Peds - Endo

Question 1

Ht velocity

<4, 4-6, 6-puberty

Answer 1

<4 yo: 7cm/y
4-6 yo: 6cm/y
6-puberty: 5cm/y

Question 2

peak ht velocity

Answer 2

13. 5y (boys)

11. 5 (girls)

Question 3

arm span

Answer 3

For boys <11, girls <11-14

AS < ht (w/in 2cm)

Question 4

familial short stature

Answer 4

deceleration in growth 6-18mo

- NL bone age, g. velocity, ht/wt proportional

Question 5

worried about short stature - labs?

Answer 5

CMP
ESR
thyroid function test
bone age
chromosomes (female)
IGF-1, IGFBP-3

Question 6

GH def in neonate clinical presentation

Answer 6

microphallus
hypoglycemia
midline defects

Question 7

GH def in kids clinical presentation

Answer 7

dec growth velocity
Low IGF-1 and IGFBP-3
Low GH (when stim)
w/ supp GH, growth velocity increases

Question 8

DM1 kid presenting not in DKA - how to proceed

Answer 8

insulin SQ

Question 9

DM (assumed type 2) kid - when to do insulin

Answer 9

ketones

glu > 300

Question 10

T2DM kid - insulin not indicated - how to tx?

Answer 10

metformin

Question 11

how to calculate insulin for kids

Answer 11

0-2yo <0.5 u/kg/d
prepuberty 0.5-1 u/kg/d
pubertal 1u/kg/d

Question 12

1 unit insulin covers __ carbs

Answer 12

10g

Question 13

how much will 1 unit of insulin drop blood glucose?

Answer 13

1800 / TDD

tdd=total daily dose

Question 14

DM “sick day rules”

Answer 14

BG check q3-4h
correction factor insulin based on ^ as needed
urine ketone checked 3-4h
fluids: glu<200 sugarcontaining, glu>200 sugarfree

Question 15

sick DM kid - when to bring them in

Answer 15

2x vomiting w/ ^urine ketones
rapid breathing
AMS
can’t do the sick day rules

Question 16

PE sign of insulin resistance

Answer 16

skin tag

acanthosis nigricans

Question 17

when to start insulin in T2DM kid

Answer 17

if HbA1c 9%+ despite max metformin dose

Question 18

5-2-1-0 reduce obesity

Answer 18

5 fruits/veg
<2 hours screen time
1 hour physical activity
0 sugar sweetened beverage