Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Royal College Studying > Endocrinology > Flashcards

Endocrinology Flashcards

(95 cards)

Start Studying
1
Q

What is protective against T2DM

A

breastfeeding, weight loss, healthy behavior interventions, bariatric surgery, orlistat/metformin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Risk factors for T2DM development

A

first or second degree relative with T2DM
being a member of a high risk group (Asian, indigenous, african, arab, hispanic)
obesity
impaired glucose tolerance
PCOS
exposure to diabetes in utero
acanthosis nigricans
HTN, dyslipidemia
NAFLD
atypical antipsychotic medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is recommended screening test for T2DM

A

fasting blood glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is target AIC for most children with T2DM

A

< 7.0%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When do you need to start insulin immediately in T2Dm

A

present in DKA
A1C > 9
severe symptoms of hyperglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Who is higher risk for developing CV and microvascular complications T1 or T2

A

T2DM children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

RF for complications in T2Dm

A

older age at diagnosis
poorer metbaolic control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Screening for complications schedule in T2Dm

A

Neuropathy- yearly at diagnosis (asking about symptoms , vibration sense, light touch and ankle reflexes)
retinopathy- yearly screening at diagnosis
nephropathy- yearly screening at diagnosis with first morning ACR
dyslipidemia- at diagnosis and yearly afterwards
HTN- at diagnosis and every diabetes related encounter after (at least twice per year)
NAFLD0 yearly screening at diagnosis
PCOS yearly screening at diagnosis
OSA- yearly
depression- yearly
binge eating- yearly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Who to screen for T2DM and when

A

Every 2 years using a combination of A1C and HPG in children with > 3 risk factors nonpubertal (starting age 8) or >2 risk factors pubertal
RF:
- obesity (BMI >95)
- high risk ethnic group
- first degree relative with T2DM or exposure to DM in utero
- signs of insulin resistnace (acanthosis, HTN, dyslipidemia, NAFLD)

Also screen: PCOS, IFG, use of atpical antipsyhotic medicationsq

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

A1C target T1DM

A

< 7.5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

increased DKA risk

A

children with poor control or previous episodes of DKA
peripubertal and adolescent girls
children with pumps
ethnic minorities
children with psych disorders
difficult family cirucmstances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

RF for cerebral edema

A

bolus of insulin before infusion
early insulin (within 1 hour of fluid)
young children (<5)
First presentation DM
greater severity of acidosis
high initial urea
low CO2
rapid administation of hypotonic fluids
failure of serum sodium to rise during treatment
use of bicarbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Screening in T1DM

A

Thyroid disease- TSH and TPO, at diagnosis and every 2 years after (every 6-12mo if TPO Ab +)
AI- as clinically indicated
celiac disease- as clinically indicated

nephropathy- yearly starting at age 12 if DM >5 years with first morning ACR
retinopathy- yearly screening starting at age 15 with DM > 5 years
Neuropathy - children over 15 with poor control should be screened after 5y of DM

Dyslipidemia- delay screening until control stable, screen at 12 and 17 years f age, < 12 only screen if BMI > 97th, family history
HTN- all children with T1DM at least twice per year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How much glucagon to give >5 and < 5

A

1mg over 5 and 0.5mg under 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

when to start giving dextrose in DKA

A

BG < 17

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

definition of albuminuria

A

> 2.5mg/mmol AER >20mcg/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

when should you do genetic testing for neonatal DM

A

Before 6mo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how to diagnose DM

A

FAsting BG > 7
Random BG or 2hr OGT BG >11
antibodies- GAD, insulin, islet cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How is MODY inherited

A

autosomal dominant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Enzyme deficiency for MODy

A

glucokinase, HNF1a, HNF4a

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How to treat MODY

A

sulfonylureas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

critical sample for hypoglycemia

A

blood glucose, insulin, c-peptide, growth hormon, cortisol, ketones, lactate
total and free carnitine and acylcarnitine, plasma amino acids, ammonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

