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Year 2 Diabetes & Endocrinology (JK) > Paediatric endocrinology and diabetes > Flashcards

Paediatric endocrinology and diabetes Flashcards

1
Q

Briefly describe how to measure height in a child

A

use a stadiometer
stand up straight with legs together, look forward with heels, buttocks and scapulae against wall
remove shoes and socks
straighten head and take deep breath in
be very accurate and read height to last complete mm

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2
Q

Why do we measure length in children?

A

cannot stand or walk

under 2

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3
Q

Why do we measure sitting height in children?

A

trunk in respect to limbs

body problems eg achondroplasia

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4
Q

How to measure head circumference in children

A

routine in children under 2

forehead to occipital prominence

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5
Q

What is the maximal circumference of the head?

A

forehead to occipital prominence

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6
Q

What shape do we use to plot on a graph?

A

dots - for accuracy

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7
Q

List some things found on the RCPCH UK 2-18 growth chart?

A

predicted adult height scale
parent height comparison
birth centiles
WHO standards until age 4

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8
Q

List some condition specific growth charts

A

downs syndrome
turners syndrome
boy/girl

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9
Q

What is the mid parental centile?

A

average adult height centile to be expected for all children of those parents

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10
Q

How do we do bone age?

A

TW 20 - 20 bones in hand

radiograph

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11
Q

Osteopenia

A

bone mineral density is lower than normal

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12
Q

How do we plot bone age?

A

on a graph using a triangle

plot chronological age on same graph

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13
Q

Assessment tools

A 
Height/ length/ weight 
• Growth Charts and plotting 
• MPH and Target centiles
 • Growth velocity 
• Bone age
 • Pubertal assessment
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14
Q

List the letters used in tanner staging of puberty and the numbers

A 
B 1-5
G 1-5
PH 1-5
AH 1-3
T 2ml - 20ml
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15
Q

What do the number in tanner staging mean?

A 
1 = pre pubertal 
2 = start of puberty 
5 = adult
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16
Q

What is used to measure testicular volume?

A

prader orchidometer

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17
Q

Why is a precise definition of normal growth difficult?

A 
wide range in healthy population 
ethnic subgroups 
inequality in basic health and nutrition 
normality to individuals and populations
genetics
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18
Q

List some factors which influence height

A

sex, race, nutrition, chronic disease, emotional status, parental height, bone age, puberty, general health, specific growth disorders, socio-economic status

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19
Q

Describe briefly the increase in height per year in infancy, childhood and puberty

A

I - very rapid
C - constant
P - large peak - girls earlier

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20
Q

What are the types of hormones involved in puberty?

A

sex and growth

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21
Q

List the chronological pubertal changes in boys

A

testicular growth, penile growth, facial hair

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22
Q

List the chronological pubertal changes in girls

A

breast bud, breast development, menstruation

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23
Q

What stage in tanner is breast budding?

24
Q

What stage in tanner is testicular enlargement?

A

G2

T 3-4 ml

25
Earliest objective signs of puberty in boys and girls
breast bud | testicular enlargement
26
What does obesity do to height and puberty?
make you tall stimulate puberty obese and small is worrying
27
List some indications for referral for growth disorders
``` extreme tall or short - off centiles height below target height abnormal height velocity - cross centiles history of chronic disease obvious dysmorphic syndrome early/late puberty ```
28
3 common causes of short stature
SGA/IUGR familial constitutional
29
What do SGA babies benefit from?
growth hormone
30
What is constitutional growth?
period of delayed growth
31
List some pathological causes of short stature
``` undernutrition chronic illness eg IBD iatrogenic eg steroids psychological and social eg in care hormonal eg GHD, hypothyroidism syndromes eg turner, noonans ```
32
Early and delayed puberty in boys
early <9 = rare | delayed >14 - common, especially CDGP
33
Early and delayed puberty in girls
early <8 | delayed >13 rare
34
Constitutional delay in growth and puberty
mainly boys FH - hard to obtain bone age delay exclude organic disease
35
List some other causes of delayed puberty
gonadal dysgenesis chronic disease impaired HPG axis peripheral eg testicular irradiation
36
Thelarce
onset of female breast development
37
precocious
developed earlier than usual
38
adrenarche
early sexual maturation - adrenals
39
menarche
menstruation
40
What is central precious puberty and describe it
early onset of breast and testicular development | growth spurt and advanced bone age
41
central precocious puberty: worrying for boys or girls?
boys girls - normal, pituitary imaging boys - underlying cause eg brain tumour
42
Treatment of central precocious puberty
GnRH agonist
43
What is precocious pseudopuberty?
gonadotrophin independent - low hormone levels abnormal sex steroid secretion secondary sexual characteristics
44
How to manage ambiguous genitalia in newborn
do not guess karyotype MDT, exam of genitalia and internal
45
What should you exclude in newborns with ambiguous genitalia?
congenital adrenal hyperplasia
46
Management of congenital hypothyroidism and causes
hypoplastic, dyshormogenic | screen and start treatment within 2 weeks
47
Causes and consequence of acquired hypothyroidism
autoimmune FH lack of height gain, pubertal delay and poor school performance
48
How to assess an obese child
BMI, height, weight | skin folds, waist circumference, history, exam, complications
49
Causes of child obesity
``` simple drugs eg insulin, CCS, sodium valproate syndromes endocrine disorders eg GHD, hypothyroidism, leptin deficiency hypothalamic damage ```
50
Treatment of obesity
exercise diet psychological drugs??
51
Syndromes causing obesity
PW, downs
52
4 T's of type 1 diabetes
thirst thinner toilet tired
53
Testing for type 1 diabetes and DKA
skin prick capillary glucose | >11mM
54
What do you do for child with type 1 diabetes with DKA?
same day review
55
red flag for type 1 DKA
wetting bed
56
under 5 signs/symptoms of type 1 diabetes
heavy nappies irritable recurring skin infections blurred vision
57
DKA symptoms
``` nausea and vomiting coma drowsiness acetone breath abdominal pain deep, rapid respiration ```

Year 2 Diabetes & Endocrinology (JK) (24 decks)

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