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Board Review > Endocrinology > Flashcards

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?

A

PCOS

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
Q

in what disease is radioiodine uptake (RAIU) decreased?

A

thyroiditis, amiodarone use

26
Q

what is the most common cause of congenital hypothyroidism?

A

thyroid agenesis/dysgenesis

27
Q

what should you think about with enlarged posterior fontanelle?

A

congenital hypothyroidism (also look for large sutures)

28
Q

what happens to growth in acquired hypothyroidism?

A

growth stops

29
Q

what is the most common cause of goiter and hypothyroidism in children >6yrs old?

A

autoimmune thyroiditis (hashimoto)

30
Q

what immunoglobulin is found only in Graves disease?

A

thyroid stimulating immunoglobulin

31
Q

what does a high TSH in a person on synthroid mean?

A

noncompliance!

32
Q

what is subacute (de quervain) thyroiditis?

A

self-limited inflammation after URI - gland tenderness, hyperthyroid symptoms, followed by hypothyroidism - manage pain symptoms

33
Q

what are the symptoms of thyroidtoxicosis in children?

A

muscle weakness, anxiety, palpitations, and increased appetite, weight loss

34
Q

how do you treat grave’s disease?

A

beta-blockers, radioactive iodine tx, surgical removal, or methimazole (or PTU)

35
Q

what is a serious side effect of methimazole?

A

agranulocytosis

36
Q

how do malignant nodules present?

A

multiple nodules, “cold” lesions, solid lesions

37
Q

how do you work up a nodule?

A

ultrasound, RAIU, and then FNA/biopsy

38
Q

what hormone is associated with medullary carcinoma?

A

calcitonin

39
Q

what are the lab findings in pseudohypoparathyroidism?

A

normal or high PTH, low calcium, high phosphorus

40
Q

how do children with pseduohypoparathyroidism present?

A

short, stocky builds, tetany, dimpling on hand, short fingers

41
Q

what are the lab findings in hypophosphatemic rickets?

A

low phos, high urine phos, high alkphos, normal PTH (kidney problem) – usually x-linked

42
Q

in children, hyperparathyroidism is almost always due to what?

A

secondary cause such as vit d rickets, malabsorption, chronic renal disease, pseudohypoparathyroidism

43
Q

causes of primary hyperparathyroidism?

A

MEN1 (AD, pancreas, parathyroid, anterior pituitary); MEN2A (pheo, parathyroid, medullar carcinoma)

44
Q

how does a child with hyperparathryoidism present?

A

nausea, vomiting, weakness, polyuria, constipation (look for hypercalcemia!)

45
Q

lab findings in hyperparathyroidism?

A

high Ca, low phos, high PTH ((if PTH low, look for other cause of hypercalcemia)

46
Q

“increased pigmentation” “tan”

A

Addison disease (adrenocortical deficiency)

47
Q

do people with decreased ACTH have increased pigmentation?

A

no, they have hypoglycemia

48
Q

what is the most common cause of addison disease?

A

autoimmune destruction of the adrenals

49
Q

what should you test for if you’re thinking someone has adrenoleukodystrophy (clumsiness, neurologic deterioration)

A

very long chain fatty acids

50
Q

what is waterhouse-friderichsen syndrome?

A

damage to the adrenals after meningococcemia

51
Q

do patient with primary ACTH deficiency need mineralocorticoid replacement?

A

no

52
Q

what is the most common defect in CAH?

A

21-hydroxylase deficiency (90% of cases)

53
Q

is 21-hydroxylase deficiency salt-wasting or not salt-wasting?

A

usually salt-wasting

Board Review (11 decks)

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