Paediatric Endocrinology Flashcards
What are the earliest objective signs of puberty?
Breast budding in girls
Testicular enlargement in boys
What are the indications for referral in reference to growth disorders?
Extreme short or tall stature Height below target height Abnormal height velocity History of chronic disease Obvious dysmorphic syndrome Early/later puberty
What are the common causes of short stature?
Familial
Constitutional delay of growth and puberty
Small for gestational age (SGA)
What are the pathological causes of short stature?
Undernutrition Chronic illness Iatrogenic (steroids) Psychological and social Hormonal Syndromes
What ages are considered to be early and delayed puberty?
Boys: Early- <9 years Delayed- >14 years (common) Girls: Early- <8 years Delayed- >13 years (rare)
What are the characteristics of constitutional delay of growth and puberty (CDGP)?
Mainly affects boys
Family history
Bone age delay
Need to exclude disease
What are the causes of delayed puberty?
CDGP Gonadal dysgenesis Chronic disease Impaired HPG axis Peripheral (testicular irradication, cryptorchidism)
How should ambiguous genitalia of a newborn be managed?
Multidisciplinary approach
Exam- gonads, internal organs
Exclude congenital adrenal hyperplasia
What are the causes of congenital hypothyroidism?
Athyreosis/ hypoplastic/ ectopic thyroid
Dyshormonogenic
What issues does acquired hypothyroidism present in childhood?
Lack of height gain
Pubertal delay
Poor school performance
What are the causes of childhood obesity?
Simple obesity (increased intake, decreased activity)
Drugs (insulin, steroids, antithyroid drugs)
Syndromes (Prader Willi, Down’s)
Endocrine disorders (Hypothyroidism, GH deficiency, excess glucocorticoid)
Hypothalamic damage
What are the cardinal symptoms of type 1 diabetes?
Thirsty
Tired
Thinner
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