What type of diabetes is common in children?
Type 1 diabetes
In what emergency situation can children be newly diagnosed with Type 1 diabetes?
Type 1 diabetes in children has a strong ___ component.
What sort of precipitating event can trigger Type 1 diabetes in children?
In the pre-diabetes change, what biochemical abnormality can be detected in children?
Production of islet cell autoantibodies
What are the signs of hyperglycaemia in children?
thin (weight loss)
What are major signs of DKA in children?
Kussmaul breathing +/- pear drop breath
A fasting blood glucose of over ___ mmol/L is diagnostic of Type 1 diabetes.
A random blood glucose of over __ mmol/L is diagnostic of diabetes.
Apart from symptoms, what do you need to diagnose a child with DKA?
pH < 7.3
What is a fatal complication of DKA in children?
What is the most common symptom of new onset diabetes in children?
What tests would you perform on a child who you suspect has diabetes?
Random blood glucose
As cerebral oedema is a fatal complication of DKA in children, what must be administered carefully?
In DKA, fluids and insulin are administered based on the ___ of the child.
In DKA of patients under 18 years, when is insulin given?
1 hour after fluids
A goal of diabetes treatment in children is ensuring they have normal ___ and development and their education isn’t disrupted.
normal growth and development
What are the HbA1c targets in children?
< 48 mmol/mol in first year after diagnosis
< 58 mmol/mol thereafter
Obviously the lower the better
What microvascular screens are done for children in diabetes clinics?
What are the blood glucose targets
a) before meals
b) 2hrs after meals
c) at bedtime?
a) Before meals: 4-7 mmol/L
b) After meals: 5-9 mmol/L
c) Bedtime: 4-7 mmol/L
What type of insulin therapy are children with Type 1 diabetes offered?
What new technology avoids the use of skin prick tests to measure blood glucose?
What thyroid abnormalities may babies be born with?
Dysplastic, absent or abnormal-site thyroids
Congenital thyroid diseases may also be caused by problems with the ___ gland.
What are some signs of congenital thyroid disease?
Poor feeding, normal weight gain
Hypotonia (reduced muscle strength)
Skin and hair changes
Which general test is carried out on Day 5 after birth to diagnose a variety of diseases in babies?
Where can ectopic thyroid be found?
What is the result of untreated hypothyroidism in babies?
What are some signs of hypothyroidism in children?
Slow growth, delayed puberty
Poor general health
What will a thyroid function test look like in a hypothyroid child?
How is paediatric hypothyroidism treated?
What are some signs of hyperthyroidism in children?
Behavioural problems, sleep disturbance
Face, eye signs
What will a thyroid function test look like in a hyperthyroid child?
How is paediatric hyperthyroidism treated?
Beta blocker for autonomic symptoms
Anti-thyroid drugs - e.g carbimazole
+/- Radio-iodine, surgery
What is the most common primary cause of underactive adrenal glands in children?
Congenital adrenal hyperplasia
What is the most common secondary cause of underactive adrenal glands in children?
High dose steroid therapy
What is overproduction of steroids by the adrenal glands caused by?
Cushing’s disease / syndrome
Children with adrenal problems will present with overly ___ features.
Problems with the hypothalamic-pituitary-gonadal axis e.g in congenital adrenal hyperplasia can produce ___ genitalia in children.
What are some causes of ambiguous genitalia in children?
Congenital adrenal hyperplasia
How is the sex confirmed when a baby has ambiguous genitalia?