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Flashcards in Endocrine Deck (52)
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1
Q

HLA a/w DMT1

A

HLA DR3,4

2
Q

HLA a/w DMT1

A

HLA DR3,4

3
Q

decrease risk DMT1 HLA

A

HLA 2,5

4
Q

PC DMT1 triad

A
polyuria
polydipsia
weight loss
\+ skin infections
\+ secondary enuresis
5
Q

resting plasma glucose and sympt

A

11.1mmol/L

6
Q

FBG

A

7mmol/L

7
Q

HbA1c

A
8
Q

Regular

A

onset: 30-60minutes
take b4: 15-30minutes
duraiton: 8 hours
peak: 2-4 hours

9
Q

NPH

A

onset: 1-2 hours
peaks: 4-12 hours

10
Q

antibody a/w DMT1

A

GAD

11
Q

blood ketone levels in DKA

A

> 3 mmol/L

12
Q

diagnosis of DKA

A
  1. blood glucose
  2. blood ketones
  3. urea/ creatinine/ electro’s
  4. urinary ketones
  5. ECG/ K+ levels
  6. metabolic acidosis– blood gases
  7. weight
  8. trigger– culture blood/urine
13
Q

decrease risk DMT1 HLA

A

HLA 2,5

14
Q

PC DMT1 triad

A
polyuria
polydipsia
weight loss
\+ skin infections
\+ secondary enuresis
15
Q

resting plasma glucose and sympt

A

11.1mmol/L

16
Q

FBG

A

7mmol/L

17
Q

HbA1c

A
18
Q

Regular

A

onset: 30-60minutes
take b4: 15-30minutes
duraiton: 8 hours
peak: 2-4 hours

19
Q

NPH

A

onset: 1-2 hours
peaks: 4-12 hours

20
Q

antibody a/w DMT1

A

GAD

21
Q

blood ketone levels in DKA

A

> 3 mmol/L

22
Q

causes of congenital hypothyroidism

A

MCC= maldescent and athyrosis
dyshormonogenesis
MCC WORLDWIDE= iodine def
TSH deficiency= panyhypopit

23
Q

tx DKA

A
  1. fluids– slowly over 48-72hours
    + monitor fluid status
    2……….insulin (after 1 hour of fluids), after 24hrs– blood glucose around 14mmol/L
  2. potassium– ONCE URINE PASSED, monitor heart
  3. acidosis– self corrects,; only give bicarb if in shock
  4. re-establish oral fluids, sc insulin, diet [only stop IV insulin once oral given for 1 hour)
  5. ID and Tx underlying cause
24
Q

other autoimmune diseases associated with diabetes

A

celiac
hypothyroidism
addisons

25
Q

monitoring for DMT1 complications

A

yearly:

  • HTN
  • kidneys– microalbuminuria
  • hypothyroidism

3 years:
- celiac screen

5 years:
- retinopathy/cataracts

26
Q

permanent neuro sequelae of hypoglycaemia

A
  1. epilepsy
  2. developmental
  3. microcephaly
27
Q

causes of hypoglycaemia - insulin XS

A
  1. OD
  2. nesidioblastosis/ insulinoma
  3. autoimmune Ab to receptor
  4. beck with syndrome
  5. sulphonylureas
28
Q

causes of hypolgycaemia- no insulin XS

A
  1. liver disease
  2. ketotic hypoglycaemia of childhood
  3. glycogen storage disorder
  4. hormonal def– GH, ACTH
29
Q

causes of hypoglycaemia= reactive

A
  1. galactosemia
  2. fructose intolerance
  3. leucine sensitivity
  4. hormonal def
  5. alcohol or aspirin poisoning
  6. maternal diabetes
30
Q

Diagnosis of hypoglycaemia

A

CONFIRM BLOOD GLUCOSE

— then run through the labs specific to the numerous causes

31
Q

Tx of hypoglycaemia from weird causes

A
  1. glucose 10% ml/kg dextrose, followed by 10% dextrose infusion
  2. IM glucagon
  3. corticosteroids– hypopituitarism, hypoadrenalism
32
Q

thyroid hormones kids

A

fetal= reverse T3= inactive

at birth SURGE TSH, then decreases, normalises at 1 week

33
Q

causes of congenital hypothyroidism

A

MCC= maldescent
dyshormonogenesis
MCC WORLDWIDE= iodine def
TSH deficiency= panyhypopit

34
Q

PC juvenile hypothyroidism/ acquired

A
  • goitre
  • loss of eyebrow hair
  • coarse skin
  • dry hair
  • cold
  • bradycardia
    neurodevelopment decreased
  • decrease reflexes
    SUFE
    obesity
35
Q

juvenile hypothyrodism a/w which two syndromes

A

DOWNS

TURNERS

36
Q

what autoimmune diseases a/w juvenile hypothyroidism

A
V.RAD
vitiligo
RA
addisons
DM
37
Q

difference in presentation of hyperthyroidism in kids

A

NO EYE SIGNS

38
Q

Two NB bone things for hyperthyroidism in kids

A

rapid growth height

advanced bone maturity

39
Q

true or false, maternal TSI antibodies can cross the placenta

A

TRUE! IgG

40
Q

causes of hypoparathyroidism

A
  1. preme- common
  2. DiGeorge
  3. Addisons– older
  4. McCune Albright syndrome
41
Q

McCune Albright Syndrome

A
  • cafe au lait
  • endocrine– precocious puberty
  • bone problems
  • obesity
  • subcutaneous nodules
  • 4th metacarpal
42
Q

PC hypoparathyroidism

A
  • spasms
  • fits
  • paraesthesia
  • diarrhea
  • irritable
  • chovstek/ troussea
43
Q

Tx hypoparathyrodism

A
  1. calcium gluconate– slowly increase

2. chronic: calcium, vit D

44
Q

Hyperparathyroidism PC

A
  • constipation
  • anorexia
  • behavioural change
  • polyuria
  • polydipsia
  • bone erosions of phalanges
  • lethargy
45
Q

Hyperparaythroidism in neonate/young

A

Williams

46
Q

Hyperparaythoidism in oder kid

A

MEN 1/ 2A

47
Q

diagnosis of adrenal crisis

A
  1. labs
  2. decrease cortisol
  3. increase ACTH
  4. SynACTHen test
48
Q

treatment of acute adrenal insuficiency

A
  1. IV saline
  2. IV hydrocortisone
  3. IV glucose
49
Q

treatment of chronic adrenal insufficiency

A

long term

  • glucocorticoids (X3 if sick or surgery)
  • mineralcorticoids
50
Q

MAIN CAUSE OF CUSHINGS IN KIDS

A

STEROID USE– long term

51
Q

diagnosis of cushings

A
  1. 24hours urine cortisol
  2. dexamethasone
  3. CT/MRI (Adenoma)
52
Q

tx cushings

A

UNDERLYING CAUSE

  1. steroids
  2. adrenalectomy + Rtx
  3. transsphenoidal + Rtx