female

A

PHI- pre pubertal; PHII- sparse pigmented long straight along labia or base of penis; PHIII- dark coarser curlier; PHIV- filling out towards adult distribution; PV- adult

42
Q

staging genital development male

A

GI- preadolescent, GII- lengthening of penis, GIII- further growth in length and circumference, GIV- glans penic, scrotal skin darkening; GV- adult genitalia

43
Q

is an organic cause more likely in males or females for precocious puberty

A

more likely in males

44
Q

causes precocious puberty females

A

familial, idiopathic. organic causes- dissonance, rapid onset, neuro signs eg neurofibromatosis

45
Q

causes precocious puberty males

A

intracranial tumour, gonadotropin release, small testes- adrenal cause, unilat- gonadal tumour

46
Q

age of precocious puberty in females

A

8

47
Q

age of precocious puberty in males

A

9

48
Q

gonadotropin dependent causes of precocious puberty

A

CNS abnormalities- hydrocephalus, infection, tumours; hypothyroid

49
Q

gonadotropin independent causes of precocious puberty

A

adrenal- tumours, congenital adrenal hyperplasia; ovarian and testicular tumours; exogenous sex steroids

50
Q

management precocious puberty

A

GnRH analogues for dependent, inhibitors of sex steroids in independent

51
Q

what is the term for prem breast development

A

thelarche

52
Q

when does thelarche take place

A

6m-3y. doesn’t pass stage 3. absence axillary and pubic hair growth and growth spurt. self limiting

53
Q

what is premature pubarche (adrenarche)

A

pubic hair develops