Endocrinology and Growth Flashcards

Question

How does congenital hypothyroidism present?

Answer 1

``` Asymptomatic and found on screening Failure to thrive Prolonged jaundice Constipation Large tongue Umbilical hernia Goitre ```

Answer 2

``` Females>males Short stature/growth failure Cold intolerance Dry skin Cold peripheries Bradycardia Thin, dry hair Goitre Pale, puffy eyes with loss of eyebrows Delayed puberty ```

Answer 3

Mainly Grave's disease Eye signs less common Low TSH and high T3/4 ``` Anxiety Increased appetite Sweating Diarrhoea Weight loss Rapid height growth Tremor tachycardia Warm, vasodilated peripheries Goitre ```

Answer 4

Carbimazole or propylthiouracil beta-blockers for symptomatic relief

Answer 5

``` Common in minority girl 12-16 years Acanthosis nigricans Obesity Hypertension No thirst or increased urination ```

Answer 6

Glucocorticoid excess usually due to long term treatment for asthma, nephrotic syndrome or bronchopulmonary dysplasia Improve by taking mediation in morning on alternate days ACTH-driven - pituitary adeoma, ectopic tumour

Answer 7

``` Growth failure Short stature Face and trunk obesity Red cheeks Hirsutism Striae HTN Bruising Muscle weakness and wasting ```

Answer 8

Failure to produce ADH --> polyuria and polydipsia Genetic condition, treated with desmopressin for life Vigorous suck with vomiting Fever without cause Constipation Excessively wet nappies

Answer 9

Isolated defect or secondary to panhypopituitarism Congenital mid-facial defects - craniopharyngioma Trauma Hypothalamic tumour Meningitis Bone age is decreased

Answer 10

Biosynthetic GH given subcut daily | ?IGF-1

Answer 11

Occurs in half of males during puberty Medicines Cannabis or steroids Tumours Klinefelter syndrome Leydig tumour - increased oestrogens Viral orchitis- reduced testosterone

Answer 12

Premature breast development - 6 months-2 years | Absence of axilalry and pubic hair

Answer 13

Pubic hair before 8yo in females and 9yo in males Without other signs of sexual development Accentuation of normal maturation of androgen production by adrenal gland More common in Asian and Afro-Carribean children Rule out late-onset CAH and adrenal tumour

Answer 14

Fetal - fastest period of growth (30% of eventual height) Determined by size of mother, placental nutrition Infantile - infancy to 18 months Dependent on nutrition, good health and normal thyroid function Accounts for 15% of height Failure to thrive if inadequate Childhood - contributes to 40% of height Pituitary growth hormone produces insulin-like growth factor 1 at epiphyses Needs adequate nutrition, good health, thyroid, vit D, steroids Pubertal - sex hormones cause back to lengthen 15% of final height Causes fusion of the epiphyseal growth plates and cessation of growth

Answer 15

21-45 days 3-7 days blood loss 6pads/day is heavy bleeding

Answer 16

``` History Urine M, C + S Stool M, C + S Stool for reducing substances Height, weight and head circumference ```

Answer 17

Serum glucose and ketones Insulin, c-peptide, GH and cortisol levels FFA, TFT Urine ketones, glucose, urinalysis Screen for infection - FBC, blood culture

Answer 18

IV dextrose 10% 2.5ml/kg in neonates 2ml/kg in children

Answer 19

Males - bilateral large testicles - central or peripheral tumour - unilateral large testicle - gonadal tumour Females - pelvic USS - ?PCOS

Answer 20

Polyuria, polydipsia, weight loss Intracranial tumours or injury -> decreased production of ADH

Endocrinology and Growth Flashcards

(44 cards)