Endocrine Flashcards
role of PTH
made by chief cells
causes high calcium
activates vitamin D
release is dependent on Mg
turners syndrome hormones
hypergonadotropic hypogonadism
abnormal ovaries
high FSH and LH, low oestrogen
give exogenous oestrogen
BM for hypoglycaemia
<2.6
3 features of McCune Albright
1) fibrous bone dysplasia
2) cafe au lait spots
3) precocious puberty
Turner’s syndrome + virilisation=
Y chromosome material = gonadoblastoma risk
CAH inheritance and pathophysiology
autosomal recessive
overproduction of androgens
underproduction of mineralocorticoids and gluclocorticoids
DI urine and blood results
dilute urine
hypernatraemic hypovolaemia
C peptide production
low in T1DM
high in T2DM
first signs of puberty
breast buds in F
testicular enlargement >4mm in M
bone age in thyroid disease
delayed in hypothyroid
advanced in Hashimotos (Ab like FSH)
advanced in hyperthyroid
DKA initial bolus
10ml/kg for all children (no K+)
<15 mins if shocked
<30 mins if not shocked
DKA further fluids
deficit (% x kg x 10) + maintenance/ 48
include K+
subtract bolus unless shocked
when to start and stop IV insulin
start after 1-2 hours of fluids
stop when E+D and ketones <1 and 30 mins of SC insulin completed
when to add glucose to fluids in DKA
BM <14
FSH and LH in AIS
FSH normal
LH high
AIS karyotype
46XY
how can CAH be treated in utero
give dex to oppose androgens effect on genitals
fast growth in CAH
inadequate treatment (high androgens drive growth)
Kallman’s hormones
low GnRH causes low LH and FSH
pathophysiology of discordant puberty
GnRH independent
peripherally driven
overactive androgens
presentation of discordant puberty
breast or penile enlargement
small testes
no pubic hair
adrenal medulla hormones
noradrenaline
adrenaline
dopamine
thyroid in Turner’s
low (Hashimoto’s)
Diagnosis of delayed puberty
No testicular enlargement by 14
No breast buds by 13
No periods by 15
tests for growth hormone deficiency
insulin tolerance test
glucagon stimulation test
adrenal crisis U+Es
high potassium
low sodium
high renin
neck swelling that moves on tongue protrusion
thyroglossal cyst
USS to r/o ectopic thyroid tissue
DKA pH and bicarb limits
Mild: pH 7.2-7.29, bicarb 10-15
Moderate: pH 7.19-7.2, bicarb 5-10
Severe: pH <7.19, bicarb <5
assumed dehydration levels in DKA
mild and moderate 5%
severe 10%
which hypo cut off to use
2.6 normally
4 in diabetics
contents of annual review for T1DM
TFTs and HbA1c
bp and urinary A:Cr and retinopathy for 12yo+
Ix for rickets
bloods and XR long bone
rickets in vegans
offer lichen based colecalciferol or vit D2 (ergocalciferol) instead
type 1 vs type 2 vitamin d dependent rickets
type 1 has low 1,25
type 2 has high 1,25
both have low calcium and secondary hyperparathyroidism
