Week 4 - K - Paediatric endocrine and P values

Question 1

How common is type 1 diabetes in children?

Answer 1

1 in 450 children

Question 2

Which country has the greatest incidence of type 1 diabetes?

Answer 2

Finland

Question 3

What are the random and fasting glucose levels required for diabetes diagnoses?

Answer 3

Random - glucose greater than 11.1 mmol/l

Fasting - glucose greater than 7mmol/l

Question 4

What are the symptoms of DKA?

Answer 4

Vomiting

Stomach pain

Pear drops on breath

Polydipsia and polyuria

Kausmmal breathing (deep laboured breathing)

Question 5

Children wetting the bed repeatedly at night can be known as nocturnal enuresis What is the commonest symptom of new diabetes in children?

Answer 5

Secondary nocturnal enuresis - secondary as it is due to diabetes

Question 6

What is the expected biochemical results in dka? (ph, ketones and glucose)

Answer 6

pH less than 7.3

Ketones on urine stick - +++ (greater than 3)

Glucose greater than 11 usually

Bicarb - 14 and less

Question 7

What are the 4Ts of diabetes?

Answer 7

Toilet (polyuria)

Thirsty (polydipsia)

Tired

Thinner

Question 8

What is the target HbA1c for children with diabetes?

Answer 8

Target - 58mmol/l - 7.5%

Question 9

What are early changes of vascular disease in chidlren with type 1 diabetes mellitus?

Answer 9

Microalbuminuria - due to nephropathy

Cardiovascular autonomic neuropathy

Sensory nerve damage

Retinopathy

Question 10

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Answer 10

Insulin to carb ration is 1:10 therefore 5 units of insulin is requried Due to high blood sugar premeal a correction dose is required and the BG is high by 4 Insulin snesitivty to blood sugar is 1:2 therefore 2 extra units are required Total of 7units of insulin is dosage

Question 11

What test is the screening for congenital thyroid disease carried out on? What is the test name?

Answer 11

Guthrie test carried out on day 5

Question 12

What does the absence of thyroxine after 3 months of age lead to?

Answer 12

Leads to cretinsim - hypothyroidism of children

Question 13

What enzyme is the primary cause of congenital adrenal hyperplasia?

Answer 13

A 21-OH deficiency

Question 14

What can a 21-OH deficiecny cause in female children?

Answer 14

Cause an abnormal androgen production cause male appearing genitalia at birth making it difficult to assume the gender of the child

Question 15

21-OH deficiecny will cause absent cortisol and aldosterone and can lead to an Addison crisis What are the three features of an addison crisis?

Answer 15

Hyponatraemia

Hyperkalaemia

Hypotension

Give steroid, and saline (salt) quickly

Question 16

A numerical value indicating the probability that this observation has occurred due to chance What is this?

Answer 16

This is the P value

Question 17

What happens when the p value is less than 0.05?

Answer 17

This value is of statistical significance as it shows the observation has probably not occurred due to chance

Question 18

If the pvalue is 0.05, what percentage of the time do we reject the null hypothessis when it is true? (the null hypothesis states there is no statistical significance between two results)

Answer 18

This says that 1in20 times, we reject the null hypothesis even though it is true

Question 19

Type I Error What is this?

Answer 19

Rejecting the null hypothesis when the null hypothesis is true.

Question 20

Type 2 error What is this

Answer 20

Accepting the null hypothesis when it is false