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Endocrinology Flashcards

1
Q

What is the equation for osmolality?

A

Osm = 2Na + Glu/18 + BUN/2.8

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2
Q

what is septo-optic dysplasia?

A

abnormality of optic nerve, agenesis or hypoplasia of septum pellucidum or corpus callosum, and often hypothalamic insuffiency

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3
Q

what hormone deficiency should you look for in a child with a single central incisor? micropenis?

A

growth hormone deficiency

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4
Q

what tumor presents in the hypothalamus?

A

crainopharyngioma

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5
Q

true or false: prolactin levels are high in hypothyroidism

A

true

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6
Q

what is the bone age, growth velocity and family history of: genetic short stature, consitutional growth delay, hormonal growth delay?

A

Genetic: normal bone age, normal growth velocity, family members are short
Consitutional: bone age equal to height age (delayed), normal growth velocity, family history of delayed growth
Hormonal: delayed bone age (75%), decreased growth velocity, +/- hormonal abnormalities in family

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7
Q

what makes up silver-russell syndrome?

A

short stature, triangular facies, frontal bossing, asymmetry

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8
Q

what hormone is involved in diabetes insipidus?

A

ADH (can’t concentrate urine)

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9
Q

what drug induces nephrogenic DI?

A

lithium

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10
Q

what medications can help with nephrogenic DI?

A

thiazides, indomethacin

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11
Q

how does Sotos syndrome present?

A

LGA then accelerated growth as infant, big hands and feet, clumsy. usually normal adult height (no evidence of hormonal disorder on testing)

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12
Q

symptoms of prolactinoma?

A

amenorrhea, galactorrhea, headache, visual field deficit

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13
Q

what cancers are children with beckwidth wiedemann syndrome at risk for?

A

wilms tumor, hepatoblastoma, adrenocortical carcinoma

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14
Q

Is having a tumor causing precocious puberty more common in boys or girls?

A

boys

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15
Q

what hormone should you test for to see if puberty has started?

A

LH

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16
Q

is bone age delayed, normal, or advanced in precocious puberty?

A

advanced

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17
Q

what medicine should you use for precocious puberty?

A

leuprolide (GnRH analog - interrupts pulsatile secretion that is needed for puberty)

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18
Q

what syndrome consists of precocious puberty, skeletal and skin findings, and other hormonal problems?

A

mccune albright

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19
Q

what should you do if you see a boy younger than age 9 with enlarged testes?

A

order MRI!

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20
Q

what labs should you check for premature telarche?

A

estrogen, estradiol, FSH, and LH, and bone age – should all be normal for age if idiopathic

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21
Q

what labs should you check for premature adrenarche?

A

need to rule out CAH or adrenal tumor = so testosterone, DHEA-S, androstenedione, 17OH and bone age

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22
Q

what are girls with premature adrenarche at risk for in the future?

23
Q

what is the most common brain tumor that causes true precious puberty?

A

hypothalamic harmatoma

24
Q

in what diseases is radioiodine uptake (RAIU) increased?

A

Graves, hot nodules, hcg-secreting tumors

25
in what disease is radioiodine uptake (RAIU) decreased?
thyroiditis, amiodarone use
26
what is the most common cause of congenital hypothyroidism?
thyroid agenesis/dysgenesis
27
what should you think about with enlarged posterior fontanelle?
congenital hypothyroidism (also look for large sutures)
28
what happens to growth in acquired hypothyroidism?
growth stops
29
what is the most common cause of goiter and hypothyroidism in children >6yrs old?
autoimmune thyroiditis (hashimoto)
30
what immunoglobulin is found only in Graves disease?
thyroid stimulating immunoglobulin
31
what does a high TSH in a person on synthroid mean?
noncompliance!
32
what is subacute (de quervain) thyroiditis?
self-limited inflammation after URI - gland tenderness, hyperthyroid symptoms, followed by hypothyroidism - manage pain symptoms
33
what are the symptoms of thyroidtoxicosis in children?
muscle weakness, anxiety, palpitations, and increased appetite, weight loss
34
how do you treat grave's disease?
beta-blockers, radioactive iodine tx, surgical removal, or methimazole (or PTU)
35
what is a serious side effect of methimazole?
agranulocytosis
36
how do malignant nodules present?
multiple nodules, "cold" lesions, solid lesions
37
how do you work up a nodule?
ultrasound, RAIU, and then FNA/biopsy
38
what hormone is associated with medullary carcinoma?
calcitonin
39
what are the lab findings in pseudohypoparathyroidism?
normal or high PTH, low calcium, high phosphorus
40
how do children with pseduohypoparathyroidism present?
short, stocky builds, tetany, dimpling on hand, short fingers
41
what are the lab findings in hypophosphatemic rickets?
low phos, high urine phos, high alkphos, normal PTH (kidney problem) -- usually x-linked
42
in children, hyperparathyroidism is almost always due to what?
secondary cause such as vit d rickets, malabsorption, chronic renal disease, pseudohypoparathyroidism
43
causes of primary hyperparathyroidism?
MEN1 (AD, pancreas, parathyroid, anterior pituitary); MEN2A (pheo, parathyroid, medullar carcinoma)
44
how does a child with hyperparathryoidism present?
nausea, vomiting, weakness, polyuria, constipation (look for hypercalcemia!)
45
lab findings in hyperparathyroidism?
high Ca, low phos, high PTH ((if PTH low, look for other cause of hypercalcemia)
46
"increased pigmentation" "tan"
Addison disease (adrenocortical deficiency)
47
do people with decreased ACTH have increased pigmentation?
no, they have hypoglycemia
48
what is the most common cause of addison disease?
autoimmune destruction of the adrenals
49
what should you test for if you're thinking someone has adrenoleukodystrophy (clumsiness, neurologic deterioration)
very long chain fatty acids
50
what is waterhouse-friderichsen syndrome?
damage to the adrenals after meningococcemia
51
do patient with primary ACTH deficiency need mineralocorticoid replacement?
no
52
what is the most common defect in CAH?
21-hydroxylase deficiency (90% of cases)
53
is 21-hydroxylase deficiency salt-wasting or not salt-wasting?
usually salt-wasting

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