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SM Endocrine > Paediatric aspects of diabetes and endocrinology > Flashcards

Paediatric aspects of diabetes and endocrinology Flashcards

1
Q

How common is type 1 diabetes

A

250 children attend the paediatric diabetes service
one of the most common chronic diseases seen in children
Becoming more common

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2
Q

What is the incidence of type 1 diabetes in children

A

1 in 450

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3
Q

In 25% of new cases, what is the presentation for type 1 diabetics

A

DKA

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4
Q

What are 4 classic symptoms of type 1 diabetes

A

polyuria
polydipsia
weight loss
general malaise

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5
Q

What are symptoms of DKA

A 
vomiting 
abdominal pain
altered consciousness
acidotic breathing 
dehydration
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6
Q

What would a fasted blood glucose level be to suggest type 1 diabetes

A

7 or more

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7
Q

What would a random blood glucose level be to suggest type 1 diabetes

A

11 or more

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8
Q

If DKA is left untreated what can it lead to

A

Coma and death

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9
Q

What would be seen in urinalysis in DKA

A

pH

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10
Q

What are some of the other risks/ problems of type 1 diabetic children

A

Based on weight (10ml/kg)
careful fluid resuscitation
risk of cerebral oedema
insulin commenced 1 hour after IV fluids started

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11
Q

What are some of the early changes of vascular diabetes in children with type 1 diabetes

A 
microalbuminuria
cardiovascular autonomic neuropathy 
sensory nerve damage
retinopathy
cheirarthropathy
skin vascular changes
vascular endothelial pathology
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12
Q

In what way can we achieve optimal glycaemic control in type 1 diabetes

A

Early intensification - multiple daily injection, pumps, insulin adjustment from the start
consistent approach
consistent targets
good support - friends, school, family

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13
Q

What part of the body is faulty in primary thyroid disease

A

thyroid gland

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14
Q

What part of the body is faulty in secondary thyroid disease

A

Pituitary

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15
Q

What part of the body is faulty in tertiary thyroid disease

A

Hypothalamus

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16
Q

What is secondary/ tertiary thyroid disease usually associated with

A

hypopituitarism

17
Q

What are some clinical symptoms that may be present in congenital thyroid disease

A

delayed jaundice
poor feeding, but normal weight gain
hypotonia
skin and hair changes

18
Q

What is the test performed for congenital thyroid disease

A

Guthrie Test

19
Q

How is the Guthrie test performed

A

On day 5 of after birth
capillary blood on dry blotting paper
Test for TSH and T4

20
Q

Why is the Guthrie test not performed immediately at birth?

A

The TSH and T4 levels take a few days to normalise

21
Q

How can we diagnose congenital thyroid disease

A

Absence of thyroxine in the first 2 weeks of life

22
Q

Why does a foetus appear normal who has congenital disease

A

They have been protected by placental thyroid hormones

23
Q

What is a major complication of congenital thyroid disease

A

Developmental delay

24
Q

what type of disease is acquired thyroid disease

A

Autoimmune

25
Q

What are some symptoms of hypothyroidism in children

A 
Growth failure 
delayed puberty 
poor general health 
educational difficulties
goitre
26
Q

What would be the results of thyroid function tests in hypothyroidism

A

Low free T4 and T3
High TSH
High thyroid cell antibody titres

27
Q

What is the treatment for hypothyroidism in children

A

Thyroxine replacement for life

Dose depends on the size of the child

28
Q

What are some of the general symptoms of hyperthyroidism

A 
Behaviour problems 
Sleep disturbance 
eating difficulties 
Goitre 
high pulse rate
precocious puberty
29
Q

What would the results of the thyroid function test be in a patient with hyperthyroidism

A

Suppressed TSH
high free T4 and T3 levels
high thyroid cell antibody titres

30
Q

What is the initial treatment for hyperthyroidism

A

Beta blockade

31
Q

What is the treatment for suppressant therapy in hyperthyroidism

A

Carbimazole +/- thyroxine

32
Q

What are some permanent treatment strategies for hyperthyroidism

A

Radio-iodine or surgery

33
Q

What is more common in children- hypothyroidism or hyperthyroidism

A

Hypothyroidism

34
Q

If a patient has an underachieve adrenal gland, what do they produce low doses of

A

Steroids

35
Q

What is the main cause of primary adrenal disease

A

Congenital adrenal hyperplasia

36
Q

What is also known as overactive production of steroids

A

Cushing syndrome

37
Q

What is the treatment for Cushing disease

A

cortisol therapy

38
Q

What are signs of Virilisation in males and then in females

A

Males - precocious puberty

Females - ambiguous genitalia

SM Endocrine (27 decks)

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