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Pediatrics > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

solitary maxillary central incisor indicates high likelihood of __ deficiency

A

GH deficiency

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2
Q

Prolactin is (low/high) in hypothyroidism

A

HIGH because TRH is increased which inhibits production of DA from hypothalamus

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3
Q

Constitutional growth delay:

growth velocity?

bone age?

fam hx?

A

NORMAL growth velocity

DELAYED bone age

+ Fam Hx of delayed puberty

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4
Q

Diagnosis of DI

A

Clinical: polyuria, polydipsia, chronic dehydration

Urine: pale, colorless, Osm <300, SG <1.010

Dx via water deprivation test of giving DDAVP

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5
Q

SIADH:

serum NA?

serum Osm?

urine Osm?

urine volume?

ADH?

atrial natriuretic peptide?

A

HYPOnatremia

LOW serum Osm

HIGH urine Osm

LOW urine output

HIGH serum ADH

NORMAL atrial nat peptide

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6
Q

What causes SIADH?

A

pna,t umor, TB, CF, meningtiis, head trauma

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7
Q

What causes hyponatremia in ICU setting?

A

SIADH vs cerebral salt wasting (caused by CNS disorders such as tumor, CVA, head trauma, hydrocephalus)

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8
Q

What will you see with cerebral salt wasting?

serum NA?

serum Osm?

urine Osm?

urine volume?

ADH?

atrial natriuretic peptide?

A

HYPOnatremia

LOW serum Osm with HYPOvolemia

HIGH urinary Na excretion

INCREASED urine output

LOW vasopressin

HIGH atrial peptide

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9
Q

what causes cerebral salt wasting?

what is treatment?

A

hypersecretion of atrial natriuretic peptide

Replacement of urine output with IV fluids (NS to 3% saline)

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10
Q

What is inheritance pattern of these disorders that cause tall stature?

  1. Klinefelter syndrome
  2. Marfan’s
  3. homocystinuria
A
  1. XXY
  2. AD
  3. AR
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11
Q

Marfan syndrome has (up/down) lens subluxation and (up/down) IQ.

A

Marfan: UP/UP

Homocystinuria: Down/Down

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12
Q

What is Sotos syndrome (aka cerebral gigantism)

A
  • Infants born >90th% and grow rapidly in 1st year of life to >97th%
  • Growth continues for 4-5yrs, then returns to normal rate
  • children have big hands/feet and are clumsy
  • most end up with normal height
  • GH levels are NORMAL! (this is NOT an endocrine d/o)
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13
Q

How would an adolescent female present with prolactinoma?

A
  • HA
  • Amenorrhea
  • galactorrhea (milk from breasts)
  • visual-field defects
  • Usually presents after puberty
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14
Q

What is Beckwith-Wiedemann syndrome?

A
  • fetal overgrowth with organ hypertrophy
  • macroglossia, HSM, nephromegaly
  • pancreatic B-cell hyperplasia (hypoglycemia)

**predisposed to WIlms tumor, adrenocortical carcinoma, and hepatoblastoma

  • need to follow with abd U/S every 3mo until age 8 and AFP every 6wks until age 6
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15
Q

What hormone is reponsible for initiation of puberty?

A

GnRH

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16
Q

What is initial sign of puberty in girls?

How long before menarche begins?

A

Breast development (usually by 10-11yo)

Menarche occurs about 2-2.5yr later; which is breast Tanner stage 4

17
Q

When is peak height velocity in girls?

When does growth spurt occur in boys?

A

Girl: breast stage 2-3 (bt 11-12yrs) and ALWAYS before menarche…they will continue to growh about 3 more inches after menarche

Boy: During genital states 4-5 (bt 13-14yo)

18
Q

First signs of puberty for boys?

Normal age for male puberty to begin? Female?

A

Testicular growth and scrotal thinning…then penis lengthening….then pubic hair

Normal male age: bt 9-14yo

Normal girl age: bt 6-8yo

19
Q

Def of precocious puberty?

How to diagnose precocious puberty?

A

Def: onset of 2ndary sexual characteristics before 8yo in female and before 9yo in males

Dx: measure LH during sleep bc it is pulsatile (will be detectable in 50-70% in precocious girls and boys)

Measuring GnRH is boys is helpful…will see LH>FSH response in early stages

20
Q

What is most common brain lesion to cause precocious puberty?

A

Hypothalamic hamartoma (ectopic neural tissue that contains GnRH secretory neurons)

surgical intervention not recommended, except for those with intractable sz

21
Q

What syndrome has these clinical features?

Cafe-au-lait spots with jagged “coase of Maine” borders that usually follow midline

Polyostotic fibrous dysplasia (bone fractures)

Precocious puberty d/t autonomous endocrine hormone excess

A

McCune-Albright syndrome

22
Q

What is classic endocrine presentation of McCune-Albright in girls?

A

Vaginal bleeding

23
Q

What is premature thelarche

A

isolated breast development that occurs** before age 2**

usually benign condition; must r/o exogenous exposure to estrogen creams/shampoo/OCPs

Pediatrics (19 decks)

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