Endocrine Lecture Cards Flashcards
10 yo female, short stature. What is the differential dx?
Familial short stature. Genetic (Turners, pradar will). Bone Disease. Hormonal (hypothyroidism, GH deficiency, Cushings). Constitutional Growth Delay (Delayed growth; short for age but catch up). [Unlikley; calorie deficit, downs]
What are some signs of turners syndrome?
webbed neck, shield check (wide flat), abnormally spaced nipples, increased carrying angle of the arm, coarctation of the aorta (non ductal dependent; can present at any age)
What is a CXR finding you would see with coarctation?
rib notching (erosion)
What are some investigations you would do for short stature
Bone Age, CBC, Urea, Cr, Electrolytes, TSH. GH Stim test (hard to do have to bring pt in hospital), karyotyping (take a long time).
What is the screening bloodwork done postnatally testing for?
Phenylketonuria, Hypothyroidism, Cystic Fibrosis, Sickle Cell Disease, Fatty Acid/ Metabolic conditions, congenital adrenal hypoplasia (high false positive)
What is DKA
Relative Insulin Deficiency
What two things happen in DKA (one cellularly, one in serum)
- Cells do not get glucose because there is no insulin to transport it into the cell. 2. Glucose builds in the serum to cause hyperglycaemia.
What happens to cells when they do not get energy from glucose and why is this dangerous?
They turn to fat for energy and break it down. Byproducts of breakdown = ketoacids. Therefore ketoacidosis can happen.
What happens clinically once ketoacidosis begins?
pt will start vomiting and be unable to keep fluids down
What % of glucose that makes it to the glomerulus gets reabsorbed until normal conditions?
ALL glucose is reabsorbed. Therefore it is abnormal to have glycosuria at any level.
What three things do you need to fix DKA
K+ replacement, fluids, insulin
What two things can you give if your DKA patient gets cerebral edema?
Mannitol for diuresis; 3% NaCl for osmols
