Paediatric Endocrinology

Question 1

what should pH be in DKA?

Answer 1

<7.3

Question 2

commonest symptom of new diabetes in children?

Answer 2

secondary nocturnal enuresis

Question 3

how could you see if a baby is experiencing symptoms of thirst?

Answer 3

ask mum if theyre needing milk alot

Question 4

what should you do if a child has elevated blood glucose, ketones and vomiting?

Answer 4

emergency referral to paeds

Question 5

what should you do if a child has elevated blood glucose, ketones and is clinically well?

Answer 5

urgent referral to paeds for same day review

Question 6

what should you do if a child has elevated blood glucose, no ketones and is clinically well

Answer 6

urgent phone contact with duty paeds team for 24hr review

Question 7

best achievable HbA1C for a child?

Answer 7

<58mmol/l

Question 8

what is the target HbA1C for a child 1yr after diagnosis

Answer 8

<48mmol/l

Question 9

what constitutes the microvascular screening done for children with diabetes

Answer 9

BP
retinal screening
albumin/creatinine ratio

Question 10

what is the difference in DKA management for children compared to adults?

Answer 10

fluids first

THEN IV insulin after 1hr

Question 11

target BGL 2hrs after meals?

Answer 11

5-7mmol/l

Question 12

what is cheirarthropathy and when would it present?

Answer 12

thickened skin

joint contractures as a microvascular ocmplication of T1DM

Question 13

what does the insulin regime of an insulin pump look like?

Answer 13

rectangular

Question 14

how many insulin units would u give to get to BG:

patient has a 1:10g ratio and had 50g carb and an insulin sensitivity of 1:2

Answer 14

5 units to cover carb

1:2 so need 1 unit of insulin to reduce BGL by 2mmol so need 2 units = 7 units

Question 15

signs of congenital thyroid disease?

Answer 15

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

Question 16

what is the guthrie test?

Answer 16

to test for congenital hypothyroidism

Question 17

why is the guthrie test on day 5 of birth?

Answer 17

TSH high straight after birth so need to wait for it to slow down

Question 18

when would a child display cretinism and why?

Answer 18

3 months as mothers hormones are gone

Question 19

symptoms of hypothyroidism in kids?

Answer 19

growth failure

delayed puberty

Question 20

symptoms of hyperthyroidism in kids?

Answer 20

goitre
high pulse rate
precocious puberty

Question 21

are you more likely to present with goitre in hypo or hyperthyroidism?

Answer 21

hypo

Question 22

what hormone production can IBD prevent?

Answer 22

cortisol

Question 23

give an example of secondary hypoadrenalism?

Answer 23

pituitary disease

Question 24

give an example of primary hypoplasia?

Answer 24

adrenal hypoplasia

inborn error of metabolism

Question 25

which gender gets ambiguous genitalia in congenital adrenal hyperplasia

Answer 25

females