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Pediatrics > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Most common presenting complaint to pediatric endocrinologist

A

growth disturbances

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2
Q

fetal growth dependent on

A

maternal factors

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3
Q

late infancy growth dependent on

A

GH/IGF-1 axis and thyroid hormone

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4
Q

pubertal growth dependent on

A

sex hormones as well as GH/IGF-1 axis and the thyroid gland

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5
Q

define short stature

A

height less than 3% on growth chart

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6
Q

endocrine causes of short stature

A

growth hormone deficiency or resistance
hypothyroid
diabetes mellitus

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7
Q

Decreased growth velocity, delay in skeletal maturation. Short stature (below 5th percentile), grows normally for first year but drops off during the 2nd. Height may be more retarded than weight

A

growth hormone deficiency

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8
Q

most common form of growth hormone deficiency

A

idiopathic

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9
Q

treat GH deficiency

A 
correct underlying disease
replace GH (only for FDA approved conditions
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10
Q

what do you worry about with excessive GH secretion (rare)

A

pituitary adenoma

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11
Q

most common cause of hypothyroid in childhood. Most common cause of goiter and thyroiditis

A

Hashimotos thyroiditis (autoimmune thyroiditis)

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12
Q

most common neonatal metabolic disorder

A

congenital hypothyroid

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13
Q

treat hashimoto

A

levothyroxine (not if euthyroid)

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14
Q

who has increased incidence of hashimoto

A

trisomy 21, turners

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15
Q

physical and mental sluggishness, pale, gray, cool mottled skin. Non pitting edema, constipation, large tongue, poor muscle tone, lordosis, bradycardia, hoarse cry or voice, skin dry, coarse, scaly, yellowish. Lateral thinning of eyebrows

A

hypothyroid

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16
Q

most common cause of hyperthyroidism in kids

A

graves

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17
Q

nervousness, emotional lability, hyperactivity, weight loss. Insomnia, personality changes, diarrhea ,palpitations, heat intolerance,tremor, increased sweating

A

hyperthyroid (graves)

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18
Q

labs for graves

A

TSH low

FT4, T3, T4 elevated

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19
Q

labs for hashimoto

A

T3, T4, and FT4 decreased. TSH elevated

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20
Q

treat hyperthyroid

A

beta blocker, antithyroid meds (PTU, methimazole)

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21
Q

this is more common in girls. Younger than 8 years old

A

precocious puberty (central idiopathic precocity)

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22
Q

central precocious puberty

A 
CNS abnormality (tumor)
familial
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23
Q

peripheral precocious puberty

A

ovarian cyst, adrenal tumors, CAH

24
Q

adrenarche – pubic hair, axillary hair, acnea, some increased body odor

A

adrenal tumor

25
Q

Symptoms of estrogen excess – breast development and vaginal bleeding

A

ovarian cysts or tumors

26
Q

treat central precocious puberty

A

GnRH analog- Leuprolide

27
Q

boys- pseudoprecocious puberty

A

peripheral stimulation, GnRH independent, small testes

28
Q

boys- true precocious puberty

A

central stimulation, GnRH dependent, large testes

29
Q

define delayed puberty in boys and girls

A

boys 14 no signs, girls 13 no signs

30
Q

primary hypogonadism

A

absence / malfunction/ destruction of ovarian or testicular tissue

31
Q

central hypogonadism

A

pituitary or hypothalamic dysfunction (panhypopituitarism, CNS tumor, gonadotropin deficiency)

32
Q

most common cause of delayed puberty in boys

A

Kleinfelter syndrome

33
Q

labs for primary vs central hypogonadism

A

primary: LH, FSH elevated
central: LH, FSH low

34
Q

treat hypogonadism

A

sex steroid replacement

35
Q

most common cause of female virilization, pseudohermaphrodite

A

CAH

36
Q

most frequent cause of ambiguous genitalia in the newborn

A

CAH

37
Q

labs for CAH

A

elevated 17 OH, deficiency of 21 hydroxylase, electrolyte imbalances

38
Q

treat CAH

A

hydrocortisone, mineralcorticoid

39
Q

most common etiology of CAH

A

deficiency of 21 hydrocylase

40
Q

adrenal insufficiency

A

uncommon
CAH
autoimmune destruction (Addisons)

41
Q

adrenal excess

A

uncommon, Cushings

Exogenous steroids most common cause of cushings in children

42
Q

test for adrenal insufficiency

A

ACTH stim test

43
Q

treat adrenal insufficiency

A

replace hydrocortisone, fludrocortisone

44
Q

Truncal adoposity with thin extremities, moon facies, muscle wasting, weakness, easy bruising, purplish striae
HTN, osteoporosis, glycosuria, hyperglycemia

A

Cushing’s syndrome

45
Q

test for cushings

A

urinary cortisol level

dexamethasone suppression test

46
Q

type I DM

A

insulin dependent, juvenile diabetes or IDDM

47
Q

most common type of DM in children

A

type I (this is almost not true anymore)

48
Q

what other endocrine system would you check in a kid with type I DM

A

thyroid (hypothyroid can be associated)

49
Q

treat type I DM

A

insulin, diet,exercise, stress management, glucose monitoring

50
Q

triad type I DM

A

polyuria
polydipsia
polyphagia

51
Q

ancanthosis nigricans

A

changes in skin related to type II DM

52
Q

type II DM

A

“Non-insulin dependent” – insulin resistance and insulin insensitivity

53
Q

type II DM has an association with this syndrome

A

polycystic ovarian syndrome

54
Q

what do children die from in DKA

A

cerebral edema

55
Q

ketone effect on serum pH

A

lower (the produce free hydrogen ions)

56
Q

treat DKA

A

replace fluid
insulin
replace body salts
correct acidosis

Pediatrics (15 decks)

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