Endocrinology Flashcards
Deficiency of GH with or without deficiency of other pituitary hormones
Hypopituitarism
Short stature, vomiting, visual field defect, thin dry hair, increased thirst and fluid intake, increased urination, hypotonia, poor balance, constipation are symptoms of
Craniopharyngioma (because they are usually located in the optic chiasm)
Most common cause of pituitary gigantism
pituitary adenoma
Normal range for height but over time, it starts falling off the height curve
Pathologic short stature
Example: malnutrition or underlying medical problem
Normal range for height; normal final adult height is reached but the growth spurt and puberty are delayed
Constitutional short stature
Stay parallel to the growth curve; due to Genetics
Familial Short stature
Parallel to the growth curve but is much more marked; Very low birth weight (500-100g)
Prenatal short stature
Criteria for stopping growth hormone therapy: Growth rate _____ and bone age ______in girls and _________ in boys
Growth rate 14 years in girls and>16 in boys
How is bone age determined?
X-ray of left wrist
More precise and cost-effective diagnostic method for hyperpituitarism
Serum IGF-1/Somatomedin C (Uniformly increased in untreated cases)
GH levels fluctuate and have short serum half-life (22 mins)
Surgical management if with well circumscribed pituitary adenoma:
transsphenoidal surgery (complete removal of thetumor)
Earliest signs of sexual maturity in girls
breast bud
Earliest signs of sexual maturity in boys
testicular swelling
Onset of secondary sex characteristics before 8 years old in girls and 9 years old in boys
PRECOCIOUS PUBERTY
Given to true precocious puberty patients
Leuprolide acetate – 0.25-0.3 mg/kg IM once every 4weeks
Definitive treatment for Grave’s disease
radioactive iodine ablation or thyroidectomy
Most common etiology of congenital hypothyroidism
Thyroid dysgenesis
Most common cause of thyroid disease in children & adolescents
THYROIDITIS Lymphocytic / Hashimoto / Autoimmune
2 Human Leukocyte Antigen (HLA) associated with an increased risk of goiter & thyroiditis
HLA-DR4, HLA-DR5
Secreted by parafollicular cells of thyroid gland
Calcitonin
Inhibits bone resorption by decreasing the number and activity of bone-resorping osteoclasts
Calcitonin
Tapping of cheeks at the area of the facial nerve produces facial twitching
Chvostek sign; in hypocalcemia
Thumb is adducted and the other fingers are extended; exhibited when you get the BP and let it stay in the mean blood pressure
Trosseau sign or laryngeal & carpopedal spasm; hypocalcemia
Emergency treatment for neonatal tetany:
5-10 ml of 10% solution of calcium gluconate IV at a rate o f0.5-1 mL/min while HR is monitored
1,25-dihydroxycholecalciferol (calcitriol) should be given – initial dose 0.25 ug/day & maintenance dose 0.01-0.1 ug/kg/day; given in 2 equal divided doses
Characterized by hyperplasia or neoplasia of the endocrine pancreas, the anterior pituitary & parathyroid glands
multiple endocrine neoplasia (MEN) syndrome
Most consistent X-ray finding in hyperparathyroidism
resorption of subperiosteal bone of the phalanges
A useful test to determine CAH
serum 17-hydroxyprogesterone
Rounded face, prominent cheeks, moon facies, buffalo hump, generalized obesity, abnormal masculinization, impaired growth, hypertension, increased susceptibility to infection
Cushing syndrome
Tumors of pheochromocytoma is most often found on what laterality
Right
Syndrome of males and females with normal karyotypes who have certain phenotypic features that occur also in females with Turner syndrome
NOONAN SYNDROME
Autosomal Dominant
47, XXY chromosome
KLINEFELTER SYNDROME
Most common sex chromosomal aneuploidy in males
KLINEFELTER SYNDROME
Tall, slim, underweight, long legs, small testes & penis, gynecomastia, azoospermia, associated with leukemia& lymphoma; with mental retardation & psychosocial, learning, or school adjustment problems
KLINEFELTER SYNDROME
45, X chromosomal complement
TURNER SYNDROME
Most common endocrine-metabolic disorder of childhood & adolescence
DIABETES MELLITUS
MPattern of undetected hypoglycemia followed by hyperglycemia that typically occurs in the middle of the night
SOMOGYI PHENOMENON
Elevations of blood glucose occur between 5-9 am without preceding hypoglycemia
DAWN PHENOMENON
Reflects the waning effects of insulin probably due to increased clearance of insulin & nocturnal surges of GH that antagonize insulin’s metabolic effects
