endo, poisioning

Question 1

precocious puberty -> normal bone age = pemature adrenarche if isolated pubic hair or peremature thelarche i isolated breast development

precocious puberty -> advanced bone development. low LH + low lh after GNRH stimmulation = peripheral precocious puberty eg non classic CAH!!!!!, gonadal/adrenal tumour.
but if high LH or high after GNRH stimulation = central precocious puberty eg idiopathic cns tumour

Question 2

organo phosphte posioing signs?

management?

Answer 2

DUMBELSS

remove all clothing and irrigate!!!!
then atropine + pralidoxine

Question 3

symptoms of depression but also pulse is 50 and intermittent constipation

next step in management?

Answer 3

obtain a thyroid test

Question 4

most common cause of congenital hypothyroidism?

Answer 4

thyroid dysgenesis!!

Question 5

infant botulism -> suspect in ptsoiss, hypotonia, progressive weakness -> give antitoxin

Question 6

baby consumed bleach, first step in managemet?

Answer 6

removal of contaminated clothing!!!

then upper GI endoscopy!!!! Or ESOPHAGOSCOPY!!!!

Question 7

3 YO
abdominal pain
hematemesis
vitals show shock
radio-opaque pills on abdominal x ray
metabolic acidoisis (low bicarb)

next step in management?

Answer 7

Deferoxamine!!!

acute iron posioning

Question 8

2 day old
ambigous genitalia
normal electrolytes
raised testosterone
46 XX
most likely diagnosis?

Answer 8

congenital adrenal hyperplasia!!!! - buildup of 17-hydroxyprogesterone and testosterone!!!
electrolyte abnormalities dont develop until age 1-2 weeks

NOT androgen insensitivity as would be male XY but female looking parts. same with 5alpha reductase deficiency

Question 9

vomting, diarrhea, drooling (muscarinic symptoms)

stimulatory phase (hypertension, tachycardia, siezures, myoclonos)

most likely diagnosis?

Answer 9

nicotine posioning!!!

stimulatory phase often followed by inhibitory phase = hypotension, bradycardia, coma

treatment is supportive. can give benzos for siezures and atropine for bradycardia

Question 10

bone pain, fatigue for 6 months
hepatosplenomegaly
height and weight at 5th percentile (poor growth)
+ tanner stage 1 breasts (pubertal delay)
cytopenias seen

Answer 10

gauchers disease!!

Question 11

heat exhaustion presentation

Answer 11

hyperthermia, profuse sweating, vomiting, dizziness. fevere <40

contrast heat STROKE
= fever >40, confusion, siezures, loss of consciousness

Question 12

large local reaction vs systemic reaction