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Paediatrics > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What is congenital hypothyroidism

A

When hypothyroidism presents at birth

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2
Q

Types of congenital hypothyroidism

A

Athyreosis
Thyroid dysgenesis
Dyshormonogenesis

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3
Q

Ix for congenital hypothyroidism

A

All babies screened at birth
Heel prick blood test

The Guthrie Card

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4
Q

Rx for congenital hypothyroidism

A

Paediatric endocrinologist

Levothyroxine

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5
Q

Causes of acquired hypothyroidism

A

Autoimmune (Hashimoto’s Thyroiditis)
Hypopituitarism
Trisomy 21

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6
Q

Define acquired hypothyroidism

A

Hypothyroidism acquired after birth

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7
Q

Clinical features of hypothyroidism

A 
Stunted growth (short limbs)
Delayed dentition 
Inactivity
Lack of energy 
Constipation 
Dry skin 
Slow mental development 
Poor school performance
Delayed puberty 
Slow speech 
Hair loss 
Weight gain
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8
Q

Rx for acquired hypothyroidism

A

Levothyroxine

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9
Q

Which type of DM is mainly seen in children

A

Type I

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10
Q

Pathology of Type I DM

A

Autoimmune condition
T cell mediated destruction of pancreatic beta cells
Insulin deficiency
Therefore, glc in the blood cannot be taken up by tissues
Blood glc increases

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11
Q

THINK symptoms DM

A

Thirsty
Thinner
Tired
Toilet

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12
Q

Ix for DM

A

Test immediately:
Random blood glc >11mmol/l

Fating blood glucose >7mmol/l

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13
Q

Rx for DM

A

MDT team
Insulin
(may benefit from sub. cut insulin infusion)

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14
Q

What is the most concerning complications of DKA in children

A

Cerebral oedema

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15
Q

Pathology of DKA

A

Insulin deficiency
Rise in counter-regulatory hormones (e.g glucagon, cortisol, growth hormone)
Inappropriate gluconeogenesis
Accelerate catabolism from lipolysis of adipose tissues
Increased fatty acid circulation

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16
Q

Clinical features of DKA

A 
Confusion 
Dehydration (severe)
Vomiting 
Polyuria 
Polydipsia 
W.t loss 
Abdominal pain 
Sweet smelling breath ‘pear drops’
Rapid, deep ‘sighing’ respiration (Kussmaul’s Respiration)
17
Q

Children <5yrs DM signs

A 
Heavier than usual nappies 
Blurred vision 
Candidiasis (oral, vulval)
Constipation 
Recurring skin infections 
Irritability 
Behavioural changes
18
Q

Ix for DKA

A

Hyperglycaemia:
>11mmol/l

Acidosis:
Venous pH <7.3

Ketones present:
Urine (dipstick)
Blood

19
Q

Emergency Rx of DKA

A

Fluid resuscitation (0.9% IV saline no K+)

IV fluids maintenance (+ correction of K+)

Start IV insulin (after 1hr of fluid)

Avoid bicarbonate

20
Q

What should you avoid RX in DM

A

Bicarbonate

21
Q

Most common cause of obesity in children

A

Simple obesity

22
Q

Common causes obesity

A

Poor diet
Decreased exercise
Genetics FH

23
Q

Which medications can cause weight gain children

A

Sodium valproate
Carbamezepine
Steroids

24
Q

Medical causes obesity in children

A

Hypothyroidism
Cushing’s Syndrome
GH deficiency
Prader-Willi Syndrome

25
Q

What is abnormal relating to obesity

A

Short and obese

26
Q

For <4yrs which charts should be used to measure child obesity

A

WHO charts

27
Q

For >4yrs which measurement should be used to measure child obesity

A

BMI

28
Q

Is Ix commonly needed for obesity

A

No rarely needed

29
Q

Rx for obesity

A

Diet modification
Exercise

If underlying condition treat

30
Q

Medium term consequences child obesity

A 
Insulin resistance
Type II DM 
Sleep apnoea
Orthopaedic problems 
Non-alcoholic fatty liver disease
31
Q

Long term consequences child obesity

A 
Atherosclerosis 
Early onset CVD 
Some cancers (part. breast and bowel)
Subfertility 
Hypertension
32
Q

Is diet alone Rx recommended

A

No

33
Q

which gender go through puberty earlier?

A

Females

34
Q

Common causes short stature

A

short parents

Late growth spurt

35
Q

Pathological causes short stature

A 
Undernutrition 
Hypothyroidism 
Turner 
Noonan 
Deprivation 
Iatrogenic - steroids
Chronic illness (JIA, coeliac)
36
Q

Which staging system is used to measure puberty

A

Tanner

37
Q

Causes delayed puberty

A 
Gonadal dysgenesis (Turner, Klinfelter)
Chronic disease (asthma, Crohn's)
Impaired HCG axis
38
Q

What does Tanner Staging take into account

A

Breasts
Pubic hair
Genitals
Axillary hair

Paediatrics (13 decks)

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