Endocrinology and Growth Flashcards
What are the 3 phases of normal growth?
- Infantile phase
- Childhood phase
- Pubertal phase
During the infantile and childhood growth phases, which 2 hormones are depended upon?
Growth hormone
Thyroxine
Which hormone stimulates GH and epiphyses fusion in both sexes?
Oestrogen
At which age does the adolescent growth spurt happen in both sexes?
Girls: 12 years
Boys: 14 years
Define short stature
Height more than 2 SD below population mean (below 2.5th centile)
Define tall stature
Height >2 SD population mean (97-98th centile)
Define sexual precocity
Early sexual development irrespective of cause
Define precocious puberty
True puberty before age of 8 in girls and 9 in boys
Give 3 causes of short stature
- Normal genetic short stature
- Intrauterine growth retardation
- Dysmorphic syndromes
Give 2 organic causes of faltering weight
Coeliac Disease
Renal insufficiency
Which body system and it’s pathologies are commonly associated with early puberty in girls?
CNS e.g. cerebral palsy
What management can be started for boys with 4-6ml testes presenting with delayed puberty?
3 injections per month of testosterone
In terms of endocrine disorders, which areas do the following affect?
a) primary
b) secondary
c) tertiary
a) Organ e.g. testes
b) pituitary
c) hypothalamus
Although true growth hormone deficiency is rare, how is replacement hormone given?
Subcut. injection every night until final height reached
What usually causes delayed puberty?
Central impairment with intact gonadal axis e.g. anorexia
Give 2 causes of primary ovarian failure
Turner’s syndrome
Total body irradiation pre BM transplant
Give 2 causes of primary testicular failure
After cryptorchidism surgery
Klinefelter’s
How is primary hypothyroidism screened for in babies?
TSH on Guthrie card
What usually causes acquired adrenal insufficiency?
Exogeneous steroids suppressing HPA axis
How long after birth can congenital diabetes insipidus take to manifest?
1 year
Which tumour can cause acquired diabetes insipidus?
Craniopharyngioma
What is the most common cause of polyuria/polydipsia in kids?
Habit drinking
Define type 1 diabetes
AI destruction of pancreatic beta cells causing absolute insulin deficiency and ultimately hyperglycaemia, ketoacidosis, coma and death
Give 4 symptoms of diabetes
- Lethargy
- Weight loss
- Polydipsia
- Polyuria
Give 4 signs and symptoms of DKA
- Laboured breathing
- N&V
- Abdominal pain
- Confusion
What is the pathophysiology of DKA?
Insulin deficiency impairs glucose uptake causing a metabolic acidosis
Fat undergoes beta oxidation to form ketones
What is commonly enough to diagnose diabetes I children?
Single random plasma glucose >11.1 with definite symptoms
What may U&Es show in diabetes?
Na: appears low
K: initially high
Urea: high (dehydration)
HCO3: depends on acidosis
What is the onset and give one example of rapid acting insulin
5-10 mins
Novorapid
What is the onset and give one example of regular human insulin
30 mins
Actrapid
What is the onset and give one example of isophane insulin
1-3hr
Insulatard
What is the onset and give one example of long-acting insulin
3-4hr
Lantus
Give one example of mixed insulin
Humalog mix
What is the BM target range in diabetes?
4-8mmol/L
Give 2 acute complications of diabetes
DKA
Hypoglycaemia
Give 3 chronic complications of diabetes
Nephropathy
Neuropathy
Stroke
