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RACP Paediatric Exam - Medstudy edition > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

What regulates prolactin release?

A

Under inhibition from dopamine

More dopamine = less prolactin

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2
Q

What is the strongest osmolar stimulant of ADH osmoreceptors?

A

Sodium

Next is mannitol

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3
Q

What is the most potent known stimulus to ADH?

A

Nausea

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4
Q

What osmolality does thirst begin?

A

295 mOsm/kg

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5
Q

True or false. Prolactin levels are high in hypothyroidism.

A

True

Prolactin elevates with primary hypothyroidism, and with any inhibition of dopamine from hypothalamus

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6
Q

What is septooptic dysplasia?

A

Abnormality of the optic nerve, agenesis or hypoplasia of . the septum pellucidum or corpus callosum, and various degrees of hypothalamic insufficiency

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7
Q

Which endocrine abnormality do you look for if a patient has a solitary maxillary incisor

A

High likelihood of GH deficiency

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8
Q

Which structure is key in determining the level of pituitary involvement in a patient with an ectopic posterior pituitary?

A

Anterior pituitary problems

Stalk:
Normal stalk - isolated GH def
Abnormal stalk - multiple pit hormone def

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9
Q

What is the most common tumour to cause pituitary hormone deficiency

A

Craniopharyngioma

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10
Q

What are the clinical clues that make you suspect congenital GH deficiency?

A

Normal length and weight at birth
Micropenis
Hypoglycaemia
Prolonged direct hyperbilirubinaemia

Falling off growth curve after 3 years

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11
Q

What is idiopathic short stature?

A

Normal children who are short >2.25SD below mean but have normal GH secretion

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12
Q

True or false. Children with constitutional growth delay typically require GH to reach normal adult height

A

False

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13
Q

What is Russel Silver syndrome

A

Short stature, frontal bossing, triangular facies, shortened and incurved 5th fingers, asymmetry
SGA and FTT

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14
Q

Which children with short stature are FDA approved to receive GH to reach a more normal height

A 
ISS who are unlikely to reach normal adult height 
Chronic renal insufficiency 
Turner syndrome
Prader Willi syndrome 
Noonan
SGA (if not caught up by 2yo)
SHOX
AIDs wasting syndrome
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15
Q

Child with severe head injury 3/7 ago, now severe hyponatremia, what aetiology should you consider

A

Central diabetes insipidus

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16
Q

What is the most common medication to cause nephrogenic DI

A

Lithium

17
Q

how is SIADH best managed

A

Fluid restriction

18
Q

Name 3 abnormal causes of tall stature

A

Klienfelter
Marfan
Homocystinuria

19
Q

What is Beckwith Wiedemann syndrome

A

Overgrowth syndrome
Macroglossia, hepatosplenomegaly, nephromegaly, pancreatic B cell hyperplasia

Predisposed to Wilms tumor, adrenocortical carcinoma and hepatoblastoma

20
Q

What is Sotos syndrome

A

Syndrome - rapid growth in childhood with no evidence of endocrine disorder
Born above 90th and grow rapidly in 1st year to >97th

21
Q

How might an adolescent female present with prolactinoma

A

Headache, amenorrhoea, galactorrhoea

22
Q

What is the best way to diagnose prolactinoma

A

MRI of sella

23
Q

Risk with GH treatment

A

No inc risk of leukaemia

SCFE, pseudotumor cerebri, transient carb intolerance, transient hypothyroidism and scoliosis

24
Q

Hormone for initiation of puberty?

A

GnRH

25
Q

How long for menarche after initial signs of puberty (girls)

A

2-2.5yrs

26
Q

When does peak height velocity occur in girls

A

11-12 years

27
Q

mean menarche age

A

12.5 years

28
Q

First signs puberty in boys

A

Testes enlargement

29
Q

Which occurs first, penis enlargement or pubic hair

A

Testes -> penis lengthening -> pubic hair

30
Q

When does growth spurt occur in boys

A

2 years later than girls

31
Q

Lab results for central precocious puberty

A

Girls: adrenal and gonadal involvement
Boys - gonadal involvement

LH spikes

32
Q

Most common brain lesion - CPP

A

Hypothalamic hamartoma

33
Q

What causes peripheral precocious puberty?

A

Excess secretion of sex hormones from gonads, adrenal glands or germ cell tumours
Exogenous exposure to sex steroids

34
Q

What causes testes to grow

A

FSH

RACP Paediatric Exam - Medstudy edition (9 decks)

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