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Peds II > Pediatric Endocrinology > Flashcards

Pediatric Endocrinology Flashcards

1
Q

What are the two age peaks for Type I DM?

A
  • 4-6 years

- 10-14 years

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2
Q

What population is most affected by Type I DM?

A

Non-Hispanic whites

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3
Q

What condition is associated with HLA-DR3, HLA-DR4 genes?

A

Type I DM

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4
Q

What three symptoms are associated with Type I DM? What other two symptoms are often associated?

A

3 P’s: polyuria, polydipsia, polyphagia

  • Weight loss
  • Fatigue
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5
Q

What is the recommended treatment for Type I DM?

A

INSULIN

- Start low, go slow

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6
Q

How is hypoglycemia affected by age?

A

As age increases, hypoglycemia risk decreases

- Bigger range for tolerated blood glucose readings

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7
Q

What is the “physiologic regimen” recommended as treatment for Type I DM? What is the purpose of each?

A
  • Short-acting (Regular Insulin): pre-meal bolus

- Intermediate-acting (NPH Insulin): maintain baseline levels

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8
Q

What are the three types of administration for Insulin in Type I DM?

A
  • Syringe: less training BUT prone to hyperglycemia and needle sticks
  • Pen: easy to use and portable BUT $
  • Pump: more accurate, improve HbA1c, can exercise without increase in carbs BUT $$$
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9
Q

What are four risk factors associated with Type II DM?

A
  • Obesity
  • +FH
  • High-risk ethnicity
  • Conditions associated with insulin resistance
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10
Q

What are the five high-risk ethnicities associate with Type II DM?

A
  • Native American
  • AA
  • Latino
  • Asian
  • Pacific Islander
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11
Q

What three condition are associated with insulin resistance in Type II DM?

A
  • PCOS
  • Acanthosis nigricans
  • Dyslipidemia
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12
Q

What three symptoms are associated with Type II DM?

A
  • Polyuria (bed wetting)
  • Vision issues
  • Acanthosis nigricans = early sign
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13
Q

What four diagnostic tests are associated with Type II DM?

A
  • Fasting plasma glucose (126+)
  • Random plasma glucose (200+)
  • OGTT (200+ after 2 hours)
  • HbA1c (6.5+%)
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14
Q

What is the recommended screening for Type II DM (___ + ____ + __(4)__)?

A 
10+ years
PLUS
Overweight/obese
PLUS
2+ of...
- FH
- High-risk ethnicity
- Sxs of insulin resistance or PCOS/acanthosis nigricans/dyslipidemia
- Maternal DM/gestation DM in utero
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15
Q

What is the recommended treatment for Type II DM?

A

Metformin

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16
Q

If a patient has DM AND HTN, what medication should be added?

A

ACE-I/ARBs

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17
Q

If a patient has DM AND dyslipidemia, what is the recommended treatment plan (2)?

A
  1. 6 months of non-pharm

2. Add statin if needed

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18
Q

What is considered overweight for peds?

A

85th to 95th percentile

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19
Q

What is considered obese for peds?

A

Above 95th percentile

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20
Q

What three ethnicities are at higher risk for obesity?

A
  • Indian American
  • AA
  • Mexican American
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21
Q

What is the recommended exercise for peds? What should be the limit for screen time?

A
  • Exercise: 30-60 minutes/day

- Screen time: 2 hours/day

22
Q

What are the guidelines for Short Stature in peds (2)?

A

2+ standard deviations below mean

- Less than 2.3%

23
Q

What method can be used to diagnose Short Stature in peds, and what does this involve?

A

Greulich-Pyle Atlas method (GP method)

- XR of left hand, left wrist

24
Q

What are the two causes of NORMAL variation for Short Stature in peds, and which is more common?

A
  • Familial short stature

- Delay of growth = MORE common

25
Of the etiologies of Short Stature, which is the only one that involves NORMAL adult height?
Delay of growth
26
What etiology of Short Stature involves parents short: bone age and pubertal timing normal?
Familial short stature
27
What etiology of Short Stature involves delayed bone age AND delayed pubertal timing?
Delay of growth
28
If a patient has low IGF-1, low IGFBP-3 and delayed bone age, what etiology of Short Stature is this indicative of?
GH Deficiency
29
Which condition involves short stature, “boxy” body shape, webbed neck?
Turner Syndrome
30
Which condition involves streaked gonads, CoA?
Turner Syndrome
31
Which condition involves short stature and obesity?
Prader-Willi Syndrome
32
Which two Short Stature etiologies are autosomal dominant?
- Noonan Syndrome | - Achondroplasia
33
Which condition involves short stature, CHD?
Noonan Syndrome
34
Which condition involves short stature, disproportionate with rhizomelic shortening, macrocephaly?
Achondroplasia
35
What gene is associated with Achondroplasia?
FGFR3 gene
36
Which condition involves excess GH BEFORE epiphyseal closure → excessive growth of ALL long bones?
Gigantism
37
What condition involves high serum IGF-1? What other test can be performed, and what is an abnormal response?
Gigantism | - GH suppression test (abnormal = GH remains higher than 1 ng/mL after glucose administration)
38
What is the recommended treatment for Gigantism?
Octreotide
39
What is considered precocious puberty in females? Males?
- Before 8 years in females | - Before 9 years in males
40
What lab finding can be used to differentiate Central = Gonadotropin-Dependent from Peripheral = Gonadotropin-Independent?
- Central = Gonadotropin-Dependent: HIGH LH/FSH | - Peripheral = Gonadotropin-Independent: LOW LH/FSH
41
Which etiology of precocious puberty is idiopathic; more common in girls?
Central = Gonadotropin-Dependent
42
What is the recommended treatment for Central = Gonadotropin-Dependent?
GnRH agonists
43
If gynecomastia is pubertal, what does this indicate? If it is prepubertal, what does this indicate (3)?
- Pubertal = benign | - Prepubertal = Klinefelter’s Syndrome, obesity, tumor
44
What condition involves stimulation of adrenal gland IN UTERO?
Congenital Adrenal Hyperplasia
45
What condition involves 21-hydroxylase deficiency?
Congenital Adrenal Hyperplasia
46
What four lab findings are seen with 21-hydroxylase deficiency?
- No Aldosterone - No cortisol - HIGH androgens - HIGH ACTH
47
What is salt losing Congenital Adrenal Hyperplasia mean, and how does this present in females? Males (2)?
NO 21-hydroxylase - Genital atypia in females - Hyponatremia and hyperkalemia in males
48
What is non-salt losing Congenital Adrenal Hyperplasia mean, and how does this present in females? Males?
LOW 21-hydroxylase - Genital atypia in females - Early virilization at 2-4 years in males
49
What is non-classic Congenital Adrenal Hyperplasia mean, and how does this present in females AND males (2)? What is also seen in females (2)?
LATE ONSET Early pubarche, precocious sexual in females AND males - Hirsutism, menstruation irregularities in females
50
What three treatments are recommended for Congenital Adrenal Hyperplasia?
- GnRH agonist - Hydrocortisone - Fludrocortisone

Peds II (12 decks)

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