endocrine

Question 1

how much should children grow?

Answer 1

2 inches per year between 3 and puberty

Question 2

how tall should a kid be?

Answer 2

when kids stop growing they are within4 inches of their mid-parental height

Question 3

what history should make you think hypopituitarism?

Answer 3

hypoglycemia
prolonged jaundice
cryptorchidism
microphallus

Question 4

normal upper to lower body ratios

Answer 4

birth - 1.7
3yo - 1.3
>7 - 1

Question 5

familial short stature - define

Answer 5

normal bone age and normal onset of puberty - but at least 2sd below MPH

Question 6

constitutional short stature

Answer 6

at least 2sd and delayed bone age and late onset puberty

Question 7

proportionate short

Answer 7

less than 2inches a year but ratio is normal

Question 8

disproportational short - cuases

Answer 8

rickets and skeletal dysplasia

Question 9

craniopharyngeoma - when to consider

Answer 9

if older than 5 years and not growing 2 inches per year

Question 10

gh deficiency clinical

Answer 10

prolonged neonatal jaundice,
hypocalcemia
central obesity
microphallus 
cryptorchidism
midline defect

Question 11

what to do if delayed bone age

Answer 11

image study of brain

Question 12

mc- cune albright

Answer 12

bony changes, skin finding, cafe au lait and endocrinography

Question 13

lawrence-moon biedl syndrome

Answer 13

obesity, retinits pigmentosa, hypogonadism and polysyndactyly

Question 14

hypergonadotropic hypogonadism - causes

Answer 14

kleinfelter
turner
autoimmune- hashimottos

Question 15

waterhouse- friderichsen syndrome

Answer 15

adrenal hemorrhage in neonates

Question 16

how to detect low cortisol?

Answer 16

random value of >20 - in the presence of stress excludes adrenal insufficiency

Question 17

ACTH stimulation test -

Answer 17

baseline level vs. 1 hr after injection of ACTH
normally cortisol should double
if blunted response then adrenal insufficiency

Question 18

cushing disease

Answer 18

excessive gucocorticoid production caused by excessive ACTH production by a pituitary tumor

Question 19

typoe 1 DM genetics

Answer 19

HLA haplotype DR3 or DR4

Question 20

Type 1 DM antibody

Answer 20

85% will have islet cell antibodies

Question 21

somogyi phenomenon

Answer 21

high glucose in the AM and ketones in urine bc the previous night too much insulin so body secreted cortisol and and epinephrne - therefore trx is to reduce the night time cortisol

Question 22

presentation of DM 2

Answer 22

asymptomatic - mild DKA
obesity
acanthosis nigricans

Question 23

pendred syndrome

Answer 23

causes early hearing loss in children. It also can affect the thyroid gland and sometimes may affect a person’s balance.
organification defect -

Question 24

PTH

Answer 24

will maintain serum ca
release cal from bone and reabsorb ca from kidneys
release phos from bone and excrete phos from kidney

Question 25

1alpha-hydroxylase vit. D.

Answer 25

converte 25-OH to active vvit. D (1,25 OH) which is stimulated by PTH

Question 26

1, 25Oh in the gut?

Answer 26

will absrob cal in intestines