Paediatric Endocrinology - Liam

Question 1

Type 1 DM

• symptom triad

Answer 1

Polyuria

Polydipsia

Weight loss

Question 2

T1 DM

• long term complications

Answer 2

• Macrovascular
  
  • Coronary artery disease
  • Peripheral ischaemia
• Microvascular
  
  • Peripheral neuropathy
  • Retinopathy
  • Kidney disease

Question 3

DKA:

• diagnosis

Answer 3

Hyperglycaemia (blood glucose >11 mmol/L

Ketosis (blood ketones > 3mmol/L

Acidosis (pH < 7.3)

Question 4

DKA-

treatment

Answer 4

• Correct dehydration over 48 hours
• Fixed rate insulin infusion
  
  • Prevent hypoglycaemia with IV dextose when BG < 14mmol/L
• Monitor for cerebral oedema

Question 5

Congenital adrenal hyperplasia

• pathology

Answer 5

Congenital deficiency of 21-hydroxylase enzyme, causing underproduction of cortisol and aldosterone and overproduction of androgens from birth

Question 6

Congenital adrenal hyperplasia

• severe presentation

Answer 6

• Females with ambigious genitalia due to high testosterone
• Hyponatramia, hyperkalaemia and hypoglycaemia shortly after birth

Question 7

Congenital adrenal hyperplasia

• mild presentation

Answer 7

• Female
  
  • Tall, facial hair, absent periods, deep voice, early puberty
• Male
  
  • Tall, deep voice, large penis, small testicles, early puberty

Question 8

Congenital adrenal hyperplasia

• treatment

Answer 8

Cortisol replacement (hydrocortisone)

Aldosterone replacement (fludrocortisone)

Surgery for ambigious genitals

Question 9

Congenital hypothyroidism

• diagnosis

Answer 9

Screened for at birth in newborn blood spot screening

Question 10

Acquired hypothyroidis

• cause

Answer 10

Autoimmune thyroidisis (also called Hashimotos thyroiditis)

Question 11

Hypothyroidism

• symptoms

Answer 11

• Fatigue and low energy
• Poor growth
• Weight gain
• Poor school performance
• Constipation
• Dry skin and hair loss

Question 12

Hypothyroidism

• treatment

Answer 12

• TFT, thyroid USS and thyroid antibodies
• Levothyroixin to replace normal thyroid hormones