micropenis size

A

< 2.5cm in term infant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

clitoromegaly defn

A

> 9mm in term infant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what is the msot common DSD in 46XX
CAH
26
what is responsible for testes determination/formation
SRY gene on Y chromosome
27
what do Leydig and sertoli cells secrete
Leydig- testosterone Sertoli- AMH
28
What is Swyer syndrome
XY individuals but defect in SRY gene so can't develop testes, can't develop AMH Phenotypically female and have mullerian structures but gonads are streak gonads, they do not go through breast development or menarche at puberty Can have some virilization
29
Denys Drash
partial gonadal dysgenesis with undervirilized or ambiguous genitalia and absent mullerian structures they also have renal dsiease and will develop ESRD WT1 gene mutation increased risk for wilms tumor
30
when to suspect Complete androgen insensitivity
prepubertal girl with male goands during evaluation of inguinal hernias or evaluation for primary amenorrhea
31
How to diagnose adrenal insufficiency
ACTH stimulation test- low dose for central AI and high dose for eripheral AI cortisol drawn at 0, 30 and 60 minutes Cortisol peak > 350 is normal at ACH
32
What is normal growth velocity
>4.5cm per year pre pubertal
33
Ddx poor growth velocity
GH deficiency hypothyroidism AI Cushings chronic disease states
34
how to calculate mid parental height
mothers height + fathers height (+/-13cm) /2
35
Ddx short statrue with normal bone age
familial short stature turner, russel sliver, prader willi
36
Features of GH deficiency
poor growth velocity crossing percentiles hypogylcemia micropenis
37
how to diagnose GH deficiency
May have low IGF-1 Gold standard = growth hormone stim test by giving arginine, clonidine, L-dopa, propanolol or glucagon (insulin not used in peds) normal peak of >5 on ether test rules out GHD
38
Side effects of GH
SCFE, IIH, hyergylcemia, growth of nevi, carpal tunnel, injection site reactions, sudden death in pt with OSA
39
INdications for GH therapy
turner, chronic renal failure, SGA with inadequate catch up growth, ISS, SHOX mutation, prader willi, noonan, GH deficiency
40
Tall stature ddx
klinefeleter, familal, late onset CAH, recocious puberty, growth hormone exesss obesity overgrowth syndromes in infants
41
timing of puberty boys and girls
8-13 in girls 9-14 in boys
42
normal pubertal progression in girls
thelarche pubarche within 6mo peak growth spurt tanner 2-3 menarche 2y after thelarche
43
normal pubertal progression in boys
increased testicular volume, scrotal thinning pubarche secondary sexual characterisitics peak growtwh velocity tanner 5
44
Benign premature thelarche
usually within first 2 years of life no advancement of bone age no other pubertal changes
45
benign premature adrenarche
virilizing changes between 6-8 years no bone age advancement no other pubertal changes
46
Red flags for precocious puberty
rapid progression of puberty bone age advancement > 2 years CNS signs and symptoms
47
Investigations for precocious puebrty
Boys ALWAYS need head imaging, girls if young age peripheral- labs/imaging to determine source
48
How to treat precocious puberty
GnRH analog (lupron)
49
define delayed puberty
absence of secondary sexual characteriitics by age 13 in girls, 14 in boys
50
what do sertoli cells produces
AMH
51
what do leydig cells produce
testosterone
52
definition of clitiromegaly
wider than 6mm longer than 9mm
53
micropenis
<2.5cm in term infant
54
inheritance CAH
AR
55
what % of CAH is 21OH def
95%
56
when does salt wasting present
DOL 7-14
57
how does classic non salt wasting CAH present
virilization age 2-4
58
what first AM cortisol suggests insuff
< 100 > 350 is normal
59
causes of primary AI
autoimmune (addisons) CAH Adrenoleukodystrophy, Smith lemli opitz infection, drugs, infiltration
60
stress doings doses
HC moderate 30-50mg/m2 severe 100mg/m2
61
triad for septo optic dysplasia
optic nerve hypoplasia midline brain abnormalities pituitary hypoplasia
62
what is septo optic dysplasia associated with
lower maternal age and primiparity
63
growth velocity first year, 1-4 and over 5
0-1 25cm/year 1-4 10cm/year 5< 5cm/year
64
what are you look for on water deprivation test
as serum osm increases over 300, urine concentration should > 1000
65
how is nephrogenic DI inherited
X linked
66
how is central DI inherited
AD, AR, x-inked
67
what medications/interventions can cause nephrogenic DI
osmotic diuresis (hypertonic saline bolus), lithium, hypercalcemia, hypoklamiea, CKD
68
fluid status in SIADH
normovolemia
69
fluid status in cerebral salt wasting
hypovolemia
70
MEN 1
pituitary, parathyroid, pancreas tumors (insulinoma)
71
Autoimmune polyglandular syndrome
Type 1 DM, esp AI or hypoparathyroidism, candidiasis, ectodermal dystrophy
72
APS 2
AI, thyroid, DM
73
Albrights osteodystrophy
pseudohypoPTH, dont respond to this so you get low Ca and high PO4 Also get short stature, brachydactylyl of digits 3/4/5, round face with low nasal bridge,
74
Whats the most important way to get vit D
cutaenous synthesis
75
vitamin D dependent ricketts
dont have 1, alpha hydroxylase to make 1,25 vit D
76
x-linked hypophosphatemia
dont respond to FGFR23 so low phophate, normal calcium
77
Lab findings in PCOS
High LH/FSH ratio (and high androgens)
78
What is the bone age in GH deficiency
Delayed
79
Cause of proximal RTA
cystinosis (most common) tyrosinemia galactosemia heredtiary fructose deficiency wilsons
80
DEnt disease
x-linked nephrolithiasis
81
What to consider in phenotypic female with bilateral inguinal hernias
androgen insensitivity
82
Most common cause of ectopic ACTH secretion in a baby
adrenalcortico tumor
83
Most common cause of ACTH secretion in a older child
pituitary adenoma
84
What lyte disturbances can cause nephrogenic DI
hypoK and hyperca
85
What is target HbA1C in DM
< 7.5
86
Growth velocity in first year of life
18-25cm/yr
87
Laron syndrome
GH resistance
88
LAurence moon biedel
short stature, retinitis pigmentosa
89
GH for
Turner, Gh def, noonan, CKD, SHOX def, prader willi, SGA without catch yp and idiopathic shrot < 2.25 SD
90
GH SE
edema, joint pan, PTC, local bruising , wrosening scoliosis, insulin resistance, SCFE, gynecomastia
91
When to screen for T2DM
BMI over 85th and 2 of fam hx, ethnicity, mat DM/GDM, PCOS/acanthosis, screen at age 10 or puberty, whichever is earlier
92
insulin to carb ratio
500/TDDD
93
when to start screening for nephrotpathy in DM
age 10 or after 5 years
94
Target HbA1C in T2DM
< 7
95
easy way to figure out correction factor for insulin
10-20% TDD

Royal College Studying (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions