Endo Flashcards
3.2kg, phallus short and chordee, and urethra is visible at base of phallic strucutrre and has mass like testis in inguinal canal
Female CAH, B male CAH, C gonadal dysgensis D-turner E undervirilized male
undervirilized male
4yo M has pubic hair, tanner 3. His testis 2ml bilat. Testoerone 7.8 (n is 1.8) and bone age 7 yr A- central precocious, B CAH, C craniopharynioma D cushing, E premature adrenarche
B CAH,
4yo M has pubic hair, tanner 3. His testis 2ml bilat. Testoerone 7.8 (n is 1.8) and bone age 7 yr A- central precocious, B CAH, C craniopharynioma D cushing, E premature adrenarche
CAH
if bone age is advanced by more then 2 years, then think adrneal origin
- not premature adrenarche in this case cuz BA is advanced
15yo with lack of puberty. Height is third centile, pubic hair is tanner 1, and testis 6ml bilaterally. His bone age 12yo
MOST LIKELY - constituional growth delay (esp with the bone age delay)
6yo black girl, with breast and pubic hair with no vaginal bleeding.
a-Non classical CAH (should be JUST virilization if CAH)
b-Normal puberty onset given racial background
c-Autonomous functioning ovarian cyst
d- Central precocious puberty,
next test to confirm LH/FSH
Central precocious puberty,
Child has autoimmune thyroiditis, want to monitor therapeutic treatment of levo, how do you do this?
a) TSH
b) FT4
c) T4
d) Thyroid peroxisome
a) TSH
For adolescent girls, which would be the most concerning in terms of height velocity
a) Tanner stage 2, growing 6cm/year
b) Tanner stage 3, growing 4cm/year
c) Tanner stage 4, growing 5cm/year
d) Tanner stage 5, growing 1cm/year
Tanner 3 at 4 cm
Which of the following is most consistent with a boy who is tanner 3?
Increased axillary hair
Voice deepening
Pubic hair is becoming curly
pubic hair curly
10 year old girl with an enlarged thyroid, diffuse nontender. T4 6.6 TSH >50, thyroid antibodies positive. What is your next step in management?
- Start methimazole
- Order thyroid ultrasound
- Order radionuclide scan
- Start levothyroxine
tart levothyroxine
A 7 year old boy has had type 1 diabetes for the last 3 years. If this does not result in
excessive hypoglycemia, what should the target be for his HbA1C?
a. 6.5%
b. 7.0%
c. 7.5%
d. 8.0%
c. 7.5%
Goal
<6 : 8
6-12 :< 7.5
teens : <7
A neonate’s newborn screen shows a TSH of 45. What is the NEXT step in management?
a. Book a visit for a physical exam
b. Order a TSH + free T4
c. Order a radionuclide thyroid scan
Order a TSH + free T4
A 13yo boy has become more withdrawn over the last year and seems only interested in his
friends and his computer. He has difficulty waking up in the morning and seems tired. Which
is the next step in management?
a. TSH
b. Tox screen
c. Refer to psychology
a. TSH
6 yo girl is referred to you for short stature. She is growing on the 3rd %, weight on the 50%. Her physical exam is normal. Her growth velocity is 3 cm/year and her bone age is 4 years. What is the most likely diagnosis?
a. Growth hormone deficiency,
b. Turner syndrome
c. Achrondrodysplasia
a. Growth hormone deficiency,
Teenage girl with pigmented tongue, hyponatremia. What is the best way to make a definitive diagnosis? a. ACTH level b. AM cortisol c. ACTH stim test d. 17 OHP
c. ACTH stim test
A child is noted to be drinking ++ water and has very dilute urine. What is the most likely diagnosis?
a. Psychogenic polydipsia -
b. SIADH
c. Diabetes
psychogenic or diabetes
Psychogenic polydipsia - hyponatremia, low urine osmolality
b. SIADH - would have concentrated urine and decreased u/o with hyponatremia
c. Diabetes (DM would cause high SPecific gravity,
d. DI could give this picture..)
Male teen who is football player. Has gynecomastia, hepatitis, and jaundice. Most likely taking:
Anabolic steroids
Growth hormone
Creatine
anabolic
Father 175 cm. Mother 155 cm. What is Midparental height for a boy? 165 167 169 171
171
Best test for nutritional Vit D deficiency Ca 1,25 Vit D 25 Vit D PTH
25 vit D
Longer half life
calcitriol (1,25 OH Vit D-active form)
calcidiol is the 25 OH form that is stable (before kidney converts) and best TEST
A four year old girl presents with new onset diabetes mellitus. Her initial labs reveal a glucose of 18, pH 7.14, bicarb 11. Her neurologic examination and level of alertness are initially normal. However, after 2 hours of insulin infusion, she suddenly becomes lethargic and unresponsive. What is the most appropriate initial action?
1) Obtain bedside glucose reading
2) Draw calcium, magnesium and phosphate levels
3) Start IV antibiotics
4) Give mannitol
Obtain bedside glucose reading
A 6 yo girl with precious puberty symptoms (vaginal bleed, accelerated growth), multiple Cafe Au Lait, bone abnormalities. What to test to order?
a. Genetic test for NF1
b. Echo for rhabdomyoma
c. Screen for other endocrinopathy
screen for other-
McCune-Albright Syndrome (MAS) is a rare disorder defined as the triad of peripheral precocious puberty, irregular café-au-lait (“Coast of Maine”) skin pigmentation, and fibrous dysplasia of bone
This mutation leads to continued stimulation of endocrine function (eg, precocious puberty, thyrotoxicosis, gigantism or acromegaly, Cushing syndrome, and hypophosphatemic rickets)
