Endocrinology Flashcards
[Endo/Puberty]
Sexual development sequences in female? (5)
- Thelarche (breast)
- Pubarche
- Peak height velocity
- Adrenarche
- Menarche
[Endo/Puberty]
Sexual development sequences in male? (6)
- Testicular enlargement
- Pubarche
- Penis growth
- Adrenarche
- Ejaculation
- Growth spurt
[Endo/Puberty/Precocious]
Secondary sexual development prior to ___ years in girls
Secondary sexual development prior to ___ years in boys
Secondary sexual development prior to 8 years in girls
Secondary sexual development prior to 9 years in boys
[Endo/Puberty/Delayed]
Age for delayed puberty in boys and girls
No __ development by __ years in girls
No __ enlargement by __ years in boys
No breast development by 13 years in girls
No testicular enlargement by 14 years in boys
[Endo/Puberty]
For girls,
Peak height velocity occurs at SMR stage __ to __
For boys,
Peak height velocity occurs at SMR stage __ to __
Girl Peak height velocity occurs at SMR stage 2 to 3
Boy Peak height velocity occurs at SMR stage 3 to 4
[Endo/Puberty]
For girls,
Menarche occurs at SMR stage ___
SMR stage 4
[Endo/Puberty/Gynecomastia]
When to investigate for pubertal gynecomastia? (3)
If occurs in SMR __
Atypical age __ or >__ years old
Gynecomastia > __ cm
If occurs in SMR 1 or 5 (usually seen in SMR 2-4)
Atypical age < 10 or >16 years old
Gynecomastia > 5 cm
[Endo/Pituitary]
Hormones from posterior pituitary gland? (2)
ADH
Oxytocin
[Endo/Pituitary]
Hormones from anterior pituitary gland? (6)
GH
TSH
ACTH
FSH
LH
Prolactin
[Endo/Pituitary/Cong Hypopituitarism]
Diagnosis?
Abnormality of optic nerve
Septum pellucidum or corpus callosum agenesis or hypoplasia
Variable degrees of hypothalamic insufficiency
Septooptic dysplasia
[Endo/Pituitary/Cong Hypopituitarism]
Causes of congenital hypopituitarism? (5)
- Septooptic dysplasia
- Midfacial anomalies
- Empty sella
- Ectopic posterior pituitary gland
- Craniopharyngioma
[Endo/Short Stature]
Constitutional vs genetic vs hormone
Normal growth velocity
Delayed bone age
Pubertal delay
Constitutional growth delay
[Endo/Short Stature]
Constitutional vs genetic vs hormone
Normal growth velocity
Normal bone age
Family history of short stature
Genetic
[Endo/Short Stature]
Constitutional vs genetic vs hormone
Decreased growth velocity
Delayed bone age
+/- family history of short stature
Hormone (GH deficiency or hypothyroidism)
[Endo/Short Stature/GH deficiency]
Age limit for (Growth Hormone) GH treatment in GH deficiency?
Girls bone age: ___
Boys bone age: ___
Girls bone age: 14
Boys bone age: 16
[Endo/Short Stature/GH deficiency]
Side effects of growth hormone treatment? (5)
- Slipped capital femoral epiphysis (SCFE)
- Pseudotumor cerebri
- Transient carbohydrate intolerance
- Transient hypothyroidism
- Scoliosis
[Endo/DI]
Most common drug to cause nephrogenic diabetes insipidus?
Lithium
[Endo/DI]
Treatment for nephrogenic diabetes insipidus? (2)
- Thiazide (reduce urine output)
- Indomethacin (reduce urine output)
[Endo/Hyponatremia]
Cerebral salt waisting vs SIADH vs ACTH-A-C axis deficiency
Hyponatremia
Increased urine output
High urine Na
High ANP
Hypovolemia
Cerebral salt waisting
(Due to CNS disorders: brain tumor, head trauma)
[Endo/Hyponatremia]
Cerebral salt waisting vs SIADH vs ACTH-A-C axis deficiency
Hyponatremia
Decreased urine output
High urine Na
High vasopressin
Euvolemia
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
(Due to pneumonia, tumors, tuberculosis, CNS injury)
[Endo/Hyponatremia]
Cerebral salt waisting vs SIADH vs ACTH-A-C axis deficiency
Hyponatremia
Increased urine output with low osmolality
Low cortisol
Hypoglycemia
ACTH-Adrenal-Cortisol Axis deficiency
[Endo/Hyponatremia]
Treatment?
