General

Question 1

Go look for the adenoma please

Answer 1

Loss of pit hormone due to pressure
G – GH
L – LH
F – FSH
T – FSH
A – ACTH
P – Prolactin function

Question 2

Hashimotos features

Answer 2

Hypothyroidism

Anti thyroid peroxidase antibodies, high TSH, Low T4, associated with autoimmune

Question 3

CAH symptoms

Answer 3

Lack of aldosterone - Hyponatremia
Hyperkalemia

Lack of cortisol - hypoglycemia

Deletion on chromosome 11

Question 4

What are Androgen and estrogen responsible for in puberty

Answer 4

Androgen- pubic hair, odor, acne-male
Female - Odor and hair

Estrogen-breast, increased uterine size, menarche

Question 5

what are causes of Secondary ammenorrhea

Answer 5

Pregnancy
Hypothalamic dysfunction-AN, chronic disease
Pituitary mass
Ovarian dysfunction - PcOS, ovarian and adrenal tumor
Endo - hypo hyper thyroid
Premature ovarian failure

Question 6

DKA risk factors

Answer 6

1st presentation
Less than 5 yrs
Initial corrected Na > 145, ph

Question 7

Meds causing gynecomastia

Answer 7

Ca channel blockers
Hormonal meds
Experimental
pSych- TCA, diazepam
Testosterone antagonist - spironolactone, ranitidine, cimetidine, ketoconazole

Question 8

WAGR Syndrome

Answer 8

Wilms tumor
Aniridia
GU abnormalities
Retardation

Obesity

Question 9

anosmia, delayed puberty, high arched palate, synkinesia

Answer 9

Kallman’s syndrome

Question 10

Delayed puberty signs

Answer 10

growth vlocity
visual fields
galactorhea
small testes, gynecomastia, tall - klinefelter
low BMI - AN
signs of hypothyroidism
signs of chronic disease

Question 11

endo exam- what is required

Answer 11

hgt, wgt, HC
growth pattern
BMI
arm span and upper seg to lower seg ( pubic symphisis to floor and take away from hgt
midparental hgt
vitals

Question 12

signs of hypothyroidism

Answer 12

short
incr BMI
slow pulse
dry coolskin
dry hair
periorbital puffiness
slow speech
hoarse voice

Question 13

Signs of hyperthyroidism

Answer 13

goiter
tachy
wgt loss
tremor
heat intol
hair loss
pain with looking to side for inflammation of eye muscles
secondary enuresis
ophthalmoplegia

Question 14

Signs of cortisol def

Answer 14

growth failure
weakness
hyperpigmentation
micropenis or ambiguous - 
hypotonia

Question 15

when does the growth spurt start in girls?

Answer 15

Tanner 3 for breast dev, peak velocity 8.3 cm/yr

Question 16

when does the growth spurt start in boys?

Answer 16

stage 4, peak velocity 9.5 cm

Question 17

what disorder will have an increased upper to lower body ratio

Answer 17

achondroplasia

Question 18

what disorders will have a decreased U/L segment ration

Answer 18

klinefelter

kallman

Question 19

what are the 4 hormones required for proper growth

Answer 19

GH
thyroxine
androgens
cortisol

Question 20

what features makes you think of constitutional growth delay?

Answer 20

normal or near normal growth velocity
delayed bone age
Delayed puberty
end up with expected height

Question 21

What are clinical features of hypoglycemia in a newborn?

Answer 21

jitteriness
poor feeding
pallor
low tone
low temp
apnea
dec LOC
bradycardia
Sz

Question 22

What are clinical features of hypoglycemia in the older child?

Answer 22

confusion
tremor
sweating
visual changes
HA
tachycardia
weakness
Sx
coma

Question 23

what are neonatal causes of hyperinsulinism?

Answer 23

baby of DM mom

Beckwith-wiedemann

Question 24

How do you diagnose hyperinsulinism?

Answer 24

if hypoglycemia and insulin is inappropriately high

Question 25

if patient mentions that they need to consume uncooked cornstartch - what is the Dx

Answer 25

``` glucose 6 phosphatase def severe hypoglycemia + ketosis hepatomegaly growth retartdation lactic acidosis ```

Question 26

what are the clinical features of MCAD

Answer 26

``` medium chain acyl CoA dehydrogenase def: - fasting hypoglycemia - mild hepatomegaly - mild inc LFT - mild hyperuricemia - mild inc NH4 NO KETONES DX: urine + dicarboxylic acid ```

Question 27

what are physical features of Kallman syndrome

Answer 27

decreased sense of smell one hand copies other short 4th metacarpal absent kidney

Question 28

what is hypogonadotropic hypogonadism

Answer 28

CENTRAL ISSUE | Absent or decreased ability of the hypothalamus to secrete GnRH or the pituitary gland to secrete LH and FSH

Question 29

what would you see on MRI if thought pt had Kallman?

Answer 29

absent olfactory bulbs and sulci

Question 30

what are the MC causes of hypogodadotropic hypogonadism

Answer 30

1. constitutional 2. CNS tumours 3. Kallman 4. syndromes - prader willi 5. functional - AN, hypothyroidism, chronic disease, DM, athletes

Question 31

what does hypergonadotropic hypogonadism imply

Answer 31

the defect if peripheral | making GnRH and LH and FSH but not having the desired effect

Question 32

what are the MC causes of hypergonadotropic hypogonadism

Answer 32

primary ovarian failure - turner, gonadal dysgenesis | primary testicular failure - klinefelter

Question 33

when should you screen for type 2 DM?

Answer 33

Starting at 10 years of age or at onset of puberty and every 3 years if BMI >85 + > = 2 risk factors for diabetes: - family history, - higher risk race or ethnicity, - signs of insulin resistance, - maternal history of diabetes

Question 34

what meds put you at higher risk of developing DM

Answer 34

steroids | atypical antipsychotics

Question 35

what are clinical features of neonatal hyperthyroidism

Answer 35

``` (mom had graves) prem IUGR GOITER restless, irritable, and hyperactive Microcephaly eyes are opened widely/exophthalmic HSM CHF Can develop craniosynostosis ```

Question 36

how do you dx neonatal hyperthyroid

Answer 36

HIGH T3/T4 | low TSH

Question 37

how do you manage neonatal hyperthyroid

Answer 37

propranolol + methimazole remission by 3-4 mo

Question 38

Cushing syndrome diagnosis

Answer 38

Dexamethasone suppression test. If normal, will get suppression If Cushing, still remains high