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42 Cards in this Set

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Addisons description
adrenal secretes too little cortisol, aldosterone, or both. TB used to be most common. autoimmune now most common. along with thyroid, parathyroid.
Addisons sx
chronic, progressive muscle weakness, malaise, anorexia, weight loss, GI, hyperpigmentation.
Addison labs
hypoglycemia, hyponatremia, hperK, acidosis.
Addisonian crisis
rapid adrenal destruction (adrenal hemorrhage), or when compensated patient has stress. needs fludrocortisone (mineralocorticoid), and hydrocortisone (glucocorticoid).
Turner syndrome features
1 :2000 girls. small stature, gonad dysgenesis. cardiac (bicuspid aorta), coarct, aortic stenosis, MVP. HTN. Renal abnormalities
low T4, elevated TSH, slowed growth
acuquired hypothyroidism. chronic lymphocytic thyroiditis (Hashimoto). female > male.
congenital hypothyroidism
coarse face, puffy eyelids, thick tongue, thick hair. splayed sutures.
sudden change of growth at 5yrs old, becomes fat and short.
Cushing or hypothyroidism.
Cushing S
most commonly exogenous steroids.
growth stops, become fat. central obesity, hypertension, buffalo hump, hirsutism, striae, acne.
hypothyroidism growth changes
weight loss and increased growth velocity is more common. can become short and fat however.
hypercalcemia in the immobilized
decreased bone mineralization due to no weight bearing causes Ca excess.
familial short stature
normal PE except short and small. nl birthweight. become short within first 2yrs.below but parallel to 5th percentile. bone age = chronologic age. Differs from
congenital adrenal hyperplasia, salt wasting
ambiguous genitalia, low salt, hi K, hi 17-hydroxyprogesterone.
hyperthyroid sx
tachycardia, weight loss, exophthalmos, remor. emotional labitility.
precocious puberty def.
signs of puberty before 8 in girl, 9 in boy.
work up of precocious puberty
bone age. Nl: incomlete sexual precocity. delayed bone age - hypothyroidism. advanced bone age - true precocious puberty vs pesudocomplete. (use CT for that)
hypoparathyroid sx
seizure from hypocalcemia. hi phosphate, nl Mg, low parathyroid hormone.
DiGeorge sx
cell mediated immune d. hypoparathyroidism. face, CV anomalies
DiGeorge heart
truncus, aortic arch anomalies.
hyperthyroidism sx
weight loss, impulsivity, inattentiveness, emotional lability. lid lag, jittery, tremor, tachy, sweating.
hypoparathyroid does what to Ca
low Ca, hi Phos
how to differentiate GH deficiency from constitutional growth delay.
GH deficiency falls off curve in height. Constitutional is always trachking below 5th, but gaining. both have delayed bone age. FH of growth or puberty delay. familial short stature: normal linear tgrowth, bone age = chrono,
thyroid binding globulin deficiency dx
clinically euthyroid, normal growth. low T4, nl TSH, hi T3 resin
hypocalcemia in neonate
nl is 7-10 with iCa 1.0. Most common hypoCa is due to prematurity.
changes to external genitalia of term infant caused by what hormones
androgens alone cause external genitalia to change.
estrogens may cause withdrawl bleed, lactation
pubertal gynecomastia diff
often start unilat, most become bilat.
Klinefelters: tall, small testes.
testicular carcinoma: secrestes estrogens, mass
lipomas, usually not beneath areola. obese patients have adipose tissue, no breast tissue.
Turner s. sx
primary amenorrhea. short, norm weight, no breast tissue (ovaries not working), normal pubic hair (androgens working)
Graves D. dx sx
big thyroid, hyper thyroid: weight loss, poor school performance, poor concentration, nervousness, heat intol. tachycardia, tremorT4 hi, TSH lo
simple goiter
big thyroid, euthyroid
thyroid nodule
discrete nodule. Refer all to ped endo to R/O malig
treatment of Graves
methimazole, carbimazole, or propylthiouracxil. suppress for 1-2 yrs, if fails then do radioI, if that fails then cut it out.
neonatal hyperthyroidism
due to transplacental TSH receptor stimulating Ab from mother with Graves. irritabale, jittery, tremulous, flushed, sweating, exopth, HS meg. tachy.
hypophosphatemia
Rickets is any disease of bones due to low phostphate or Ca. Xr hypophosphatemic rickets is most common inheritied rickets. renal wasting of phosphate.
21 hydroxylase deficiency sx
ambiguous genitalia in girl
75% have aldosterone def. = salt wasting presenting in 2nd week.. FTT, vomit, with hyperpigmentation (ACTH overproduction)
age by which height percentile stabiliizes
3yrs. significant decreases after should be investigated.
growth pattern: constitutional delay of growth and puberty.
nl birth. slow linear growth or decrease in first 3years of life. FH of late bloomer. bone age delayed to height age.
familial short stature
similar start as constitutional but bone age matches chrono. final height appropriate to parents.
short child with incrased weight to height ratio
think endocrine: GHD. either congenital septooptc dysplaisa or very rare defect in ACTH gene
short and dysmorphic
Down, Turner, Noonans, Prader-Willi
endocrine causes of short stature
thyroid def or resistance
Cushings S
congenital adrenal yperplasias
too much steroids
neuroendocrine GH disorders
single central incisor, think
GH deficiency
pale optic disk, think
septo-optic dysplasia.