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Pediatrics > Endocrinology > Flashcards

Endocrinology Flashcards

0
Q

Positive Anti TPO and Anti Thyroglobulin ABs (attacking and killing the gland)

A

Hashimoto’s Thyroiditis

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1
Q

Delayed relaxation phase of DTRs

A

Hypothyroidism

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2
Q

Positive TSH receptor antibodies (attacking and stimulating the gland)

A

Graves Hyperthyroidism

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3
Q

Sleep issues and poor school performance (ADHD like symptoms)

A

Graves disease

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4
Q

Can’t produce DHT from Testosterone which leads to undervirilized male

A

5 Alpha Reductase Deficiency

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5
Q

Caused by enzymatic block in cortisol production

A

CAH

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6
Q

Most common enzymatic block in CAH

A

21 Hydroxylase Deficiency

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7
Q

Builds up in 11-Beta Hydroxylase deficiency

A

11-Desoxycortisol (DOC)

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8
Q

Causes hypertension in 11-Beta Hydroxylase deficiency

A

Build up of 11-Desoxycortisol

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9
Q

Excess of glucocorticoids

A

Cushing Syndrome

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10
Q

Big tongue, umbilical hernia, hypoglycemia

A

Beckwith Wiedemann

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11
Q

Four hormones that bring blood glucose up

A
  1. Epinephrine
  2. Glucagon
  3. Cortisol
  4. Growth Hormone
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12
Q

Increases calcium and decreases phosphorus

A

PTH

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13
Q

Increases absorption of both calcium and phosphorus. Decreases PTH

A

Vitamin D

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14
Q

Causes hypoparathyroidism

A

DiGeorge Syndrome

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15
Q

Pseudo hypoparathyroidism

A

Albrights Hereditary Osteodystrophy

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16
Q

Steroid hormones characterized by their influence on salt and water balances (e.g. Aldosterone)

A

Mineralcorticoids

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17
Q

Class of steroid hormones known for their role in the regulation of the metabolism of glucose and its synthesis in the adrenal cortex. (e.g. cortisol, hydrocortisone)

A

Glucocorticoid

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18
Q

Stones, bones (pain), groans (abd ulcers, nausea), and psychiatric moans

A

Symptoms of hypercalcemia

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19
Q

Work up for suspected growth hormone deficiency

A

1) Obtain bone age of hand/wrists

2) Check insulin like growth factors

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20
Q

Pseudo tumor cerebri, scoliosis, and SCFE are side effects of what tx?

A

Growth hormone

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21
Q

This syndrome is different that Turners syndrome in that:

1) Can affect boys and girls
2) Cardiac lesions are right sided
3) No renal defects
4) Infertility is less likely

A

Noonan Syndrome

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22
Q

Syndrome characterized by:

1) SGA
2) Limb asymmetry
3) Triangular head
4) Cryptorchidism
5) No catch up growth

A

Russell Silver Syndrome

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23
Q

First sign of puberty in girls

A

Thelarche (breast development). Boobs before pubs

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24
Q

Average age of menarche

A

12.4 years

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25
Q

First sign of puberty in boys

A

Testicular enlargement to 4 ccs

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26
Q

Boy with central precocious puberty

A

Think brain tumor

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27
Q

Cafe-au-lait, fibrous dysphasia, & precocious puberty

A

McCune Albright Syndrome

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28
Q

Hypogonadotropic hypogonadism + anosmia

A

Kallmann syndrome

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29
Q

A child within first month of life with low blood glucose and bouncy eyes (nystagmus)

A

Consider septo optic dysplasia

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30
Q

Syndrome with:

1) FTT in infancy then hyperphagia
2) Hypotonia
3) Hypogonadism
4) Obesity
5) Developmental delay
6) Behavioral disorder

A

Prader Willi Syndrome

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31
Q

47XXY

A

Klinefelter Syndrome

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32
Q

Which type of diabetes is more genetically linked?

A

Type 2

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33
Q

From the DCCT trial, were retinopathy, nephropathy, neuropathy, macroangiopathic events, and LDL increased, decreased, or the same with intensive vs. conventional therapy?

A

All were decreased in incidence

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34
Q

Drives glucose and K into cells

A

Insulin. (Put the K back into DKA by giving DKAers K)

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35
Q

Hypoglycemia leading to rebound hyperglycemia

A

Somogyi Phenomenon

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36
Q

Tx for Somogyi Phenomenon

A

Decrease nighttime long acting insulin

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37
Q

Hyperglycemia due to early AM growth growth hormone release

A

Dawn Phenomenon

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38
Q

Tx for Dawn Phenomenon?

