Peadiatric Endocrinology

Question 1

What is a childs diabetes presentation?

Answer 1

peeing lots
thirsty a lot
bed wetting
weight loss

Question 2

What is a childs DKA presetation?

Answer 2

vomiting
stomach pain
sighing breathing
acetone breath smell

Question 3

What is the fasting and random BG values for diagnosing diabetes?

Answer 3

fasting BG >7mmol/l

random BG >11.1 mmol/l

Question 4

What does DKA pose a risk of in children? Why?

Answer 4

cerebral oedema because: increased blood glucose causes a higher osmolar gradient leading to an ICF -> ECF fluid shift
if the fluid is replaced too quickly this causes ICF volume expansion leading to cerebral oedema

Question 5

What is the treament of DKA?

Answer 5

IV fluids then insulin 1 hour later

Question 6

What is the target HbA1c for children in the first year of diagnosis?

Answer 6

<48

Question 7

What is the target HbA1c for children after the first year of diagnosis?

Answer 7

<58

Question 8

What can cause congenital thyroid disease?

Answer 8

Primary:
inborn error of thyroid hormone metabolism
dysplastic gland or abnormal site

Secondary:
congenital pituitary disease ass with hypopituitarism

Question 9

What are the symptoms of congenital thyroid disease?

Answer 9

delayed jaundice
hypotonia - floppy baby
skin and hair changes
poor feeding but normal weight gain

Question 10

How is congenital thyroid disease screened for?

Answer 10

Guthrie heel prick at baby screening

Question 11

How is congenital thyroid disease treated?

Answer 11

MUST be done by 3 months otherwise they risk developmental delay
give thyroxine replacement

Question 12

When does acquired thyroid disease occur?

Answer 12

due to autoimmune conditions, infections, iodine deficiencies or just delayed congenital thyroid disease

Question 13

What are the symptoms of aquired hyperthyroidism?

Answer 13

behaviour problems
sleep disturbances
eating difficulties
goitre
high pulse
precocious puberty

Question 14

How is aquired hyperthyroidism treated?

Answer 14

initially: beta blocker
long term: carbimazole +/- thyroxine - for 2 yrs
curative: surgery or radioiodine

Question 15

What are the symptoms of aquired hypothyroidism?

Answer 15

growth failure
delayed puberty
goitre
poor general health
high thyroid cell antibody titres

Question 16

What is the treatment for acquired hypothyroidism?

Answer 16

thyroxine replacement for life

Question 17

What is congenital adrenal hyperplasia due to?

Answer 17

21 hydroxylase enzymes do not work so you do not produce any aldosterone or cortisol so you produce tons of testosterone instead

Question 18

What are the presenting features of congenital adrenal hyperplasia for females?

Answer 18

virulisation - half and half

Question 19

What are the presenting features of congenital adrenal hyperplasia for males?

Answer 19

pigmented scrotum
precocious puberty
salt wasting

Question 20

How is the genetic mutation for CAH passed on?

Answer 20

autosomal recessive

Question 21

What is the diagnostic tests for CAH?

Answer 21

measure basal or stimulated 17-OH progesterone

Question 22

What is the treatment for CAH?

Answer 22

glucocorticoid replacement

mineralocorticoid replacement in some