Ch. 06 Endocrinology

Front 1

new-onset wt loss + polydipsia + polyphagia + polyuria

dx?

Back 1

DM2

Front 2

after x% of beta-cell fxn destroyed, clinical signficance

Back 2

90%

Front 3

when blood glucose > x, then osmotic diuresis occurs

Back 3

180 mg/dl

Front 4

DKA sx

Back 4

1.hyperglycemia
2.metabolic acidosis
3.dehydration
4.lethargy

Front 5

most common cause of DKA

Back 5

inadequate insulin dosing

Front 6

most severe complication of DKA

Back 6

cerebral edema

Front 7

most common endocrine disorder in childhood

Back 7

DM1

Front 8

DM1: main risk factor

Back 8

+FH

Front 9

hypoglycemia sx? caused by?

Back 9

trembling, diaphoresis, flushing, tachycardia

catecholamine release

Front 10

headache + n/v + abd pain + polyuria + polydipsia + fatigue

dx?

Back 10

DKA

Front 11

secondary diabetes: causes

Back 11

1.excess glucocorticoids
2.hyperthyroidism
3.pheochromocytoma
4.GH excess
5.thiazide diuretics

Front 12

diabetes dx: random plasma glucose > x

Back 12

> 200 mg/dl

Front 13

in diabetic, glucose that falls to quickly can lead to...

Back 13

cerebral edema

Front 14

insulin drip: dosage

Back 14

0.1 U/kg/hr

Front 15

diabetics develop microvascular disease after x yrs of disease

Back 15

10 yrs

Front 16

acanthosis nigricans

Back 16

hyperpigmentation & thickening of skin folds

usually neck back & flexor areas

Front 17

only oral hypoglycemic med used in children age > 10

Back 17

metformin

Front 18

inability to concentrate urine

dx?

Back 18

diabetes insipidus

no ADH

Front 19

diabetes insipidus: causes

Back 19

1.head trauma
2.brain tumor
3.CNS infxn
4.craniophargioma removal SE

Front 20

abrupt onset polydipsia + polyuria

dx?
tx?

Back 20

diabetes insipidus

desmopressin (DDAVP)

Front 21

short stature: usually due to...

Back 21

genetics
constitutional delay

Front 22

proportionate short stature: causes

Back 22

1.GH deficiency
2.primary hypothyroidism
3.Cushing disease
4.chronic systemic dz
5.psychosocial deprivation
6.Turner
7.meds

Front 23

disproportionate short stature: examples

Back 23

1.achondroplasia
2.rickets

Front 24

short stature: caused by what kind of meds?

Back 24

1.steroids
2.dexedrine
3.methylphenidate (ritalin)

Front 25

hyperthyroidism: most common cause (& other causes)

Back 25

1.grave's disease
2."hot" nodule
3.acute suppurative thyroiditis

Front 26

T/F: exophthalmos is common in hyperthyroid children

Back 26

false

Front 27

T/F: hyperthyroid childen display change in behavior & school performance

Back 27

true

Front 28

acute-onset tachycardia + hyperthermia + fever + diaphoresis + n/v

dx?

Back 28

thyroid storm

Front 29

infant that stares + jitters + hyperactive + increased appetite + poor wt gain

dx?
tx?

Back 29

neonatal grave's

resolves over first several months

Front 30

x% of children w/grave's have spontaneous remission

Back 30

50%

Front 31

hypothyroidism: most common cause

Back 31

hashimoto's (chronic lymphocytic thyroiditis)

Front 32

coarse puffy face + dry thin hair + dry skin + delayed DTRs + slow linear growth + delayed puberty

dx?

Back 32

hypothyroid

Front 33

hyperthyroid: tx

hypothyroid: tx

Back 33

PTU - hyperthyroid

levothyroxine - hypothyroid

Front 34

congenital adrenal hyperplasia: most common cause

Back 34

21-hydroxylase deficiency

a.classic salt-wasting
b.virilizing

Front 35

21-hydroxylase: needed to form...

Back 35

1.cortisol
2.aldosterone

Front 36

21-hydroxylase deficiency: inheritance pattern

Back 36

autosomal recessive

Front 37

21-hydroxylase deficiency: genital clinical presentation

Back 37

females: ambiguous genitalia

males: nl

Front 38

21-hydroxylase deficiency: dx via...

Back 38

17-hydroxyprogesterone levels (elevated)

Front 39

21-hydroxylase deficiency: sx

Back 39

1.dehydration
2.salt-wasting
3.emesis
4.shock
5.hyperkalemia, hyponatremia
6.hypoglycemia

Front 40

11-hydroxylase deficiency: sx

Back 40

1.HTN
2.hypernatremia, hypokalemia
3.decreased renin, aldosterone

Front 41

21-hydroxylase deficiency: tx

Back 41

1.cortisol
2.mineralocorticoid

Front 42

21-hydroxylase deficiency: undertreatment may lead to...

Back 42

1.premature epiphyseal fusion
2.adult short stature

Front 43

precocious puberty

Back 43

secondary sex qualities age < 7.5 (female), < 9 (boys)

Front 44

precocious puberty: causes

Back 44

girls: idiopathic
boys: CNS pathology

Front 45

premature adrenarche: cause

Back 45

early maturation of adrenal androgen secretion

Front 46

gonadotropin-dependent precocious puberty: examples

Back 46

1.glioma
2.embryonic germ cell tumor
3.hamartomas

Front 47

gonadotropin-independent precocious puberty: examples

Back 47

1.mccune-albright
2.leydig cell tumors
3.ectopic hCG production by hepatic/pineal tumors

Front 48

GDPP: tx

Back 48

leuprolide (GnRH analogue)

Front 49

pubertal delay

Back 49

(-) 2ndary sex qualities before age 13 (females), age 14 (males)

Front 50

pubertal delay: most common cause

Back 50

constitutional delay

Front 51

Cushing syndrome: most common cause in children age > 7

Back 51

Cushing disease (bilateral adrenal hyperplasia)

Front 52

Cushing syndrome: lab studies

Back 52

1.serum cortisol
2.24-hr urine free cortisol
3.dexamethasone suppression test

Front 53

prolonged dexamethasone suppression test: purpose

Back 53

differentiate adrenal tumor vs. Cushing disease

Front 54

adrenal tumor: Tx

Back 54

surgery (removal)

Front 55

addison disease

Back 55

primary adrenal insufficiency

Front 56

adrenal insufficiency: most common cause in older children & adolescence

Back 56

autoimmune

Front 57

ACTH deficiency: most common cause

Back 57

chronic steroid tx

Front 58

addisonian crisis: sx

Back 58

1.fever
2.vomiting
3.dehydration
4.shock

Front 59

addisonian crisis: tx

Back 59

1.D5W
2.STRESS DOSE IV glucocorticoids

Front 60

addisonian crisis: causes

Back 60

1.illness
2.surgery
3.trauma