Endocrine Flashcards
(45 cards)
Insulin start dose
0.5 units/kg
increase by 1-2 units/kg
DKA diagnosis
blood glucose >11.1
blood ketones >3
metabolic acidosis
DKA management
fluids resuscitation 10ml/kg
sthen slow rehydration over 48hrs
insulin 0.1units/kg/h
watch K+
Congenital hypothyroidism causes
maldescent of thyroid athyrosis dyshormonogenesis iodine deficiency TSH deficiency
Descent of thyroid gland
sublingual position -> larynx
Congenital hypothyroidism clinical features
faltering growth prolonged jaundice constipation coarse facies large tongue umbilical hernia delayed development learning difficulties
Congenital hypothyroidism management
thyroxine from neonatal period
PTH function
increased osteoblast function
if Ca low-> osteoclast activity to release ca and PO
stimulates vit D metabolism
Hypoparathyroidism can be congenital- what is the name of the syndrome
DiGeorge Cardiac abnormalities Abnormal facies Thymus hypoplasia -> cellular immune deficiency Cleft palate Hypoparathyroidism w/ low Ca 22 chromosome
Hyperparathyroidism if presents in late childhood/adulthood, can be part of what syndrome?
MEN 1 and 2a
Term babies should double and treble their weight in what period of time?
Double in 4.5m
Treble in 1 year
Puberty: development order in females
- breast development
- pubic hair and growth spurt
- menarche
Puberty: development order in males
- testicular enlargement over 4ml volume
- pubic hair
- rapid height growth
Short stature define
below 2nd gentile (2SDs below the mean)
Investigation required below which height gentile
0.4 th
Short stature causes
familial
constitutional delay
small for gestational age and extreme prematurity
chromosomal disorders
Gene involved in pathological short stature
Short stature homeobox (SHOX) gene
X chromosome
Short stature investigations
x ray l wrist FBC Creatine (CKD) Calcium, phos, alk phos TSH Karyotyope Anti-endomysial and anti-tissue transglutaminase antibodies CRP GH provocation test IGF-1 levels (GH axis) Morning cortisol and dexamethasone test MRI
Growth hormone treatment indications
GH deficiency Turner syndrome Prader-Willi syndrome CKD SHOX deficiency IUGR/small for gest. age w/o catch up by 4yrs
Tall stature causes
familial/inherited obesity hyperthyroidism XS sex steroids gigantism (XS GH) Syndromes (Marfan, Homocystinuria, Kliengelter, Sotos syndrome)
Development of undifferentiated gonad in fetes into female
absence of SRY gene (Y chromosome)
Development of undifferentiated gonad in fetes into testis in male
SRY (sex determining region on Y chromosome)
anti-Mullerian hormone (inhibits uterus and Fallopian tube development)
testosterone drives external genitalia development and maintains internal genitalia
XS androgens in females
seen in congenital adrenal hyperplasia
causes virilisation in females
inadequate androgens in male
under-virilisation caused by -receptor problem (androgen insensitivity) -5alpha reductase deficiency -abnorm. of synthesis from cholesterol