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Pediatrics Board Exam > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

When to start screening overweight kids with at least 2 risk factors for diabetes?

A

At age 10 yo and every 3 years after

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2
Q

Most common cause of goiter in adolescents. How to dx?

A

Hashimoto (Chronic lymphocytic thyroiditis); Check anti-thyroglobulin and anti-thyroid peroxidase antibodies

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3
Q

Most common presentation of Hashimoto?

A

Hypothyroidism; can get thyrotoxicosis

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4
Q

Antibody in Grave’s disease?

A

Anti-thyroid-stimulating immunoglobulin (TSH receptor Ab)

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5
Q

How to distinguish Grave’s disease from subacute thyroiditis?

A

Radioactive iodine uptake. High in Graves, Low in subacute

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6
Q

Solitary nodule in thyroid of adolescent. Next step?

A

Ultrasound and Fine needle aspiration. Adolescents have higher risk of malignancy with solitary nodule than adults

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7
Q

Abnormally low serum T4 concentrations, but normal free T4, clinically euthyroid, and normal TSH. Tx?

A

Thyroid binding globulin deficiency. Tx is not necessary as patient is euthyroid.

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8
Q

Dx of diabetes

A
  • 2 random glucose >200; OR 1 random >200 WITH sx - Fasting glucose >126 - 2 hour post gluc tolerance test >200
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9
Q

When to start monitoring lipid levels in child with DM1? When to start eye exams?

A

Lipid levels at 12, Eye exam at 10

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10
Q

DKA, when to add glucose into IV fluids?

A

Once glucose drops below 250 can add D5, once below 150 can add D10

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11
Q

Child with acanthosis nigricans, obesity. Most likely lab finding?

A

Low HDL

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12
Q

Child with vomiting, mental status changes, glucose 600s, hypernatremia, and elevated serum osmolality

A

Hyperosmolar diabetic coma

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13
Q

Criteria for metabolic syndrome

A
  1. Elevated TGs 2. Low HDL 3. HTN 4. Elevated glucose 5. Truncal obesity
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14
Q

pH and HCO3 in mild, moderate, severe DKA

A

Mild DKA: pH <7.3; HCO3 <15

Moderate: pH<7.2; HCO3 <10

Severe: pH <7.1; HCO3 <5

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15
Q

How to calculate corrected Na in diabetes?

A

Corrected Na= Measured Na + 0.016 (glucose - 100)

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16
Q

What to consider if sodium is low in DKA

A

SIADH secondary to cerebral edema

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17
Q
A
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18
Q

What does this EKG indicate?

A

Hypokalemia, U wave after T wave. Can eventually overtake T wave

19
Q

At what age can intensive insulin therapy be started in children?

A

13 yo

20
Q

Child on insulin therapy with pre-breakfast hyperglycemia. 2 am glucose is elevated. What is the issue and what is the treatment?

A

Dawn phemnomenon= early morning insulin resistance 2/2 nocturnal GH secretion. Tx by increasing the night-time long acting insulin

21
Q

Child on insulin therapy with pre-breakfast hyperglycemia. 2 am glucose is LOW. What is the issue and what is the treatment?

A

Somogyi phemnomenon= Post-hypOglycemia hyperglycemia during the night, causing prebreakfast hypoglycemia. Tx by lowering the night time long acting insulin

22
Q

What recommendations for a diabetic child on sick days?

A
  1. Check BG frequently and us rapid acting insulins
  2. Check urine ketones
  3. Stay hydrated
23
Q

Management if diabetic child has consistently elevated blood glucose before lunch?

A

Increase the AM short acting component

24
Q

Management in diabetic child with consistently elevated glucose before dinner?

A

Increase the AM long-acting insulin

25
Q

Management in a diabetic child with consistently elevated blood glucose before bedtime?

A

Increase the night time short acting insulin

26
Q

Formula for BMI

Obesity is defined as above what %tile?

A

BMI = Weight (kg) / Height (m^2)

Obesity = >95%tile

27
Q

A child who is obese at 6 yo has a what % chance of being obese as an adult?

A child who is obese at 12 yo has a what % chance of being obese as an adult?

A

6 yo has 25% chance

12 yo has 75% chance

28
Q

Most common complication of childhood obesity

A

Psychological factors: Depression and low self esteem

29
Q

Obese child with polydactyly/syndactyly, mental deficiency, eye issues, broad/short feet, abnormal kidneys

A

Bardet-Biedl Syndrome

30
Q

What does this finding indicate

A

Brushfield spots; Down Syndrome

31
Q

Moderately obese child with delayed dental eruption, short 4th metacarpals, extraskeletal calcification, hypocalcemia and hypophosphatemia (pseudohypoparathyroidism)

A

Albright hereditary osteodystrophy

32
Q

Child with growth failure. What test to order?

A

Think about hypothyroidism. Check TSH, T4 and thyroid antibodies

33
Q

Child with loss of milestones, adrenal insufficiency, multiple males in family affected

A

Adrenoleukodystrophy

34
Q

Growth failure, HTN, truncal obesity and hirsutism. How to diagnose?

A

Cushing’s disease. Overnight dexamethasone suppression test. If suppression (low cortisol), then +Cushings.

35
Q

Paroxysms of severe headache, HTN and sweating. How to dx? Tx?

A

Pheochromocytoma

Dx with urinary catechols (Metanephrine/HVA)

Tx preop alpha adrenergic blockade (phentolamine)

Surgical resection

36
Q

What 4 hormones increase glucose?

A

Growth hormone, cortisol, epinephrine, and glucagon

37
Q

Cut off for hypocalcemia?

Cut off for hypercalcemia?

A

<8.5 or ionized calcium <4.5

>11

38
Q

Symptoms of hypocalcemia

A

Painful muscle spasms

Seizures

Vomiting

Prolonged QT on EKG

39
Q

Short obese child with developmental delay, moon facies, calcification of basal ganglia. What labs to order?

A

Pseudohypoparathyroidism

Would have HIGH PTH and LOW calcium

40
Q

Children on anticonvulsants are at increased risk for what deficiency?

A

Hypocalcemia leading to rickets

41
Q

Elevated PTH, low serum calcium and phosphorus indicates what? What do you measure?

A

Vitamin D deficiency

Measure 25OH vitamin D

42
Q

Patient with hypocalcemia, hypophosphatemia, elevated PTH. Does not respond to vitamin D replacement. What is dx?

A

Vitamin D dependent Rickets

Type 1 has low 1,25 OH2 D (active form)

Type 2 has high 1,25 OH2 D

43
Q
A

Pediatrics Board Exam (23 decks)

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