Endocrine

Question 1

High TSH, low FT4

Answer 1

Hashimoto’s

Question 2

Antibody associated with Grave’s disease

Answer 2

Thyrotropin receptor stimulating antibody

Question 3

Treatment of Grave’s disease

Answer 3

1. Methimazole
2. Radio-ablation
3. Thyroidectomy

Question 4

Boy with precocious puberty, low LH

Answer 4

Peripheral precocious puberty

Check adrenals or testes

Question 5

Boy with precocious puberty, high LH

Answer 5

Central precocious puberty

MRI head

Question 6

Puberty not in normal sequence

Answer 6

Peripheral precocious puberty

Question 7

Inappropriately small testes

Answer 7

Peripheral precocious puberty

Question 8

Vitamin D dose in premature infants

Answer 8

200 IU per day

Question 9

Vitamin D dose in exclusively breastfed infants

Answer 9

400 IU per day

Question 10

Vitamin D dose in Northern communities

Answer 10

800 IU per day

Question 11

Vitamin D deficiency treatment dose

Answer 11

5000-10,000 IU per day for ~3 months

Question 12

Labs in vitamin D deficient rickets

Answer 12

1. Low 25-OH-Vitamin D
2. High PTH
3. High ALP
4. High urine phosphate

Question 13

Actions of PTH

Answer 13

1. Increased calcium release from bone turnover
2. Increased renal tubular resorption of calcium
3. Increased renal phosphate excretion
4. Increased conversion of 25-OH-D to active form: 1,25(OH)D

Question 14

Associated with septo-optic dysplasia

Answer 14

Micropenis

Question 15

Diabetes insipidus labs

Answer 15

1. Concentrated serum (>300)
2. Dilute urine (<300)
3. Hypernatremia
4. Dehydration

Question 16

Expected findings of water deprivation test in DI

Answer 16

1. Increasing serum osm

2. Failure to increase urine osm

Question 17

Bone age in constitutional delay

Answer 17

Bone age < chronological age

Question 18

Bone age in familial short stature

Answer 18

Bone age = chronological age

Question 19

Bone age in GH deficiency

Answer 19

Bone age < chronological age

Question 20

Delayed bone age

Answer 20

1. Constitutional delay
2. Endocrine disorders
3. Malnutrition
4. Chronic illness

Question 21

HbA1C targets

Answer 21

< 6 years = < 8%
6-12 years = < 7.5%
13-16 years = < 7%

Question 22

Most common cause of false positive newborn TSH screen

Answer 22

Sample taken prior to 48 hours of life

Question 23

Causes of false negative newborn TSH screen

Answer 23

1. Critical illness

2. Blood transfusion

Question 24

Risk factors for cerebral edema in DKA management

Answer 24

1. New diagnosis diabetes

2. Age < 5 years

Question 25

Diabetes: when to screen for
Nephropathy
Retinopathy
Hyperlipidemia

Answer 25

Nephropathy = 5 years after diagnosis
Retinopathy = 5 years after diagnosis or 15 years old
Hyperlipidemia = 12 and 17 years old, earlier if risk factors

Question 26

Screening Aboriginal children for T2DM

Answer 26

All of:
- Aboriginal descent
- BMI > 85th
- Age > 10
Plus one of:
- Sedentary lifestyle
- Mother with GDM
- First or second degree relative with T2DM
- Acanthosis
- Dyslipidemia
- Hypertension
- PCOS

Question 27

Screening any children for T2DM

Answer 27

> 3 risk factors if prepubertal, > 2 risk factors if postpubertal

• Obesity
• High-risk ethnic group
• Family history T2DM or in-utero hyperglycemia
• Signs of insulin resistance (AN, HTN, dyslipidemia, PCOS, NAFLD)

Or:

• Impaired fasting glucose or OGTT
• Atypical antipsychotic meds

Screen q2 years

Question 28

Differential diagnosis vitamin D deficient rickets

Answer 28

1. 25-hydroxylase deficiency
2. 1-alpha hydroxylase deficiency
3. Hypophosphatemia

Question 29

Tests to follow rickets

Answer 29

Serum calcium, phosphate, ALP

Urine calcium:creatinine ratio