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Paedriatrics > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What are the three phases of normal growth?

A

Infantile
Childhood
Pubertal

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2
Q

What are the measurements for assessing child growth?

A

Length/Height
Sitting height
Head circumference

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3
Q

What is the current chart for plotting child growth?

A

RCPCH UK2-18 growth chart

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4
Q

What chart would you use to plot against parents height?

A

Target height and mid parental heigh (MPH)

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5
Q

What other test can be used to plot growth/growth potential?

A

Bone age: TW 20

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6
Q

What are the complete assessment tools for child growth?

A 
Height/length/weight
Growth charts and plotting
MPH and target centiles
Growth velocity
Bone age
Pubertal assessment
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7
Q

What would you ask in a Hx about growth?

A 
Birth weight and gestation
PMx
Fx/Sx/schooling
Systematic enquiry
Dysmorphic features
Systemic examination including pubertal assessment
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8
Q

What are indictions for referral on suspicion of a growth disorder?

A 
Extreme short/tall stature
Height below target height
Abnormal height velocity
History of chronic disease
Obvious dysmorphic syndrome
Early/late puberty
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9
Q

What are some common causes of short stature?

A

Familial
Constitutional
SGA/IUGR

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10
Q

What are some pathological causes of short stature?

A 
Undernutrition
Chronic illness (JCA, IBD, coeliac)
Iatrogenic (steroids)
Psychological and social
Hormonal (GHD, hypothyroidism)
Syndromes (Turner, P-W)
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11
Q

What are investigations for looking at small stature?

A 
FBC and ferritin
U&E, LFT, Ca, CRP
Coeliac serology and IgA
IGF-1, TFT, prolactin, cortisol
Karyotype
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12
Q

What does FBC and ferritin investigate re: short stature?

A

General health, coeliac, Crohn’s, JCA

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13
Q

What does Ca investigate re: short stature?

A

Disorders of Ca metabolism

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14
Q

What do IGF-1, TFT, prolactin and cortisol investigate re: short stature?

A

Hormonal disorders

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15
Q

What does doing a karyotype investigate re: short stature?

A

Turner’s syndrome

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16
Q

What can be given to activate a GH stimulation test?

A

Arginine test

Insulin tolerance test

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17
Q

If someone fails the GH stimulation test what does this mean?

A

GH deficiency

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18
Q

What are two malformations of the pituitary gland which can result in GH deficiency?

A

Ectopic pituitary gland

Small pituitary gland

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19
Q

What is the typical presentation of thyroid deficiency?

A

Lost height

Gained weight

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20
Q

What are the signs of Turner syndrome?

A

L

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21
Q

What is the staging system of puberty called?

A

Tanner method

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22
Q

What are the signs of Prader-Willi syndrome?

A

D

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23
Q

What are the signs of Noonan’s syndrome?

A

D

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24
Q

What is the Tanner method of staging puberty?

A 
B - breast
G - genital
PH - pubic hair
AH - axillary hair
T - testes
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25
Q

How is the Tanner method assessed?

A

Clinical examination

26
Q

What is the device used to measure testicular maturation?

A

Prader orchidometer

27
Q

Which Tanner stage is pubertal?

A

Stage 2

28
Q

Which Tanner stage is pre-pubertal?

A

Stage 1

29
Q

What is the first sign of puberty in females?

A

Breast budding

30
Q

What happens at the end of puberty in females?

A

Menarche

31
Q

What happens at the end of puberty in males?

A

Facial hair

32
Q

What is the first sign of puberty in males?

A

Testicular growth

33
Q

When is early puberty in males?

A

> 9yrs

34
Q

When is delayed puberty in males?

A

> 14yrs

35
Q

When is delayed puberty in females?

A

> 13yrs

36
Q

When is early puberty in females?

A

<8yrs

37
Q

What is CDGP?

A

Constitutional delay of growth and puberty (CDGP)

38
Q

Who does CDGP mainly affect?

A

Boys
FH
Bone age delay

39
Q

What are some causes of delayed puberty?

A

Gonadal dysgenesis (Turner, Klinefelter)
Chronic disease
Impaired HPG axis
Peripheral (cryptorchidim)

40
Q

What happens if adrenal glands sex hormones are activated earlier?

A

Adrenarche

41
Q

What is adrenarche?

A

Development of pubic hair/axillary hair

42
Q

Where does true precocious puberty begin?

A

Pituitary gland

43
Q

What would you need to exclude if premature secondary sexual characteristics?

A

Congenital adrenal hyperplasia

44
Q

What is precocious pseudopuberty?

A

Abnormal sex steroid hormone secretion

45
Q

What is the clinical picture of precocious pseudopuberty?

A

Secondary sexual characteristics

46
Q

What is the management approach towards ambiguous genitalia?

A 
Do not guess sex
MDT
Examination
Karyotype
Exclude congenital adrenal hyperplasia
47
Q

Why should you exclude congenital adrenal hyperplasia in ambiguous genitalia?

A

Risk of adrenal crisis and death

48
Q

Which Tanner stage is breast budding in girls?

A

Tanner Stage B2

49
Q

What Tanner stage is testicular enlargement?

A

Tanner Stage G2

T3-4ml

50
Q

What can cause congenital hypothyroidism?

A

Athyreosis/hypoplastic/ectopic

Dyshormongenic

51
Q

How is congenital hypothyroidism managed?

A

Newborn screening

Treatment within first two weeks

52
Q

What is the most common cause of acquired hypothyroidism?

A

Autoimmune (Hashimoto’s) thyroiditis

53
Q

What are the childhood problems that present with acquired hypothyroidism?

A

Lack of height gain
Pubertal delay
Poor school performance
Obesity

54
Q

When should you worry about an obese child?

A

Obese + short = abnormal

55
Q

What are the causes of obesity in children?

A 
Simple obesity
Drugs
Syndromes
Endocrine
Hypothalamic damage
56
Q

What are the THINK type I diabetes symptoms?

A

Thirsty
Thinner
Tired
Toilet - more

57
Q

What are the steps to making an early diagnosis of type I diabetes?

A

THINK symptoms
TEST
TELEPHONE

58
Q

What is the immediate test for type I diabetes in children?

A

Finger prick capillary glucose test

>11mmol/l -> refer

59
Q

What is a red flag symptom of type I diabetes?

A

Return to bed-wetting

Day-wetting

60
Q

What signs should you look for in >5s with possible type I diabetes?

A 
Heavier than usual nappies
Blurred vision
Candidiasis
Constipation
Recurring skin infections
Irritability/behaviour change
61
Q

What are symptoms of DKA?

A 
Nausea &amp; vomiting
Abdominal pain
Sweet smelling ‘ketotic’ breath
Drowsiness
Rapid, deep ‘sighing’ respiration
Coma
62
Q

What result of the finger prick capillary blood glucose test indicates type I diabetes in children?

A

> 11mmol/l

Paedriatrics (19 decks)

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