Cerebral salt waisting: ___
SIADH : ___
Cerebral salt waisting: Na replacement with 3% saline
SIADH : Fluid restriction, demeclocycline
[Endo/Tall Stature]
Causes of Tall stature?
Genetic (3): ___
Overgrowth syndrome (1): ___
Pituitary gigantism/acromegaly (2): ___
Cerebral gigantism (1): ___
Genetic : Klinefelter, Marfan, Homocystinuria
Overgrowth syndrome: Beckwith-Wiedemann
Pituitary gigantism/acromegaly: McCune-Albright, Carney complex
Cerebral gigantism: Soto
[Endo/Tall Stature]
Diagnosis?
Freckles around eyes and lips
Cardiac myxoma
Adrenal tumor/cushing syndrome
Schwannoma
Carney complex
[Endo/Tall Stature]
Medical treatment for tall stature due to growth hormone excess (2)?
- Octreotide (somaostatin analogs)
- Pegvisomant (GH receptor antagonist)
[Endo/Pit/Prolactinoma]
Treatment for prolactinoma (2)?
Cabergoline
Bromocriptine
[Endo/Puberty/Precocious]
Most common brain tumor for central precocious puberty?
Hypothalamic hamartoma
[Endo/Puberty/Precocious]
Causes of precocious puberty?
Girls < 8 years old
Breast, pubic hair, growth spurt,
Advanced bone age
GnRH stimulation test, increased peak LH
Negative brain MRI
Idiopathic central precocious puberty
[Endo/Puberty/Precocious]
Cause of precocious puberty?
Boys < 9 years old
Testicular enlargement
Pubertal LH
Negative Brain MRI
Idiopathic central precocious puberty
(FSH grows testicles, gonadal involvement = central)
[Endo/Puberty/Precocious]
Causes of precocious puberty?
Precocious puberty with central features
Diabetes insipidus
Hyperthermia
Unnatural laughing
Hypothalamic hamartomas, central precocious puberty
[Endo/Puberty/Precocious]
Causes of female peripheral (Gonadotropin-independent) precocious puberty (4)?
- Ovarian cysts/tumors
- Feminizing adrenal tumors
- McCune-Albright
- Exogenous
[Endo/Puberty/Precocious]
Causes of male peripheral (Gonadotropin-independent) precocious puberty (4)?
- Congenital adrenal hyperplasia, adrenal tumors,
- Leydig cell tumors
- Familial male limited precocious puberty
- Exogenous.
[Endo/Puberty/Precocious]
Cause of precocious puberty?
Boys < 9 years old
Testicular enlargement
Suppressed LH
Detectable hCG
hCG-secreting tumor: germ cell tumor,
(hCG acts on FSH receptor, increased testicle size)
[Endo/Puberty/Precocious]
Most common estrogen secreting tumor?
Juvenile granulosa cell tumor
[Endo/Puberty/Precocious]
Most common gonadal tumor?
Associated with Turner with Y chromosome mosaicism
Gonadoblastomas
(Virilizing adrenal tumor, prophylactic removal can be done)
[Endo/Puberty/Precocious]
Name of disease?
Boys between 2 and 3 years old
Spontaneous erection, masturbatory behavior
Mildly increased testicle size
Premature adrenarche
Penile enlargement
Very high testosterone level
Advanced bone age
Familial Male Gonadotropin-Independent Precocious Puberty
(Missense mutation of the LH receptor, activation of Leydig cells)
[Endo/Puberty/Precocious]
Premature thelarche is an isolated finding in girls before ___ age and benign finding in the first ___ age
Premature thelarche is an isolated finding in girls before 8 years old and benign finding in the first 2 years old
(For boys: gynecomastia)