Paediatric aspects of diabetes and endocrinology Flashcards Preview

SM Endocrine > Paediatric aspects of diabetes and endocrinology > Flashcards

Flashcards in Paediatric aspects of diabetes and endocrinology Deck (38):
1

How common is type 1 diabetes

250 children attend the paediatric diabetes service
one of the most common chronic diseases seen in children
Becoming more common

2

What is the incidence of type 1 diabetes in children

1 in 450

3

In 25% of new cases, what is the presentation for type 1 diabetics

DKA

4

What are 4 classic symptoms of type 1 diabetes

polyuria
polydipsia
weight loss
general malaise

5

What are symptoms of DKA

vomiting
abdominal pain
altered consciousness
acidotic breathing
dehydration

6

What would a fasted blood glucose level be to suggest type 1 diabetes

7 or more

7

What would a random blood glucose level be to suggest type 1 diabetes

11 or more

8

If DKA is left untreated what can it lead to

Coma and death

9

What would be seen in urinalysis in DKA

pH

10

What are some of the other risks/ problems of type 1 diabetic children

Based on weight (10ml/kg)
careful fluid resuscitation
risk of cerebral oedema
insulin commenced 1 hour after IV fluids started

11

What are some of the early changes of vascular diabetes in children with type 1 diabetes

microalbuminuria
cardiovascular autonomic neuropathy
sensory nerve damage
retinopathy
cheirarthropathy
skin vascular changes
vascular endothelial pathology

12

In what way can we achieve optimal glycaemic control in type 1 diabetes

Early intensification - multiple daily injection, pumps, insulin adjustment from the start
consistent approach
consistent targets
good support - friends, school, family

13

What part of the body is faulty in primary thyroid disease

thyroid gland

14

What part of the body is faulty in secondary thyroid disease

Pituitary

15

What part of the body is faulty in tertiary thyroid disease

Hypothalamus

16

What is secondary/ tertiary thyroid disease usually associated with

hypopituitarism

17

What are some clinical symptoms that may be present in congenital thyroid disease

delayed jaundice
poor feeding, but normal weight gain
hypotonia
skin and hair changes

18

What is the test performed for congenital thyroid disease

Guthrie Test

19

How is the Guthrie test performed

On day 5 of after birth
capillary blood on dry blotting paper
Test for TSH and T4

20

Why is the Guthrie test not performed immediately at birth?

The TSH and T4 levels take a few days to normalise

21

How can we diagnose congenital thyroid disease

Absence of thyroxine in the first 2 weeks of life

22

Why does a foetus appear normal who has congenital disease

They have been protected by placental thyroid hormones

23

What is a major complication of congenital thyroid disease

Developmental delay

24

what type of disease is acquired thyroid disease

Autoimmune

25

What are some symptoms of hypothyroidism in children

Growth failure
delayed puberty
poor general health
educational difficulties
goitre

26

What would be the results of thyroid function tests in hypothyroidism

Low free T4 and T3
High TSH
High thyroid cell antibody titres

27

What is the treatment for hypothyroidism in children

Thyroxine replacement for life
Dose depends on the size of the child

28

What are some of the general symptoms of hyperthyroidism

Behaviour problems
Sleep disturbance
eating difficulties
Goitre
high pulse rate
precocious puberty

29

What would the results of the thyroid function test be in a patient with hyperthyroidism

Suppressed TSH
high free T4 and T3 levels
high thyroid cell antibody titres

30

What is the initial treatment for hyperthyroidism

Beta blockade

31

What is the treatment for suppressant therapy in hyperthyroidism

Carbimazole +/- thyroxine

32

What are some permanent treatment strategies for hyperthyroidism

Radio-iodine or surgery

33

What is more common in children- hypothyroidism or hyperthyroidism

Hypothyroidism

34

If a patient has an underachieve adrenal gland, what do they produce low doses of

Steroids

35

What is the main cause of primary adrenal disease

Congenital adrenal hyperplasia

36

What is also known as overactive production of steroids

Cushing syndrome

37

What is the treatment for Cushing disease

cortisol therapy

38

What are signs of Virilisation in males and then in females

Males - precocious puberty
Females - ambiguous genitalia