Endocrinology Flashcards
SMR 2
BOY - testes enlarge
GIRL - thelarche
SMR 3
BOY - penis enlarge, pubic hair begins
GIRL - enlarged breast and areola
Sexual Development
Thelarche - 10-11 years old
Menarche - 12.5 years old - AVERAGE
menstruation starts 2-2.5 years after thelarche
Precocious Puberty
GIRLS - 8 y/o
BOYS - 9y/o
Delayed Puberty
GIRLS - 13 y/o
BOYS - 14 y/o
When to suspect abnormality
13 - no thelarche
14 - no menses, hematocolpos, vagina
16 - with menses but other secondary sex characteristics not present (gonadal failure or pituitary)
Diagnostic Criteria of SIADH
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
SIADH
Na serum - LOW
Serum osmolality - LOW
Urine osmolality/Urine Na - HIGH
Diabetes Insipidu
Na serum - HIGH
Serum osmolality - HIGH
Urine osmolality/Urine Na - LOW
Cardinal Features of Diabetes Insipidus
Polyuria
Polydipsia
2 TYPES of DI
Vasopressin Deficiency (CENTRAL) Vasopressin Insufficiency (NEPHROGENIC)
Tests used to distinguish central DI from nephrogenic DI
Water Deprivation Test
ADH administration
Hormone involved in DI
VASOPRESSIN
Diagnosis of DI
serum osmolarity > 300 mOsm/kg
urine osmolarity < 300 mOsm/kg
Central DI
congenital, trauma, tumors, autoimmune infection, drugs (ethanol, phenytoin etc)
TREATMENT
fluid therapy
long acting vasopressin analog dDAVP
Nephrogenic DI
congenital (more severe), hypercalcemia, hypokalemia, renal dse, drugs (lithium, amphotericin, rifampicin)
Hyperthyroidism (Graves Disease)
decreased TSH
low FT4 and FT3
(-) extrathyroidal comversion of T4-T3
protein bound
less able to cross the placenta
PTU
10x more potent than PTU
longer serum half life
Methimazole
Hypothyroidism
elevated TSH
low serum FT3 and FT4
TREATMENT
low sodium thyroxine
MCC of thyroid disease in children and adolescents
THYROIDITIS
HLA-DR4, HLA-DR5
Average age of gonadarche
11-12 y/o
Mid-Parental Height Formula
GIRLS = father’s height - 13 + mother’s height /2
BOYS = father’s height + mother’s height + 13/2
MC endocrine-metabolic disorder of childhood and adolescence
Diabetes Mellitus
Intermittent Allergic Rhinitis
<4 days/week or < a month/year
Persistent Allergic Rhinitis
> 4 days/week
> a month/year