A

Increase nighttime long acting insulin

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39
Q

Humalog (lispro) and Novolog (aspart)

A

Rapid acting insulin

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40
Q

NPH

A

Intermediate acting insulin

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41
Q

Lantus (Glargine) and Detemir

A

Long acting (basal) insulin

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42
Q

Insulin dosing for boards a split mixed dosing of 2 shots per day with combo of short and long acting insulin

A

2/3 daily dose in AM, 1/3 in PM

Each individual dose with 2/3 long acting and 1/3 short acting

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43
Q

How many hours a day of screen time can a child have?

A

2 hours

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44
Q

If obese at age six, what percentage chance do u have of being obese as an adult? What if obese at age 12?

A

25%. 75% chance at age 12

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45
Q

Most common complication of obesity

A

Low self esteem

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46
Q

Direct insulin action on the keratin layers of your skin from hyperinsulinemia

A

Acanthosis Nigricans

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47
Q

Single central tooth

A

Congenital hypopituitarism (growth hormone deficiency). If combined with optic nerve hypoplasia it is called septoptodysplasia

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48
Q

Micropenis

A

Congenital hypopituitarism (growth hormone deficiency)

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49
Q

Syndrome with:

1) obesity
2) round face with short neck
3) delayed dental eruption
4) short 4th metacarpal
5) hypocalcemia and hyperphosphatemia

A

Albright Hereditary Osteodystrophy

(Pseudo hypoparathyroidism)

50
Q

Syndrome with:

1) obesity
2) mental deficiency
3) retinal dystrophy
4) poly, syn, or brachydactyly
5) broad short feet
6) abnormal kidneys
7) small penis/testes
8) AR

A

Bardet-Biedl Syndrome

51
Q

Brush field spots

A

Down Syndrome

52
Q

Buffalo hump

A

Cushing syndrome

53
Q

To distinguish between type 1 and type 2 DM

A

Check antibodies (islet, insulin, GAD)…more prevalent in type 1

54
Q

HLA-DR3, HLA-DR4, HLA-DQ

A

Strong association with type 1 DM

55
Q

HTN, obesity, elevated lipids

A

Metabolic syndrome

56
Q

Develops 6-12 hrs after initiation of tx for DKA

A

Cerebral edema

57
Q

The more severe and prolonged the presentation of DKA, the more likely they will get this complication

A

Cerebral edema

58
Q

The presence of acidosis in DKA is the absence of

A

Insulin

59
Q

Low c peptide, high insulin

A

Exogenous insulin

60
Q

Testes greater than 3 cc or 2.5 cm in length

A

Puberty in boys

61
Q

Peak growth velocity on boys

A

Tanner 4

62
Q

Time between Tanner 2 and Tanner 5 in boys

A

2.5 years to 5 years

63
Q

Menarche occurs how long after breast development starts

A

2.5 to 3 years

64
Q

Peak growth velocity in girls

A

Tanner 3-4

65
Q

Menarche occurs at this tanner stage

A

Tanner 4 breasts. 12.8 yrs is avg age

66
Q

At menses, this percentage of growth is complete

A

90%. Will grow another 3 inches on avg

67
Q

Mean duration of puberty in girls

A

4.2 yrs

68
Q

The most common type of tumor to cause precocious puberty

A

Hypothalamic hamartoma

69
Q

Nothing by 13 in girl, 14 in boy

A

Delayed puberty

70
Q

Like to set fires, seminiferous tubule dysgenesis, small testes, low IQ, gynecomastia and breast cancer risk

A

Klinefelters

71
Q

Male or female, webbed neck, pulmonary valve stenosis, short, pectus excavatum, increased risk of AML/CML, cubitus valgus, MR

A

Noonan

72
Q

Obesity, polydactyly, MR, hypogonadism

A

Laurence Moon Biedl/ Bardet-Biedl syndrome

73
Q

Hypogonadotropic hypogonadism, anosmia

A

Kallman Syndrome

74
Q

Hypotonia at birth, obesity, hyperphagia, MR, hypogonadism, deletion q11-13 on chromosome 15, small hands and feet

A

Prader Willi

75
Q

Absence of septum pellucidum, optic disease, pituitary disease

A

Septooptic dysplasia

76
Q

Swollen hands and feet at birth

A

Turner’s Syndrome

77
Q

Karyotype with Y chromosome in Turner syndrome

A

Increased risk of gonadoblastoma. Remove streak gonads

78
Q

Absence of SHOX gene

A

Turner Syndrome

79
Q

Web neck, wide spaced nipples, short 4th metacarpal, math and problem solving difficulties

A

Turner Syndrome

80
Q

Androgens are normal in:

