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Peds clerkship > Endocrine > Flashcards

Endocrine Flashcards

1
Q

def. hypoglycemia

A

BG

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2
Q

endocrine causes of hypoglycemia

A
  • ketotic hypoglycemia
  • GH deficiency
  • panhypothyroid
  • ACTH def.
  • addisons
  • exo insulin
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3
Q

non-endo causes of hypoglycemia

A
  • sepsis/shock
  • liver disease
  • ingestion
  • inborn errors of metabolism
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4
Q

Sx of hypoglycemia

A
  • sweating
  • weakness
  • tachycard.
  • tremor
  • lethargy
  • irritability
  • confusion
  • seizure
  • coma
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5
Q

Tx of hypo

A

5ml/kg of D10W or 2ml/kg D25W

if no IV give glucagon IM or SC

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6
Q

peak ages of T1DM

A

4-6 and 10-14

- fam Hx significant

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7
Q

3 major emergencies of T1DM

A
  • DKA
  • intercurrent illness
  • hypoglycemia
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8
Q

DDx for T1DM

A
  • T2DM
  • genetic defect in B-cells
  • meds
  • diseases of exocrine panc.
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9
Q

presentation of T1DM

A
  • polyuria/dypsia
  • weight loss
  • enuresis
  • recent infectiong
  • vomiting
  • abdo pain
  • fam/ Hx
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10
Q

Phx for T1DM

A
  • vitals
  • dehydration signs
  • lethargy
  • Kussmauls
  • ketone breath
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11
Q

lab Dx of DM1

A
  • HBa1c > 6.5
  • fasting BG > 7
  • random BG >11
  • urine glucose and ketones
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12
Q

non-DKA mgmt of DM1

A
  • initiate daily dose insulin .4-.6 unit/kg/day
  • 2/3 in arm, 1/3 in leg
  • 1/3 rapid, 2/3 intermediate
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13
Q

long term mgmt of DM1

A
  • visits q3mos
  • illnesses - do not stop insulin, check glucose andketones q4h, ensure fluid intake, ER if vomiting
  • hypoglycemia - juice, dextrose tabs
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14
Q

def. short stature

A
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15
Q

DDx for short

A 
Alone - neglect
Bone dysplasia
Chromosome - turners, DS
Delayed growth - constitutional delay
Endocrine - GH def., cushings
Familial
GI malabsorption - celiac, chrons
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16
Q

def. of non-path short stature

A

normal growth velocity

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17
Q

3 main types of non-path short

A
  1. constitutional delay
    - normal velocity
    - delayed bone age and puberty
    - attain near normal height
    - may need short term androgens
  2. family short
    - normal bone age, growth velocity, puberty
    - Fam Hx
    - no Tx
  3. syndromic
    - special growth charts for turner and achondroplasia
18
Q

7 types pf patho short

A
  1. primordial - all 3 affected
  2. chromo
  3. skeletal dysplasias
  4. IUGR
    - teratogen
    - placental insuff.
  5. endocrine
    - GH def.
    - hypothyroid
    - hypopit.
    - hyper cort
  6. Chronic disease
    - cyanotic heart
    - malnutrition
    - malabsorption
  7. neglect
19
Q

Phx for short

A
  • charts
  • vitals
  • arm span
  • systemic changes with endocrine
  • sex dev. staging
  • upper to lower segment
20
Q

def. upper to lower segment ration (U/L)

A
  • lower landmark is pubic sym
  • normal
    newborn - 1.7
    4yo - 1.4
    adult 0.9 M 1 F
21
Q

investigations

A
  1. midparental height (P102)
    2 bone age
  2. endo workup
  3. chronic illness (lytes, Cr, BUN, LFT, IgG/M/A, ESR
  4. malabsorption - fecal fat, albumin, celiac screen, sweat chloride
  5. karyotype
22
Q

Normal age and dev. order for female puberty

A

7-13
breast>pubarche>growth>menarche
- early common but less worrysome

23
Q

Normal age and dev. order for male puberty

A

9-14
testes>pubarche>peak growth
- early puberty uncommon, but worrysome

24
Q

Phx for puberty

A
  • growth charting
  • stigmata of endocrinopathy - hirsuit, virilization
  • tanner staging
25
Q

3 parts of tanner stage

A
  • pubic hair
  • breast dev.
  • penis dev.
26
Q

def. precocious puberty

A

secondary sexu dev.

27
Q

isosexual vs. contrasexual

A

isosexual - phenotypically appropriate sex char

contrasexual - opposite to genotypic type

28
Q

complications of early puberty

A
  • decreases adult height

- psych outcomes

29
Q

2 general cat. of etiology of early puberty

A
  1. central (GnRh dep)

2. peripheral - GnRh indep.)

30
Q

features of central early puberty

A
  • bone age adv. + growth accel + sex chars
  • high LH/FSH and T and E
  • premature HPG activation
  • F:M 9:1
31
Q

features of peripheral

A
  • low LH/FSH, high T and E

-

32
Q

6 tests to always do for precocious

A
  1. bone age
  2. LH/FSH
  3. E and T
  4. DHEA-S
  5. 17- hydroxyprogesterone
  6. TSH, T4
33
Q

mgmt of central early

A

goal to preserve height

- GnRH agonsist - downregulate when given continuously

34
Q

mgmt of peripheral early

A

goals to treat underlying path, limit sexsteroid effects

- ketoconazole, spironolactone, tomoxifen,

35
Q

intdications to medically delay puberty

A
  • male
  • bone age faster than height
  • age
36
Q

def. late puberty

A

13 in F, 14 in M

  • late worse in girls
  • absebce of menarche by 16 or 5 years after onset
37
Q

features of central late

A
  • low LH/FSH and T/E
  • delayed bone age
  • late HPG activation
38
Q

feat. of peripheral late

A
  • primary gonadal failure

- high FSH/LH, low T/E

39
Q

Hx for late

A
  • wieght loss
  • family stature
  • fam. Hx
  • med illness
40
Q

7 investigations to always do for late

A
  1. bone age
  2. CBC, lytes
  3. ESR/CRP
  4. FSH,LH,T/E
  5. TSH, T4
  6. IGF-1
  7. urinalysis
41
Q

mgmt of late

A
  • ID and fix cause

- hormone replacement (T/E)

Peds clerkship (22 decks)

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