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Step 2 CK: Pediatrics > Endocrine, Diabetes & Metabolism > Flashcards

Endocrine, Diabetes & Metabolism Flashcards

1
Q

Clinical Manifestation:

  1. Arrhythmia
  2. Cardiopulmonary failure

in a hospitalized anorexia nervosa patient

A

Refeeding syndrome

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2
Q

Pathogenesis:

Refeeding syndrome

A

sudden carbohydrate intake –> insulin activity is increased –> insulin promotes the cellular uptake of phosphorus, potassium and magnesium –> increased risk for arrhythmias and cardiopulmonary failure

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3
Q

What is a potential complication precipitated by providing carbohydrates to a patient with anorexia nervosa?

A

Refeeding syndrome is a common and potentially fatal complication seen when hospitalized anorexia nervosa patients are given nutrition without electrolyte repletion.

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4
Q

Diagnosis:

Electrolyte imbalance associated with initiation of nutrition in a patient with anorexia nervosa

A
  1. Hypokalemia
  2. Hypomagnesium
  3. Low phosphorus
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5
Q

Clinical manifestation:

  1. Delayed growth spurt
  2. Delayed puberty
  3. Delayed bone age
A

Constitutional growth delay

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6
Q

What is the most common cause of congenital hypothyroidism?

A

Thyroid dysgenesis

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7
Q

What is the most common clinical presentation seen in infants with congenital hypothyroidism?

A

Most are ASYMPTOMATIC! However, they can present with decreased activity, hoarse cry and jaundice.

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8
Q

Clinical Manifestation:

  1. decreased activity
  2. hoarse cry
  3. jaundice
  4. apathy
  5. hypotonia
  6. large tongue
  7. abdominal bloating
  8. umbilical hernia

in an infant

A

Congenital hypothyroidism

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9
Q

What aspect of development suffers the most injury if congenital hypothyroidism is not recognized and treated early?

A

Neurodevelopment

Newborns are screened for hypothyroidism, phenylketonuria and galactosemia in all states!

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10
Q

gonadotropin-independent vs. gonadotropin-dependent:

Peripheral precocious puberty

A

gonadotropin-independent

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11
Q

gonadotropin-independent vs. gonadotropin-dependent:

Central precocious puberty

A

gonadotropin-dependent

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12
Q

Diagnosis:

Peripheral precocious puberty

A
  1. Low baseline LH
  2. Low baseline FSH
  3. No LH stimulation after stimulation with GnRH agonist
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13
Q

Clinical Manifestation:

late-onset (nonclassic) congenital adrenal hyperplasia

A
  1. advanced bone age
  2. coarse axillary and pubic hair
  3. severe cystic acne
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14
Q

What enzyme is deficient in late-onset (nonclassic) congenital adrenal hyperplasia?

A

21-hydroxylase

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15
Q

Which populations of pediatric patients are at increased risk of precocious sexual development if obese?

A
  1. Black

2. Hispanic

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16
Q

Pathogenesis:

premature adrenarche

A

adrenal androgen release is activated early

17
Q

Clinical manifestation:

Premature adrenarche

A
  1. pubic hair (pubarche)
  2. axillary hair
  3. acne
  4. body odor

in girls younger than 8 or boys younger than 9

18
Q

True or False:

Bilateral pubertal gynecomastia is normal in adolescent boys during mid to late puberty, but unilateral, painful pubertal gynecomastia is associated with an increased risk for cancer.

A

False.

Pubertal gynecomastia is common in 2/3 of adolescent boys during puberty and it can be unilateral, bilateral or painful.

19
Q

Treatment:

Pubertal gynecomastia

A

None.

Pubertal gynecomastia typically resolves in months to 2 years.

20
Q

Clinical manifestation:

Central precocious puberty

A
  1. premature adrenarche (onset of axillary and pubic hair growth, odor, acne)
  2. premature thelarche (onset of breast development)
  3. advanced bone age
21
Q

Diagnosis:

Central precocious puberty

A
  1. High baseline LH
  2. High baseline FSH
  3. Elevated LH after stimulation with GnRH agonist
22
Q

Treatment:

Central precocious puberty

A
  1. GnRH agonist therapy to maximize height velocity

Also, all patients with central precocious puberty should undergo CT or MRI brain imaging.

23
Q

Clinical manifestation:

21-hydroxylase deficiency

A
  1. Virilization of female infants

2. Salt-wasting

24
Q

What cholesterol metabolite is elevated in patients with 21-hydroxylase deficiency?

A

17-hydroxyprogesterone

Step 2 CK: Pediatrics (22 decks)

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