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Paeds > Endoctine > Flashcards

Endoctine Flashcards

1
Q

Which infants and children are at higher risk of hypoglycaemia

A

Premature
IUGR or small for gestational age
Born to diabetic mothers
Septic or severe illness

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2
Q

What is the standard value of hypoglycaemia in paediatric

A

<2.6 glucose

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3
Q

Symptoms of hypoglycemia

A

Poor feeding
Lethargy
Seizures
Coma
Older: anxiety, palpitations, tremors, blurred vision, confusion and weakness.

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4
Q

What are the causes of hypoglycaemia in paeds

A

Hyperinsulinism
Counter-regulatory hormone deficiency (GH deficiency, hypocortisol, glucagon deficiency)
Glycogen storage or release diseases
Mt fatty acid oxidation defects
Keton utilisation defects
Defective gkuconeogenesis
Exogenous drugs
Miscellaneous causes (ketotic, hypoglycaemia, reactive hypoglycaemia)

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5
Q

Treatment of congenital hyperinsulinism

A

Diazoxide

Best managed in tertiary as some need surgery

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6
Q

what is the average rate of growth in the first 2 years of life

A

25cm per year in the first year then 12 cm per year in the second .

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7
Q

what regulates growth in the pubertal period

A

GH and sex steroids (oestrogen and teestosterone)

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8
Q

What is the average height difference between girls and boys during puberty

A

13cm

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9
Q

what is the cut off age foe measuring a child with a infantometer

A

2 years, then use a stadiometer

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10
Q

what is the normal mid parenteral height

A

indicates a child’s genetic growth potential
average of parents height and add or subtract 6.5 for boys or girls respectively. If above 8.5 cm outside target height investigate further

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11
Q

what are the clinical clues to the presence of endocrine cause of short statue

A
  1. GH deficiency- Cherubic appearance face (noncancerous painless growths in child’d jaw, lwading to wide jaw and round cheeks)
  2. Increased weight to height ratio, child appears obese

(Clues: hypoglycemia and micropenis)

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12
Q

list the endocrine causes of short statue

A

Hypopituitarism
GH deficiency
Hypothyroidism
precocious puberty
CAH
Cushings syndrome
Pseudohypoparathyroidism
Poorly controlled DM

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13
Q

causes of pituitary gland malformations

A

Congenital
Cranial malformations: Holoprosencephaly, Septo-optic dysplasia and midline craniocerebral
Embryonic defects: Pituitary hypoplasia, Pituitary aplasia, Congenital absence of pituitary gland

Acquired: Tumours, Cranial radiotherapy or surgery, head trauma, Infection from meningitis/encephalitis, Infiltrative disorders ei Langerhans cell histiocytosis&sarcoidosis

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14
Q

Investigations for suspected hypopituitarism

A

Thyroid function
Serum cortisol
IGF

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15
Q

CAuses of tall statue

A

Thyrotoxicosis
Precocious Puberty
CAH
Gigantism
Genetics (Marfans, Klinefelter, Soto syndrome & homocystinuria )

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16
Q

Precocious puberty is the onset of secondary sex maturation at what age

A

<8 in girls
<9 in boys

17
Q

How can you confirm DM 1 in paediatrics

A

diabetes associated antibodies (GAD, IA2, IAA or ZnT8)

18
Q

What are the functions of major endocirine glands (what do they regulate)

A

Hypothalamus- Homeostasis&regulates body temp, HR &BP

Pituitary- Anterior regulates GH, Posterior increase reabsorption of water into kidneys.

Pineal gland- Melatonin production for sleep-wake cycle

Thyroid- Metabolic rates

Parathyroid - Calcium reabsorption, Phosphorus

Adrenal: Adrenalin and Cortisol production

Pancreas- Blood sugar levels through production of insulin and glucagon

Thymus- T cells (WBC)

Ovary and Testes- Reproductive

19
Q

Difference between premature thelarche and adrenarch

A

Thelarche is breast enlargement without other sex characteristics.
Adrenarche is appearance of pubic hair without other signs of puberty

20
Q

Clinical features of SIADH

(just think of its pathophysiology, you should be fine lol)

A

Muscle weakness
Nausea
Vomitting
Headache
Neurological impairement
Convulsions and coma
Some pt develop oedema

so SIADH causes increased renal tubular water reabsorption results in diminished output with highly concentrated urine and dilutional hyponatremia without dehydration.

21
Q

Features of hypothyroidism vs features of hyperthyroidism

A

Hypo
Short statue
Goitre
Obesity
Constipation
Delayed puberty
Cold peripheries
Dry skin
Hypotonia
Coarse facial features
WIde posterior fontanelle
Macroglossia
Hoarse cry
Development delay

Hyper
Irritable or emotional lability
Nervousness
Tremor
palpitation
sweating
weight loss

Paeds (24 decks)

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