Paediatric - Endocrine and reproductive

Question 1

What is the most common cause of thyrotoxicosis?

Answer 1

Graves’ Disease

Question 2

Name a risk factor for developing Hyperthyroidism

Answer 2

Family history, High iodine intake, Smoking, Thyroid trauma, Toxic multinodular goitre, Childbirth, Highly active antiretroviral therapy

Question 3

Name 6 symptoms/signs of hyperthyroidism

Answer 3

Symptoms: Weight loss or gain, increased or decreased appetite,Increased or decreased appetite, Irritability, Weakness and fatigue, Diarrhoea, Sweating, Tremor, Heat intolerance, Loss of libido, Oligomenorrhoea or amenorrhoea
Signs: Palmar erythema, Sweaty palms, Fine tremor, Tachycardia, Hair thinning/alopecia, Urticaria, pruritus, Brisk reflexes, Goitre, Proximal myopathy, Gynaecomastia, Lid lag

Question 4

Which autoantibodies might present in Graves’ disease?

Answer 4

Thyroid peroxidase antimicrosomal antibodies, Antithyroglobulin antibodies, TSH-receptor antibodies

Question 5

Name 2 antithyroid drugs as well as the treatment of choice in relapsed Graves’

Answer 5

Carbimazole and Propylthiouracil; radio-Iodine

Question 6

Name 3 symptoms of Hypothyoidism

Answer 6

Tiredness, Weight gain, Constipation, Aches, Feeling cold, Dry skin, Dull or coarse hair, Fluid retention, Mental slowing, Depression, hoarse voice, Irregular or heavy periods, Infertility, Loss of sex drive, Carpal tunnel syndrome

Question 7

What is the most common cause of hypothyroidism in the UK?

Answer 7

Autoimmune Thyroiditis

Question 8

What is the most common cause of hypothyroidism worldwide?

Answer 8

Iodine deficiency

Question 9

What is the first-line treatment of hypothyroidism?

Answer 9

Levothyroxine

Question 10

Congenital Adrenal Hyperplasia follows what inheritance pattern?

Answer 10

Autosomal recessive

Question 11

Most cases of Congenital Adrenal Hyperplasia are caused by what enzyme deficiency?

Answer 11

21-hydroxylase deficiency

others = 11-beta-hydroxylase deficiency

Question 12

How is deficiency of glucocorticoids and mineralocorticoids treated in classic congenital adrenal hyperplasia?

Answer 12

Glucocorticoids: Hydrocortisone
Mineralocorticoids: Fludrocortisone

Question 13

CAH causes underproduction of what hormones and overproduction of what hormones?

Answer 13

cortisol + aldosterone; Androgens

Question 14

Name the main glucocorticoid hormone

Answer 14

Cortisol

Question 15

Name the main mineralocorticoid hormone

Answer 15

Aldosterone

Question 16

What is 21-hydroxylase responsible for converting?

Answer 16

Progesterone into Aldosterone/Cortisol

Question 17

Name a cause of Hyperaldosteronism (Conn’s Syndrome)

Answer 17

Adrenal adenoma, Adrenal hyperplasia, Familial hyperaldosteronism, Adrenal carcinoma

Question 18

Name a classic feature of hyperaldosteronism (Conn’s syndrome)

Answer 18

Hypertension / Hypokalaemia / Metabolic alkalosis / Sodium normal or slightly raised

Question 19

Name an aldosterone antagonist used in the treatment of Conn’s syndrome

Answer 19

Spironolactone / Eplerenone

Question 20

A phaeochromocytoma is a rare tumour that secretes what?

Answer 20

Catecholamines (epinephrine (adrenaline), norepinephrine (noradrenaline), and dopamine)

Question 21

Which condition has a classic presentation of Primary Amenhorroea and on examination of the abdomen you can feel two masses in the groin

Answer 21

Androgen Insensitivity

Question 22

In most cases the testes will descend by what age?

Answer 22

By 3-6 months

Question 23

What surgery is performed on undescended testes after 6 months old?

Answer 23

Orchidopexy (surgical correction of undescended testes)

Question 24

A syndrome characterized by delayed or absent puberty and an impaired sense of smell. This disorder is a form of hypogonadotropic hypogonadism

Answer 24

Kallman Syndrome

Question 25

long-term administration of what type of drugs may cause adrenal insufficiency?

Answer 25

Corticosteroids

Question 26

What are some symptoms of Addison’s crisis?

Answer 26

• Severe vomiting and diarrhoea.
• Pains in the back and abdomen.
• Lack of fluid in the body (dehydration).
• Low blood pressure.
• Collapse.

Question 27

What is the name for primary adrenal insufficiency?

Answer 27

Addison’s disease

Question 28

What stimulates secretion of IGF-1 and where does this take place?

Answer 28

GH from anterior pituitary stimulates release of IGF-1 from liver