Endocrinology

Question 1

SMR 2

Answer 1

BOY - testes enlarge

GIRL - thelarche

Question 2

SMR 3

Answer 2

BOY - penis enlarge, pubic hair begins

GIRL - enlarged breast and areola

Question 3

Sexual Development

Answer 3

Thelarche - 10-11 years old
Menarche - 12.5 years old - AVERAGE

menstruation starts 2-2.5 years after thelarche

Question 4

Precocious Puberty

Answer 4

GIRLS - 8 y/o

BOYS - 9y/o

Question 5

Delayed Puberty

Answer 5

GIRLS - 13 y/o

BOYS - 14 y/o

Question 6

When to suspect abnormality

Answer 6

13 - no thelarche
14 - no menses, hematocolpos, vagina
16 - with menses but other secondary sex characteristics not present (gonadal failure or pituitary)

Question 7

Diagnostic Criteria of SIADH

Answer 7

ABSENCE of
renal, adrenal or thyroid insufficiency, CHF, nephrotic syndrome or cirrhosis, diuretic ingestion ,dehydration

URINE OSM > 100
SERUM OSM < 280
SERUM NA < 135
URINE NA > 25

Question 8

SIADH

Answer 8

Na serum - LOW
Serum osmolality - LOW
Urine osmolality/Urine Na - HIGH

Question 9

Diabetes Insipidu

Answer 9

Na serum - HIGH
Serum osmolality - HIGH
Urine osmolality/Urine Na - LOW

Question 10

Cardinal Features of Diabetes Insipidus

Answer 10

Polyuria

Polydipsia

Question 11

2 TYPES of DI

Answer 11

Vasopressin Deficiency (CENTRAL)
Vasopressin Insufficiency (NEPHROGENIC)

Question 12

Tests used to distinguish central DI from nephrogenic DI

Answer 12

Water Deprivation Test

ADH administration

Question 13

Hormone involved in DI

Answer 13

VASOPRESSIN

Question 14

Diagnosis of DI

Answer 14

serum osmolarity > 300 mOsm/kg

urine osmolarity < 300 mOsm/kg

Question 15

Central DI

Answer 15

congenital, trauma, tumors, autoimmune infection, drugs (ethanol, phenytoin etc)

TREATMENT
fluid therapy
long acting vasopressin analog dDAVP

Question 16

Nephrogenic DI

Answer 16

congenital (more severe), hypercalcemia, hypokalemia, renal dse, drugs (lithium, amphotericin, rifampicin)

Question 17

Hyperthyroidism (Graves Disease)

Answer 17

decreased TSH

low FT4 and FT3

Question 18

(-) extrathyroidal comversion of T4-T3

protein bound

less able to cross the placenta

Answer 18

PTU

Question 19

10x more potent than PTU

longer serum half life

Answer 19

Methimazole

Question 20

Hypothyroidism

Answer 20

elevated TSH
low serum FT3 and FT4

TREATMENT
low sodium thyroxine

Question 21

MCC of thyroid disease in children and adolescents

Answer 21

THYROIDITIS

HLA-DR4, HLA-DR5

Question 22

Average age of gonadarche

Answer 22

11-12 y/o

Question 23

Mid-Parental Height Formula

Answer 23

GIRLS = father’s height - 13 + mother’s height /2

BOYS = father’s height + mother’s height + 13/2

Question 24

MC endocrine-metabolic disorder of childhood and adolescence

Answer 24

Diabetes Mellitus

Question 25

Intermittent Allergic Rhinitis

Answer 25

<4 days/week or < a month/year

Question 26

Persistent Allergic Rhinitis

Answer 26

> 4 days/week

> a month/year