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Pediatrics > Pediatric Endocrinology > Flashcards

Pediatric Endocrinology Flashcards

1
Q

What hormones are produced by the posterior pituitary gland?

A
  1. Oxytocin

2. ADH

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2
Q

What hormones are produced by the anterior pituitary gland?

A
  1. FSH
  2. LH
  3. ACTH
  4. TSH
  5. PRL
  6. Indorphins
  7. GH

FLAT PIG

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3
Q

[SMR landmarks]

Identify the stage for boys:

Testes enlarge

A

Stage 2

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4
Q

[SMR landmarks]

Identify the stage for boys:

Penis enlarge
Pubic hair begins

A

Stage 3

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5
Q

[SMR landmarks]

Identify the stage for boys:

Curly pubic hair

A

Stage 4

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6
Q

[SMR landmarks]

Identify the stage for boys:

adult testis, pubic hair to medial surface of thigh

A

Stage 5

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7
Q

[SMR landmarks]

Identify the stage for girls:

Thelarce

A

Stage 2

TWOlarche = TWOtoy

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8
Q

[SMR landmarks]

Identify the stage for girls:

Enlarged breast and areaola

A

Stage 3

Imagine 3 as breast

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9
Q

[SMR landmarks]

Identify the stage for girls:

Pubic hair becomes curly
Papilla form secondary mound

A

Stage 4

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10
Q

[SMR landmarks]

Identify the stage for girls:

pubic hair forms adult triangle spreading to the medial surface of the thigh

A

Stage 5

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11
Q

[Breast Development]

Identify the stage:

Prepubertal
Elevation only of papilla

A

Stage 1

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12
Q

[Breast Development]

Identify the stage:

breast bud forms below the areaola

A

Stage 2

Imagine 2, bud

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13
Q

[Breast Development]

Identify the stage:

Enlargement and elevation of breast and areaola

A

Stage 3

Imagine, 3 as breast

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14
Q

[Breast Development]

Identify the stage:

secondary mound

A

Stage 4

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15
Q

[Breast Development]

Identify the stage:

Recession of the secondary mound and smooth breast contour

A

Stage 5

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16
Q

[Male Genitalia Development]

Identify the stage:

Enlargement of testes
No enlargement of penis

A

Stage 2

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17
Q

[Male Genitalia Development]

Identify the stage:

Testes continues to enlarge
Penis begins to enlarge

A

Stage 3

  1. Lengthens first
  2. Then later in diameter
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18
Q

[Male Genitalia Development]

Identify the stage:

Continued lengthening and enlargement of glans

A

Stage 4

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19
Q

[Male Genitalia Development]

Identify the stage:

adult size and proportion

A

Stage 5

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20
Q

[Staging for pubic hair]
Both sexes

Fine vellus hair

A

Stage 1

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21
Q

[Staging for pubic hair]
Both sexes

Sparse straight hair

A

Stage 2

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22
Q

[Staging for pubic hair]
Both sexes

darker
curlier

A

Stage 3

3 = curl

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23
Q

[Staging for pubic hair]
Both sexes

escutcheon covers a smaller area; hair resembles adult type

A

Stage 4

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24
Q

[Staging for pubic hair]
Both sexes

hair increase in volume, spread onto the medial thigh

A

Stage 5

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25
Q

What is the sequence of sexual development in girls?

A
  1. Thelarche (10-11)
  2. Pubarche
  3. Menarche (12.5 average)
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26
Q

What is the sequence of development in boys?

A
  1. Gonadarche
  2. Pubarch
  3. Adrenarche
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27
Q

Age cutoff for precocious puberty in girls?

A

8 years old

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28
Q

Age cutoff for precocious puberty in boys?

A

9 years old

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29
Q

Age cutoff for delayed puberty in girls?

A

13 years old

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30
Q

Age cutoff for delayed puberty in boys?

A

14 years old

31
Q

[When to suspect abnormality]

if at age 13 there is no ___

A

thelarche

32
Q

[When to suspect abnormality]

If at age 14 there is no

A

menses

33
Q

[When to suspect abnormality]

If at age 16 there is menses but no ___

A

secondary sex characteristics

34
Q

[Growth delay]

Short stature is defined as ___ SD

A

2 or more SD below the mean height for children

35
Q

[Growth delay: short stature]

If Bone age is equal to the chronological age

A

Familial Short Stature

36
Q

[Growth delay: short stature]

If Bone age is less than the chronological age

A

Constitutional Short Stature

37
Q

Failure to thrive means that the weight is persistently less than ___ percentile

A

5th percentile

38
Q

If the growth curve crosses 2 major percentile lines on growth chart, the child is said to have ___

A

Failure to thrive

39
Q

What is the normal urine osmolality?

