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A. PEDIA BOARD REVIEW > ENDOCRINE chap 556-589 > Flashcards

ENDOCRINE chap 556-589 Flashcards

1
Q

Major regulator

Master gland

A

Pituitary gland

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2
Q

Persistent remnants of the connection between Rathke pouch and oral cavity can develop into

A

Craniopharyngioma

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3
Q

Under production of Growth hormone

A

Hypopituitarism

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4
Q

Most common cause of Acquired hypopituitarism

A

Pituitary tumors

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5
Q

Most common cause of Acquired hypopituitarism

A

Pituitary tumors

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6
Q

T/F: Diabetes Insipidus is more frequent in acquired hypopituitarism

A

True

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7
Q

Most common non pituitary tumor causing hypopituitarism

A

Craniopharyngioma

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8
Q

Presents with neonatal emergeny (apnea, cyanosis, hypoglycemia
On pe: birth weight 1 SD below the mean, frontal bossing, depressed nasal bridge, eyes are somewhat bulging, blue sclerae, short neck, micropenis, high pitched voice

A

Congenital hypopituitarism

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9
Q

Initially normal child
But came in due to weight loss, lack of energy, sensitivity to cold & absence of sweating. There was noted amenorrhea & loss of pubic and axillary hair.
Noted to be not growing (slowed growth)

A

Acquired hypopituitarism

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10
Q

Principal regulator of osmolality (tonicity)

A

Vasopressin/ADH

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11
Q

Hyperosmolality (>300 mOsm/kg)
Polydipsia
Polyuria
Serum osmolality (>300bmOsm/kg) > usine osmolality (<300 mOsm/kg)

A

Diabetes Insipidus

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12
Q

Diabetes Insipidus (DI)
Diabetes Mellitus
Optic atrophy
Deafness

A

Wolfram syndrome

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13
Q

Most common primary brain tumors associated with Central DI

A

Germinomas & Pinealomas

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14
Q

Treatment for central DI

A 
Fluid therapy (give fluids)
Desmopressin
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15
Q

Treatment for Nephrogenic DI (vasopressin insensitivity)

A 
Eliminate underlying disorder (hypercalcemia, hypokalemia, or ureteral obstruction)
Thiazide diuretics (increase sodium excretion at the expense of water causing mild volume depletion resulting to sodium and water reabsorption)
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16
Q

Hyponatremia
inappropriately concentrates urine (>100 mOsm/kg)
Normal or slightly elevated plasma volume
Norma to high urine sodium
Low serum uric acid

A

Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)

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17
Q 
Hyponatremia (Na<140 meq/L)
High urine sodium (>150meq/L)
High urine output
Hypovolemia
Normal or high uric acid
A

Cerebra Salt Wasting

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18
Q 
Lethargy
Psychosis
Coma 
Generalized seizure
Serum sodium <120meq/L
A

Acute hyponatremia

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19
Q

Rapid correction of hyponatremia

A

Hypertonic 3% sodium chloride

0.5meq/L/hr or 12 meq/L/24 hr

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20
Q

Most commonly diagnosed adenoma in childhood

A

Prolactinoma

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21
Q

MCC of infants LGA

A

Maternal DM

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22
Q 
Macrosomia
Macroglossia
Hepatomegaly
Nehromegaly 
Omphalocoele
Hypoglycemia 
Predisposed to childhood neoplasm
A

Beckwith-Widemann Syndrome

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23
Q

Most common cause of tall stature

A

Normal variant, familia or constitutional tall stature

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24
Q 
Male
Tall stature
Gynecomastia
Learning disabilities
Decreased upper body:lower body segment ratio
Hypertelorism (wide spaced eyes), hypotonia, clinodactyly (bending of finger towards adjacent finger)
Small penis & testes
Infertile
A

Kleinfelter syndrome (XXY)

25
Q

MCC pituitary tumor in adolescents

A

Prolactinoma

26
Q

Female

Headace, primary or secondary amenorrhea, galactorrhea but with normal puberty

A

Prolactinoma

27
Q

First sign of puberty in females

A

Thelarche (breast bud) - 10 to 11 years old

28
Q

Chronoligical features of puberty in females

A
  1. Thelarche (breast bud)
  2. Pubarche (pubic hair)
  3. Menarche
29
Q

First sign of puberty in males

A

Testicular enlargement

30
Q

Onset of secondary sexual characteristics before 8yrs old in girls & 9 years old in boys

