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Paediatrics > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What are some factors influencing height?

A 
Age
Sex
Race
Nutrition
Parental heights
Puberty
Skeletal maturity
General health
Chronic disease
Specific growth disorders
Socio-economic status
Emotional well-being
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2
Q

What are some measurements techniques used to asses growth?

A 
Height
Length
Sitting height
Occipitofrontal circumference
Condition specific growth charts. 
Mid Parental Height (MPH)
Bone age
Pubertal assessment
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3
Q

What are some indications for referral for growth disorders?

A

Extreme short or tall stature (off centiles)
Height below target height
Abnormal height velocity (crossing centiles)
History of chronic disease
Obvious dysmorphic syndrome
Early/late puberty

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4
Q

What are some common causes of short stature?

A

Familial
Constitutional
SGA/IUGR

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5
Q

What are some pathological causes of short stature?

A 
Under nutrition
Chronic illness (JCA, IBD, Coeliac's)
Iatrogenic (steroids)
Psychological and social
Hormonal (GHD, hypothyroidism)
Syndromes (Turner's, P-W)
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6
Q

What investigations would you carry out to test for pathological cause of short stature?

A 
FBC
Ferritin
U&Es
LFT
Calcium
CRP
Coeliac serology
IgA
IGF-1
TFT
Prolactin
Cortisol
Gonadotrophins
Karyotype
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7
Q

Hoe is Puberty staged?

A 
Tanner method
B - 1 to 5 breast development
G - 1 to 5 genital development
PH - 1 to 5 pubic hair
AH - 1 to 3 axillary hair
T - 2ml to 20ml
SO

Unless adequately trained use the Puberty Phases approach.

Prader Orchidometer to measure testicular maturation

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8
Q

What is considered early puberty?

A 
Boys = < 9 years (rare)
Girls = <8 years
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9
Q

What is considered delayed puberty?

A 
Boys = >14 years (common)
Girls = > 13 years (rare)
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10
Q

What is Constitutional Delay of Growth and Puberty (CDGP)?

A

Affects boys mainly.
Family history in Dad or brothers.
Bone age delay
Need to exclude organic disease.

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11
Q

What are some other causes of delayed puberty?

A

Gonadal dysgenesis (Turner 45X, Klinefelter 47XXY)
Chronic disease (Crohn’s, asthma)
Impaired HPG axis ( sept-optic dysplasia, craniopharyngioma, Kallman;s syndrome)
Peripheral (cryptorchidism, testicular irradiation).

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12
Q

What is thelarche?

A

Stage at which male and female breasts become distinct due to variance in hormone levels

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13
Q

What is precocious pesudopuberty?

A

Partial pubertal development that results from autonomous (gonadotropin-independent) production of testosterone in a prepubertal boy. Affected boys have premature virilization and rapid growth, but they do not produce sperm.
Secondary asexual characteristics.
Need to exclude congenital adrenal hyperplasia.

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14
Q

What is Central precocious puberty?

A

Early breast development in girls and testicular enlargement in boys.
Growth spurt
Advanced bone age
Need to exclude pituitary lesion with MRI.

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15
Q

What is the management approach for Ambiguous genitalia?

A

Do not guess sex
MDT
Karyotype
Exclude congenital adrenal hyperplasia which carries a risk of adrenal crisis in 2 weeks of life.

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16
Q

What are the features of congenital hypothyroidism?

A

1 in 4000 births
Causes; athyreosis, hypo plastic, ectopic, dyshormonogenic.
New born screening
Must start treatment within 1st 2 weeks.

17
Q

What are the features of acquired Hypothyroidism?

A

Hashimoto’s is most common cause.
Family history of thyroid/autoimmune disease
Childhood issues of lack of height gain, pubertal delay, poor school performance.

18
Q

What are some assessments used to determine obesity?

A 
Weight
BMI (kg/m2)
Height
Waist circumference 
Skin folds
History and examination
Complications
19
Q

What are the different forms of height?

A

A endogenous pathological
B lean normal
C exogenous

20
Q

What height alongside obesity is abnormal?

A

Obese + short = abnormal

21
Q

What are some complications of Obesity?

A 
Metabolic syndrome
Fatty liver disease
Gallstones
Reproductive dysfunction
Nutritional deficiencies
 etc.
22
Q

What are some causes of obesity?

A 
Simple obesity 
Drugs
Syndromes - learning difficulties
Endocrine disorders - growth failure
Hypothalamic damage - loss of appetite control
23
Q

What are the key symptoms of type 1 diabetes?

A 
Thirsty
Thinner
Tired
Using the toilet more
Return to bed wetting 
Children under 5:
Heavier than usual nappies
Blurred vision
Candidiasis
Constipation
Recurring skin infections
Irritability
Behavioural change
24
Q

What test should you do immediately if suspect type 1 diabetes?

A

Finger prick capillary glucose test.

Diabetes if result > 11mmol/L

25
Q

What are the symptoms of diabetic ketoacidosis?

A 
Nausea and vomiting
Abdominal pain
Sweet smelling breath
Drowsiness
Rapid, deep sighing respiration
Coma

Paediatrics (12 decks)

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