endocrine Flashcards
how much should children grow?
2 inches per year between 3 and puberty
how tall should a kid be?
when kids stop growing they are within4 inches of their mid-parental height
what history should make you think hypopituitarism?
hypoglycemia
prolonged jaundice
cryptorchidism
microphallus
normal upper to lower body ratios
birth - 1.7
3yo - 1.3
>7 - 1
familial short stature - define
normal bone age and normal onset of puberty - but at least 2sd below MPH
constitutional short stature
at least 2sd and delayed bone age and late onset puberty
proportionate short
less than 2inches a year but ratio is normal
disproportational short - cuases
rickets and skeletal dysplasia
craniopharyngeoma - when to consider
if older than 5 years and not growing 2 inches per year
gh deficiency clinical
prolonged neonatal jaundice, hypocalcemia central obesity microphallus cryptorchidism midline defect
what to do if delayed bone age
image study of brain
mc- cune albright
bony changes, skin finding, cafe au lait and endocrinography
lawrence-moon biedl syndrome
obesity, retinits pigmentosa, hypogonadism and polysyndactyly
hypergonadotropic hypogonadism - causes
kleinfelter
turner
autoimmune- hashimottos
waterhouse- friderichsen syndrome
adrenal hemorrhage in neonates
how to detect low cortisol?
random value of >20 - in the presence of stress excludes adrenal insufficiency
ACTH stimulation test -
baseline level vs. 1 hr after injection of ACTH
normally cortisol should double
if blunted response then adrenal insufficiency
cushing disease
excessive gucocorticoid production caused by excessive ACTH production by a pituitary tumor
typoe 1 DM genetics
HLA haplotype DR3 or DR4
Type 1 DM antibody
85% will have islet cell antibodies
somogyi phenomenon
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
presentation of DM 2
asymptomatic - mild DKA
obesity
acanthosis nigricans
pendred syndrome
causes early hearing loss in children. It also can affect the thyroid gland and sometimes may affect a person’s balance.
organification defect -
PTH
will maintain serum ca
release cal from bone and reabsorb ca from kidneys
release phos from bone and excrete phos from kidney
1alpha-hydroxylase vit. D.
converte 25-OH to active vvit. D (1,25 OH) which is stimulated by PTH
1, 25Oh in the gut?
will absrob cal in intestines