A

500 to 800 mOsm/kg water

40
Q

What is the random urine osmolality

A

300 to 900 mOsm/kg water

41
Q

What is the normal serum osmolality

A

<280

42
Q

What is the normal serum sodium

A

<135

43
Q

What is the normal urine Na

A

40 to 220 mEqs/L/day

44
Q

What is the normal urine Na

A

40 to 220 mEqs/L/day

45
Q

What are the cardinal features of Diabetes insipidus?

A

Polyuria

Polydipsia

46
Q

What test will help you distinguish central and nephrogenic DI?

A

Water deprivation test

ADH administration

47
Q

Diagnosis of DI

Serum osmolality
Urine osmolality

A

Serum > 300 mOsm/kg

Urine <300

48
Q

Diagnosis of Nephrogenic DI

Serum osmolality
Urine osmolality

A

Serum osmolality >290

Urine osmolality <290

49
Q

Diagnosis of SIADH

Serum osmolality
Serum Na
Urine osmolality

A

Serum osmolality <280
Serum Na <135

Urine osmolality >100
Urine Na >25

50
Q

Disappearance of this antibody signifies remission of Grave’s Disease

A

TRSAb

51
Q

Drug for graves disease that inhibits peripheral conversion of T4 to T3

A

PTU

52
Q

Drug for graves that can cause transient leukopenia

A

Methimazole

53
Q

Most common site of origin of pheochromocytoma is the

A

Adrenal medulla

54
Q

Most often location of pheochromocytoma

A

right side

55
Q

What are the immediate substrate of VMA?

A
  1. Metanephrine from Epinephrine

2. Normatanephrine from Norepinephrine

56
Q

What is the immediate substrate of HVA?

A
  1. 3-methoxy-dopamine from dopamine
57
Q

[Diagnosis]

Headache
palpitations
abdominal pain
dizziness
pallor
vomiting
sweating
convulsions

abdominal mass

A

Pheochromocytoma

58
Q

Urinary excretion of _____ is increased in pheochromocytoma

A

VMA

59
Q

What antibody is present in 80-90% of newly diagnose DM in pediatric patients?

A

Islet cell antibodies

60
Q

What is the criteria for DKA in children?

A
  1. Glucose >200
  2. venous pH <7.3
  3. HCO3 <15
61
Q

{Classificaiton of DKA: ISPAD]

HCO3 <10
pH <7.2

A

moderate

62
Q

{Classificaiton of DKA: ISPAD]

HCO3 <5
pH <7.1

A

severe

63
Q

What is the initial hydrating fluid used in DKA?

A

pNSS

64
Q

When will you administer glucose (5% solution in 0.2 pNSS) in patients with DKA?

A

if the blood glucose approaches 300mg/dL

65
Q

To reduce cerebral edema in patients being treated for DKA, the rate of fluid infusion should be limited to

A

4L/m2/day or less

66
Q

What is the dose of regular insulin for patients with DKA?

A
  1. 0.1 U/kg of regular insulin followed by

2. Constant infusion of 0.1 U/kg/hr insulin

67
Q

What is the most common cause of thyroid disease in children and adolescents?

A

Thyroiditis

Associated with HLA-DR4 and HLA-DR5

68
Q

Dose of Levothyroxine in pediatric patients with hypothyroidism

A

50 to 150 ug/day

69
Q

most common enzyme deficiency causing CAH

A

21-hydroxylase

70
Q

[Diagnose]

low Na
Low Cl
High K
Low serum cortiso
Increased serum aldosteronel
Increase plasma renin
A

CAH

Tx: hydrocortisone

71
Q

Most common cause of Cushing syndrome in infants?

A

Functioning adrenocortical tumor

72
Q

Normal pattern of cortisol decline

A
  1. 8am - elevated
  2. 8pm - decline by 50%

in cushing, diurnal rhtytm is lost

73
Q

Treatment for cushing syndrome if due to bilateral adrenal tumors

A

Subtotal adrenalectomy

Pediatrics (15 decks)

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