Peds: Endocrinolgy Flashcards
Normal size and weight at birth then severe growth failure in the first year. (May present with neonatal emergencies (Hypoglycemic seizures, hypothyroidism, hypoadrenalism. Dx? Test? Definitive Test? Rx?
Hypopituitarism ( Deficiency of growth hormone or other hormes. Delay in pubertal development is common. Congenital or acquired. Check IGF-1 and the IGF- binding protein 3. Definitive test is the Growth Hormone Stimulation Test. MRI indicated in all patients. Can check TSH, ACTH. Rx: For growth hormone deficiency give Recombinant growth hormone.
Caused by mostly a hormone secreting adenoma. Can cause deficiencies due to negative feedback mechanisms.Dx? Test? Rx?
Hyperpituitarism. IGF-1 and IGF-binding protein 3. MRI. Chromosomes in tall males (XXY) TSH. Give treament only if predication of adult height >3 SD above the mean. Give sex steroids to accelerate puberty and epiphyseal fusion.
Sexual Development that occurs in < 8 yrs for females and < 9 yrs for male. Dx? Test? Rx?
Precocious Puberty (Can be peripheral or central). Screen for increase in GnRH, LH, FSH, Estrogen, Testosterone. MRI for tumor. Give Leuproliode (stop sexual advancement and maintain open epiphyses so they can grow.)
Breast: Preadolescent. Genital: Preadolescent. Pubic: Preadolecent Tanner Stage?
1.
Breast: Breast Bud Genital: Enlargement of sroctum and testes, darkening of scrotum texture. Pubic: Sparse, long pigemented hair.
- Female 12 male 13.5
Breast: Continue enlargement, no contour separation. Genital Enarlgemnet of penis. Darker Coarse more curled hair.
- Female 12.5, male 14
Breast: Secondary mound, projection of areola and papilla. Genital: Increase in penis breadth and development of glans. Hair resembles adult.
- Female 13 and Male 14.5
Breast: Mature Stage Genital: Mature Stage 15 yr Pubic: Mature sage (Female 14.5, male 15)
5
2 month old presents with inadequate weight gain, constipation, decreased muscle tone, large fontanel, large tongue and umbilical hernia. Goiter or no Goiter .Dx? Test? Rx?
Congenital Hyperthyroidism. (Thyorid dysgenesis, transplacental passage of maternal thyrotropin, thyroid hormone synthesis defect, radioiodine, iodine deficiency. Low serum T4 or free T4 and increased TSH. Rx: Sodium thyroxine. (synthroid)
Hypothyroidism that presents in adolesnce. First sign is usually deceleration of growth. Diffusely increase firm nontender thyroid. Dx? Test? Rx?
Hashimoto’s Acquired Hypothyroidism. T4 and TSH. L-thyroxine - sodium thyroxine synthroid.
Child presents with hyperactivity, decling schol performance, appetitie is increased, no weight gain. Slight tremor of fingers and mild exophthalmos and neck mass. Dx? Test? Rx?
Hyperthyroidism (Graves Dz). Increased T4, T3 and Free T4. Decreased TSH. PTU or methimazole. Beta blockers.
Seizures and Spasm. Associated with Diegore and Velocardialfacial Syndrome. Dx? Test? Rx?
Hypoparathyroidism Decrease Calcium (5-7 mg/dl) Increase serum phosphorus (7-12 mg/dl) Low parathyroid hormone. For emergency neonatal tetany give IV Calcium gluconate. then calcitrol to normalize calcium
Common cause of rickets. Fractures, rachitic rosary. Dx? Test? Rx?
Vitamin D deficiency. Low phosphate and Calcium incresed PTH and alk phos. Vitamind D and calcium then Calcium and Phosphate.
1 month old presents with vomiting and dehydration examination reveals ambigous genitalia and labs show hyponatremia. Dx? Test? Rx?
Congenital Adrenal Hyperplasia. 21 alpha hydroxlase deficiency. (shunts to androgens and causes salt wasting since no aldosterone is being made) Hypotensive Panzy. Increase 17-OH present. Definitive Test is to check 17-OH after ACTH given. Rx: Hydrocortisone. Fludrocortisone.
Infants (adrenocrotical tumor) Excess ACTH from pituitary adenoma. Moon facies, trunchal obesity, impaired growth, striae, delayed puberty and amenorrhea. Muscle wasting, Hyperglycemia. Osteoporosis. Dx? Test? Rx?
Cushing Syndrome. Dexamethasone suppresion test. CT scan and MRI Rx: Remove tumor. remove adrenals.