A

1) Klinefleter’s

2) Turner’s

81
Q

Single central incisor

A

Growth hormone deficiency

82
Q

PTH resistance with high PTH but low calcium and high phos

A

Pseudohypoparathyroidism

83
Q

Short stature, stocky build, round face, short fingers

A

Pseudohypoparathyroidism

84
Q

Short stature, frontal bossing, triangular face, shortened incurved 5th metacarpal

A

Russell Silver Syndrome

85
Q

Normal length/weight at birth, microphallus, direct hyperbili, hypoglycemia

A

Growth hormone deficiency

86
Q

Responsible for growth in neonate

A

IGF 1. Growth hormone regulates glucose control in neonate, not growth

87
Q

Body makes adequate ADH but kidney does not recognize or respond to it

A

Nephrogenic DI

88
Q

Acquired causes of Nephrogenic DI

A

Lithium

Sickle cell anemia

89
Q

Hyponatremia, low serum osoms, high urine osmolality, euvolemic

A

SIADH

90
Q

Hypernatrmic, hyperosmolar serum, hypo osmotic dilute urine

A

DI

91
Q

Respond to DDAVP (desmopressin)

A

Central DI.

92
Q

Failure to Respond to DDAVP (desmopressin)

A

Nephrogenic DI

93
Q

High atrialnatriuretic peptide, excessive urine output, hypovolemic, hyponatremia, high urine sodium, low vasopressin

A

Cerebral Salt Wasting

94
Q

Increases your thyroid binding globulin (and therefore total T4)

A

OCPs

95
Q

Positive thyroid receptor stimulating immunoglobulin

A

Graves’ disease

96
Q

Check TSI in which thyroid state

A

Hyperthyroid

97
Q

Patient with low total T4 (fails newborn screen). Found to have normal FT4 and normal TSH

A

Thyroid binding globulin deficiency

98
Q

Teenage female with elevated total T4, normal FT4, normal TSH

A

On OCPs or pregnant (elevated estrogen increases TBG)

99
Q

Chronic lymphocytic thyroditis

A

Hasimoto’s Thyroditis

100
Q

Most common cause of goiter in patient older than 6

A

Hashimoto’s

101
Q

Tx for hyperthyroid kids

A

Propranolol and methimazole

102
Q

Tx for euthyroid Hashimoto’s

A

Monitor labs q 6 months as many will convert to hypothyroid

103
Q

Most common side effect of medical tx for Graves

A

Rash and transient granulocytopenia

104
Q

Most serious side effect of medical tx of Graves

A

Agranulocytosis

105
Q

Correlates with risk and severity of neonatal thryotoxicosis

A

Maternal TSI antibody levels

106
Q

PTH is normal in

A

Hypophosphatemic Ricketts (losing phos in kidneys. PTH responds to calcium level, not phos level.)

107
Q

Low calcium, low phosphorus

A

Vitamin D deficienct

108
Q

High calcium, high phos

A

Too much vitamin D

109
Q

Calcium high, phos low

A

Hyperparathyroidism

110
Q

Calcium low, phos high

A

Hypoparathyroidism

111
Q

Midline cyst moves with swallowing

A

Thyroglossal duct cyst. TFTs unnecessary. May need scan prior to surgical removal to see if only active thyroid tissue

112
Q

Common cause of female pseudohermaphroditism

A

CAH, adrenal tumor, DANAZOL (androgen used to treat endometriosis)

113
Q

Result when mom exposed to androgens in 13-18 week gestation

A

Labial fusion

114
Q

Result when mom exposed to androgens after 18 week gestation

A

Clitoral enlargement

115
Q

Result when mom exposed to androgens from 13 week gestation until birth

A

Labial fusion plus clitoral enlargement

116
Q

Total deficiency of testosterone function, ambiguous genitalia, renal failure at age 3, Wilms tumor

A

Denys Drash Syndrome

117
Q

Wilms tumor, aniridia, GU abnormalities, MR

A

WAGR Syndrome

118
Q

XY, mutation in SRY gene, gonads are undifferentiated streaks- increased risk of gonadoblastoma, testosterone levels are low, female phenotype with no breasts or menses

A

Swyer Syndrome

119
Q

Cryptorchidism, discover uterus and Fallopian tubes on surgical repair

A

Persistent Mullerian Duct Syndrome (don’t have Mullerian inhibiting factor from Sertoli cells). Leading cells function normally so normal testosterone levels

120
Q

Blind vaginal pouch, female external genitalia, no uterus (Sertoli cells work), intraabdominal testes, primary amenorrhea, elevated testosterone levels

A

Androgen insensitivity

121
Q

Early morning cortisol concentration less than 5

A

Adrenal insufficiency

122
Q

HgB A1c level of what = dx of diabetes

A

6.5%. Prediabetes = 5.7%

Pediatrics (20 decks)

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