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

Question 13

Precocious puberty in a boy with normal testicular volume for age. Where in the body is likely site of excediste hormone production?

Answer 13

Adrenal cortex!!!

If It was the pituitaru glánd, higher FSH levels would meqn larger testes!!

Question 14

Even if a patient with severe hyperkalemia may require hemodyalisis, the first step is always to give calcium chloride!!

Question 15

Salicylate poisoning causes anión gap metabólic acidosis!!

Sodium and potassium levels are unaffected!!!

Question 16

SIADH due to meningitis is more likely than the patient having factitious hyponatremia because their glucose level is 150! -> much more Severe elevations in glucose is needed for this