A

Precocious puberty

31
Q

Thelarche at 7 years old
Irregular menses
Height and weight advanced for age
Osseous maturation (bone age) is advanced for age

A

Precocious puberty

32
Q

Treatment for central precocious puberty

A

GnRH agonist (Leuprolide 0.25-0.35 mg/kg)

33
Q

Most common brain lesion causing central precocious puberty

A

Hypothalamic hamartomas

34
Q 
Precocious puberty
Gelastic seizure (uncontrolled laughing or crying)
A

Hypothalamic Hamartomas

35
Q

Precocious puberty
Patchy cutaneous pigmentation
Fibrous dysplasia

A

McCune-Albright Syndrome

36
Q

Most common extraglandular manifestation of precocious puberty

A

Phosphaturia

37
Q

2 most common forms of partial (incomplete) precocious development

A
  1. Breast development in girls

2. Sexual hain growth in both

38
Q

MCC of permanent congenital hypothyroidism

A

Thyroid Dysgenesis

39
Q

MCC of syndromic deafness
Autosomal recessive
Mutation in the chloride-iodide transport protein

A

Pendred syndrome

40
Q

Patient came in with sensorineural hearing loss and goiter. Upon thyroiodide test, there was noted positive percholate discharge. (Diagnosis?)

A

Pendrin syndrome

41
Q

MCC of congenital hypothyroidism world wide

A

Goiter or Iodine deficiency

42
Q

6 mos female came due to poor feeding
Noted to have little crying and sleeping a lot, appears sluggish, she is also CONSTIPATED
with UMBILICAL HERNIA
NO head control
Pe: large ant & POST fontanel, large TONGUE, SMALL for age, eyes are WIDE APART, DEPRESSED nose bridge, NO TEETH (delayed dentition), SHORT & THICK neck, DRY SCALY skin, COARSE SCANTY BRITTLE hair

Labs: Low T4, high TSH, macrocytic anemia
Radio: ABSENCE of DISTAL femoral & PROXIMAL tibial EPIPHYSES, WORMIAN bones in the skull

A

Congenital hypothyroidism

43
Q

Treatment of choice for congenital hypothyroidism

A

Levothyroxine (10-15 umcg/kg/day)

44
Q

MCC of acquired hypothyroidism

A

Hashimoto thyroiditis (Chronic lymphocytic thyroiditis)

45
Q

Girls
More common after 6 yrs old
With goiter (asymmetric, enlarged, firm, nontender) and growth retardation
May have pressure symptoms (difficulty swallowing, shortness of breath)
Clinically euthyroid but may jave symptoms of hypothyroidism

A

Hashimoto Thyroiditis

46
Q

Lynphoid follicle formation with germinal centers

A

Hashimoto Thyroiditis

47
Q

MCC of thyroid disease in children and adolescents

A

Hashimoto Thyroiditis

48
Q

Normal FT4, slightly elevated TSH

A

Subclinical hypothyroidism

49
Q

Antiarrythmic drug associated with congenital goiter with hypothyroidism

A

Amiodarone

50
Q

Most serious consequence of iodine deficiency

A

Endemic cretinism

51
Q

Excessive secretion of thyroid hormone

A

Hyperthyroidism

52
Q 
Female predominance
Peak at 11 to 12 years old
Emotional lability
Tremors
Voracious appettite without weigjt gain
Excessive sweating, palpitations

Pe: exopthalmos, upper eyelid lag, tachycardia, apical systolic murmur (Mitral regurgitation), hyperreflexia

Lab: low TSH, elevated T3, T4, FT3 and FT4

A

Graves disease

53
Q

Preferred treatment for hyperthyroidism in pregnancy

A

Propylthiouracil (PTU)

54
Q

Preferred treatment for hyperthyroidism in children

A

Methimazole

55
Q

Unwanted adverse effect of PTU

A

Severe liver disease

56
Q

MCC liver disease associated with Methimazole

A

Cholestatic jaundice

57
Q

Treatment for Neonatal Graves disease or Congenital Hyperthyroidism

A 
Propanolol (1-2mg/kg/24h orally in 3 divided doses)
Methimazole (0.25-1mkday q12)
Potassium iodide (1 drop per day)
58
Q

MC thyroid carcinoma in childhood

A

Papillary carcinoma

59
Q

Adolescent female
Presented with painless nodule, fast growing, large in size, firm, non-movable, with noted hoarseness, dysphagia and presence of neck lymphadenopathy

A

Thyroid carcinoma

A. PEDIA BOARD REVIEW (13 decks)

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