endo

Question 1

male pubertal development sequence

Answer 1

testicular growth
pubarche
penile growth
spermarche
peak height

Question 2

female pubertal development sequence

Answer 2

thelarche
pubarche
peak height velocity
menarche

Question 3

delayed puberty age cutoffs

Answer 3

girls: 13
boys: 14

Question 4

premature adrenarche

Answer 4

elevated DHEA and DHEA-S
low testosterone

assoc: exogenous androgen, androgen secreting tumor, late onset CAH, PCOS

Question 5

causes of premature thelarche

Answer 5

premature HPA activation
exogenous estrogen
estrogen producing tumor
benign (infants/toddlers - resolves by age 4)

Question 6

consequence of precocious puberty

Answer 6

short adult height

Question 7

when to use GnRH with precocious puberty

Answer 7

<6 yo
male
rapid sx
psychosocial disturbances

Question 8

inheritance of androgen insensitivity

Answer 8

X linked

Question 9

syndromes assoc with pan hypo pit

Answer 9

Prader Willi
Kallmann
septo-optic dysplasia

Question 10

where does Mullerian inhib factor come from?

Answer 10

Y chromosome

Question 11

male infant with shock and excessive scrotal pigmentation

Answer 11

CAH

Question 12

female infant with shock and posterior labial adhesions

Answer 12

CAH

Question 13

most common cause of CAH

Answer 13

21-hydroxylase deficiency
high 17 OHP levels
can have salt wasting variety

Question 14

cafe au lait spots, bony abnormalities, and endocrinopathies

Answer 14

McCune Albright

Question 15

Cushing Syndrome dx

Answer 15

gold standard: 24hr urinary free cortisol excretion
midnight sleeping plama cortisol
dex suppression

Question 16

DI, exophthalmos, lytic bone lesions

Answer 16

Hand Schuller Christian triad of Langerhans Cell histiocytosis
post pituitary involvement

Question 17

hormones from post pit

Answer 17

ADH

oxytocin

Question 18

rate of height growth prior to puberty

Answer 18

5-6cm/year

Question 19

micropenis, short stature, hypoglycemia, septo-optic dysplasia, breech presentation

Answer 19

congenital GH deficiency

Question 20

calculate mid parental height

Answer 20

sum of parents heights
+ 5 if boy, - 5 if girl
divide by 2
+/- 2 inches

Question 21

macrocephaly, cognitive defects, tall stature

Answer 21

Sotos syndrome

Question 22

can you mix synthroid with soy formula

Answer 22

no - decreases absorption

Question 23

boy with normal TSH and low total T4

Answer 23

X-linked thyroxine binding globulin deficiency
dx confirmed with TBG level
no replacement necessary

Question 24

differentiate Hashitoxicosis and Graves

Answer 24

radioiodine uptake - high in Graves, low/normal in Hashi

Question 25

tx Hashimoto

Answer 25

lifelong levothyroxine

Question 26

tx Graves

Answer 26

methimazole no PTU surgery if methimazole ineffective

Question 27

tx neonatal thyrotoxicosis

Answer 27

methimazole until maternal Abs cleared

Question 28

constipation, fatigue, muscle weakness

Answer 28

hypercalcemia

Question 29

causes of hypercalcemia

Answer 29

Williams ingestion (vitamin D, A, thiazides) skeletal disorders/immobilization hyperparathyroidism

Question 30

tx hypercalcemia

Answer 30

fluids, lasix, EKG

Question 31

muscle spasms, vomiting, seizures resistant to benzos

Answer 31

hypocalcemia | can have prolonged QT

Question 32

causes of hypocalcemia

Answer 32

``` pseudohypoparathyroidism (PTH resistance) nutritional DiGeorge nephrotic syndrome renal ```

Question 33

hypocalcemia and hyperPh

Answer 33

hypoPTH

Question 34

hypercalcemia and hypoPh

Answer 34

hyperPTH

Question 35

hypocalcemia and hypoPh

Answer 35

vit D deficiency

Question 36

hypocalcemia resistant to Ca replacement

Answer 36

think about mag

Question 37

bone pain, growth delay, widening of joint spaces

Answer 37

Rickets | serum alk phos ALWAYS elevated

Question 38

causes of vit D deficient Rickets

Answer 38

``` BF w/o supps no sun exposure low BW/prematurity vegan diets liver disease --> poor absorption ```

Question 39

low Ca, normal 25-OH vit D, low 1,25-OH vit D

Answer 39

vit D dependent rickets AR inadequate renal prod of activated vit D

Question 40

tx vit D dependent rickets

Answer 40

D2 and 1,25 vit D

Question 41

low Ph, low Ca, high alk phos, high PTH, high 1,25 vit D

Answer 41

hereditary vitamin D resistant rickets end organ resistance AR

Question 42

low Ph, normal Ca, high alk phos, normal PTH, normal vit D levels

Answer 42

X linked hypophosphatemic rickets XL dominant tx: 1,25 vit D and phos