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Pedia Platinum > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q 
causes linear and soft tissue growth
increase bone thickness
protein synthesis
fatty acid release from adipose tissue
insulin resistance
increase blood glucose
A

Growth hormone

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2
Q

milk production

A

prolactin

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3
Q

stimulates release of thyroxine (T4) and triiodothyronine (T3)

A

TSH

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4
Q

stimulates cortisol synthesis and secretion from adrenal cortex

A

Adrenocorticotropic hormone (ACTH)

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5
Q

promotes luteinization of the ovary and Leydig cell function of the testis

A

LH

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6
Q

stimulates follicular devt in the ovary and gametogenesis in the testis

A

FSH

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7
Q

increases water reabsorption via insertion of aquaporin 2 in the renal collecting duct

A

ADH

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8
Q

milk secretion

stimulates uterine contractions during labor and delivery

A

oxytocin

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9
Q

severe growth failure, tendency for hypoglycemia, micropenis, prolonged neonatal jaundice

A

HYPOpituitarism

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10
Q 
short and broad face, 
prominent frontal bone, 
depressed nasal bridge, 
saddle shaped nose, 
underdeveloped mandible, 
short neck, 
high pitched voice, 
well proportioned extremities but small hands and feet, 
delayed or absent sexual maturity
A

hypopituitarism

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11
Q 
atrophy of adrenal cortex
thyroid and gonads result in weight loss
asthenia
sensitivity to cold
absence of sweating
A

hypopituitarism

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12
Q
  • height is initially w/in normal range that starts falling off the height curve over time
  • delay bone age
A

pathologic short stature

prenatal onset (infection, undernutrition, chromosome defect)
postnatal (nutritional defcy, chronic systemic dse, psychosocial deprivation)
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13
Q
  • ht is sustatined at lower percentiles during childhood
  • eventual normal final adult ht
  • often with history of similar growth pattern w/ family members
  • delayed bone age (chronologic > bone age)
A

constitutional growth delay

hallmark: delayed pubertal growth spurt

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14
Q
  • stays parallel to to the growth curve
  • significant number of family members are short
  • bone age is not delayed (chronologic = bone age)
A

familial short stature

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15
Q

ht <1st percentile for age and sex

ht >2sd below sex-adjusted mid-parental ht

A

severe post natal growth failure

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16
Q

radiologic findings of hypopituitarism

A
  • delayed skeletal maturation/ bone age
  • small anterior pituitary gland
  • suprasellar calcification (if assoc w/ craniopharyngioma)
17
Q

criteria for stopping hGH treatment

A
  • decision of patient that he/she is tall enough
  • growth rate <1in /year
  • bone age >14 years in girls and >16 years in boys
18
Q

overproduction of GH that leads to Gigantism and Acromegaly

A

HYPERpituitarism

19
Q
  • longitudinal growth acceleration (Cardinal feature)
  • coarse facial feature
  • enlarged hands and feet
  • behavioral problems
  • visual field defects, loss of visual acuity
  • headache
  • visceromegaly
A

gigantism

20
Q
  • coarse facial feature
  • increase skull circumference
  • broad nose
  • enlarged tongue and jaw
  • separation of teeth
  • enlargement of distal parts of the body
  • visual field defects
  • dorsal kyphosis
A

acromegaly

21
Q

Screening for GH excess

A

elevated insulin like growth factor binding protein 3 (IGFBP-3) of IGF-1 (serum somatomedin C)

22
Q

confirmatory for GH excess

A

oral glucose suppression test: serum GH levels are not suppressed by glucose load

23
Q

management for well circumscribed pituitary adenoma

A

transsphenoidal surgery (complete removal of tumor)

24
Q

somatostatin analog for GH suppression

A

Octreotide

25
Q

GH receptor antagonist for treatment of GH excess

A

Pegvisomant

26
Q

mgt for local invasion and involvement of optic chiasm/ nerve or unsuccessful surgery

A

pituitary irradiation

27
Q

result from vasopressin deficiency

A

central DI

28
Q

vasopressin receptor insensitivity

A

nephrogenic DI

29
Q

principal regulator of tonicity (secreted in the posterior pituitary gland) which has both antidiuretic & vascular pressor activity

A

vasopressin

30
Q

cardinal feature of Diabetes insipidus

A

polyuria and polydipsia (exceeding 2L/m2/24hr

31
Q

mgt of SIADH

A

limit OFI

32
Q

mgt for CSW

A

NaCl & H2O replacement

33
Q

mgt for Central DI

A

fluid therapy
long acting vasopressin analog DDAVP
acute onset after neurosurgery: vasopressin w/ total fluid intake limited to 1L/m2/day during antidiuresis

34
Q

mgt for Nephrogenic DI

A
  • Thiazide (dec overall urine output by enhancing Na excretion at the expense of water and by causing decrease in GFR)
  • indomethacin or amiloride +/- thiazide to further reduce polyuria
  • ensure intake of adequate calories for growth and to avoid severe dehydration
35
Q

onset of secondary sexual characteristics before 8 years old in girls and 9 yo in boys

A

precocious puberty

36
Q

treatment for Central precocious puberty

A

GnRH agonist

37
Q

treatment for peripheral precocious puberty

A

Aromatase inhibitor: letrozole, testolactone
Anti-estrogen: tamoxifen
Anti-androgen: spironolactone, fluramide, bicalutamide
inhibitor of testosterone synthesis: ketoconazole

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