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EOR - Pediatrics > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

mc endocrine dz in peds

A

T1DM

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2
Q

rf for T1DM

A

fam hx/histocompatability antigens:
DR3
DR4

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3
Q

what type of breathing is associated w. DKA

A

kussmaul respirations

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4
Q

dx criteria for DM (4)

A

-random BG > 200 mg/dL PLUS symptoms
-2 separate 8 hr fasting BG > 126
-2 hr OGTT > 200
-A1C >/= 6.5

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5
Q

how does C peptide relate to T1 vs T2 diabetes

A

T1DM: low vs inappropriately low during fasting
T2DM: high

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6
Q

what abs are associated w. T1DM

A

insulin abs
GAD65
IA-2

if >/= 1 is present, consider T1DM

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7
Q

what type of infxn might make you concerned for DM in a kid

A

prolonged candidal infxn

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8
Q

A1C goal for pediatric DM

A

< 7.5

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9
Q

t/f: hypercalcemia is more concerning in kids than adults

A

t!

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10
Q

hypercalcemia is often discovered when a kid is worked up for

A

FTT

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11
Q

4 signs of end organ damage with hyperparathyroidism

A

nephrocalcinosis
nephrolithiasis
acute pancreatitis
bone pathology

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12
Q

t/f: most kids with hyperparthyroidism present w. end organ damage

A

t!

most are symptomatic at presentation

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13
Q

ddx for hypercalcemia in peds (10)

A

family hypocalciuric hyperCa
NSHPT (neonatal severe primary hyperparathyroidism )
subcutaneous fat necrosis
williams syndrome
primary hyperparathyroidism
humoral malignancy
osteolytic malignancy
granulomatous dz
vit D toxicity
immobilization

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14
Q

pharm for pediatric hypercalcemia

A

increase urinary excretion:
calcitonin
bisphosphonates
zoledronic acid

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15
Q

_ is recommended for all peds w. primary hyperparathyroidism

A

parathyroidectomy

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16
Q

mcc of hyperthyroidism in peds

A

graves dz

others:
thyroid nodule
acute supporative thyroiditis

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17
Q

adult sx of hyperthyroidism that is uncommon in peds

A

exophthalmos

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18
Q

3 sx of hyperthyroidism in peds that Smarty PANCE stresses

A

palpitations
change in behavior
change in school performance

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19
Q

what is neonatal graves dz

A

infant born to mom w. graves dz -> passage of TSH receptor abs cross placenta

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20
Q

t/f: neonates will graves dz often have a goiter

A

t!

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21
Q

tx for hyperthyroidism in peds

A

same as adults:
PTU
methimazole
radioiodine

22
Q

med preferred in pediatric hyperthyroidism

A

methimazole

fewer s.e

23
Q

t/f: half of kids w. graves dz have spontaneous remission w.in 12-24 mo

A

t!

24
Q

management of kid who had hyperthyroidism but then went into remission

A

lifelong TSH monitoring

25
Q

tx for neonatal graves

A

propranolol
+/- methimazole

most self resolve w.in 2-3 mos

26
Q

3 mo old infant - presents w. intermittent choking, constipation, lethargy, hoarse cry - on PE she is floppy and 25th %ile for weight w. protuberant abdomen, dry skin, brittle hair, and a low hairline

A

hypothyroidism

27
Q

causes of hypothyroidism in peds (6)

A

hashimoto’s -> mc
panhypopituitarism
ectopic thyroid dysgenesis
antithyroid meds
surgery for hyperthyroidism
congenital hypothyroidism (cretinism)

28
Q

presentation of congenital hypothyroidism (cretinism) (5)

A

hypotonia
lethargy
macroglossia
large fontanelles
dry skin

29
Q

2 rf for congenital hypothyroidism

A

female
fam hx

30
Q

PE findings of congenital hypothyroidism (5)

A

delayed puberty
immature body proportions
coarse, puffy facies
think hair
DTRs w. delayed rxn time

31
Q

tx for hypothyroidism in peds

A

levothyroxine

32
Q

weight classifications for peds

A

underweight: BMI < 5th %ile
normal weight: BMI 5th - 85th %ile
overweight: BMI >/= 85th %ile
obese: BMI >/= 95th %ile
severe obesity: BMI >/= 120th %ile OR >/= 35

33
Q

what lab value is most effecacious for eval of NAFLD in kids

A

ALT

34
Q

management of severely obese kids or overweight/obese kids w. comorbidities

A

referral

35
Q

sugar recs for kids

A

25g (6 tsp) sugar daily

gah! dumb rec…so much sugar :(

36
Q

2 non pathologic causes of short stature

A

familial
constitutional

37
Q

definition of familial short stature

A

-growth curves </= 5th %ile by 2 yo
-healthy otherwise: normal bone age and puberty onset

38
Q

definition of constitutional delay

A

-kid develops </= 5th %ile at normal growth velocities -> parallel to growth curve
-pubety delayed -> delay in bone age

39
Q

3 pathologic causes of short stature

A

-disproportionate short stature
-proportionate short stature
postnatal causes

40
Q

characteristics of disproportionate short stature (2)

A

short limbs
average sized trunk

41
Q

2 causes of disproportionate short stature

A

rickets
achondroplasia (dwarfism)

42
Q

characteristics of proportionate short stature (PSS)

A

small person
normal proportions

43
Q

2 classifications of pss

A

prenatal
postnatal

44
Q

5 prenatal causes of pss

A

intrauterine growth retardation
placental dysfxn
intrauterine infxns
teratogens
chromosomal abnl (trisomy 21, turner’s)

45
Q

8 postnatal causes of pss

A

malnutrition
chronic systemic dz
psychosocial
drugs
hypothyroid
GH deficiency
glucocorticoid excess
precocious puberty

46
Q

how do you determine bone age in peds

A

AP xray of left wrist

differentiates familial short stature from constitutional delay

47
Q

advanced bone age in peds indicates

A

precocious puberty

48
Q

short stature + normal bone age

A

familial short stature

49
Q

short stature + delayed bone age

A

constitutional delay

50
Q

what labs would you order to rule out GH deficiency in kid w. short stature (2)

A

IGF-1
IGF-BP3

EOR - Pediatrics (15 decks)

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