Paediatric Endocrinology

Question 1

what are the classic symptoms of T1DM presentation?

Answer 1

polyuria
polydipsia
weight loss
general malaise

Question 2

what are the symptoms of DKA?

Answer 2

vomiting 
abdo pain 
altered consciousness 
acidotic breathing 
dehydration
ketones in urine 
pH

Question 3

what is the WHO fasting blood glucose for diagnosis of T1DM?

Answer 3

> 7.0 mmol/l

Question 4

what is the WHO random blood glucose for diagnosis of T1DM?

Answer 4

> 11.0 mmol/l

Question 5

what is there a risk of when resuscitating someone from DKA under 16 yrs old?

Answer 5

cerebral oedema

Question 6

what are the causes of primary congenital thyroid disease?

Answer 6

Gland dysplasia +/- abnormal site

inborn error of thyroid hormone metabolism

Question 7

what are the causes of secondary/tertiary congenital thyroid disease?

Answer 7

congenital pituitary disease

Question 8

what is secondary/tertiary congenital thyroid disease usually associated with?

Answer 8

hypopituitarism

Question 9

what are the clinical symptoms of congenital thyroid disease?

Answer 9

delayed jaundice
poor feeding but “normal” weight fain
hypotonia
skin & hair changes

Question 10

what clinical test can be done to screen for congenital thyroid disease & when?

Answer 10

Guthrie test on day 5 of life

Question 11

how could a child acquire thyroid disease?

Answer 11

• delayed congenital
• post-infectious
• autoimmune
• iodine deficiency & nutrition
• other autoimmune diseases

Question 12

what is the treatment of hypothyroidism?

Answer 12

thyroxine replacement for life

Question 13

what is the initial treatment of hyperthyroidism?

Answer 13

beta-blockade

Question 14

what suppressant therapy can be used in hyperthyroidism?

Answer 14

carbimazole +/- thyroxine

Question 15

what can be done to provide a permanent cure to hyperthyroidism?

Answer 15

radio-iodine ablation

surgery

Question 16

what are the primary causes of an underactive adrenal gland?

Answer 16

Adrenal hypoplasia (absent/dysplastic/destroyed)
Inborn error of metabolism
Congenital adrenal hyperplasia

Question 17

what are the secondary causes of an underactive adrenal gland?

Answer 17

Pituitary disease

Suppression secondary to steroid therapy (high dose and prolonged)

Question 18

what are the causes of an overactive adrenal gland (cushing’s syndrome)

Answer 18

high dose cortisol therapy

Cushing disease