Diabeetus
Criteria to screen for type 2 diabetes in children and teens
Screening for prediabetes and type 2 diabetes is recommended in children and adolescents with a body mass index ≥85th percentile and at least 1 other risk factor (family history or evidence of insulin resistance)
True or false premature testelarche be benign
False
What genetic condition needs to be ruled out in girls presenting with short stature?
Turner Syndrome
GH, TSH, ACTH, FSH, LH, Prolactin
A patient with hypercalcemia and hypophosphatemia has which disorder?
Hyperparathyroidism
How to calculate the total daily insulin dose?
0.5-1 units/kg/day
40% given as basal insulin remainder is divided between carb ratio and corrections
Definitions of delayed puberty in girls
Delayed puberty is defined as lack of breast development in girls by age 13 years or lack of menses by age 15 years (primary amenorrhea)
The calculation for target height potential
For boys: [mother’s height + father’s height + 5 inches (13 cm)]/2
For girls: [mother’s height + father’s height - 5 inches (13 cm)]/2
Increased pigmentation is seen in what type of adrenal insufficiency?
Primary adrenal insufficiency (Addison's disease)
Most common cause of CAH?
21-hydroxylase deficiency
A 16-year-old adolescent with a 7-year history of type 1 diabetes is seen for concerns about more frequent hypoglycemia detected on their continuous glucose monitor for the past 2 weeks. Their hemoglobin A1c level was 7.8% 2 months ago, and there have not been any recent changes in their insulin regimen or diet. They have participated in dance for the past 10 years, but missed multiple classes recently because of easy fatigability and low blood glucose values. They deny recent illness or depression.
On physical examination, the adolescent’s heart rate is 102 beats/min, blood pressure is 96/58 mm Hg, and oxygen saturation is 99% in room air. Weight is 2.3 kg less than at a visit 2 months ago. There is hyperpigmentation in the creases of the hands. The remainder of the physical examination findings are unremarkable.
Of the following, this adolescent’s MOST likely diagnosis is
A.autoimmune adrenalitis B.celiac disease C.an eating disorder D.hypothyroidismA. autoimmune adrenalitis
Which lab result indicates central precocious puberty?
LH spikes - usually undetectable in prepubertal children
A 13-year-old adolescent boy is seen for a routine health supervision visit. He is concerned about his small size. The boy is healthy, has no significant past medical history, and has a negative review of systems. His mother is 5 feet, 5 inches tall, and had menarche at 12 years of age. His father is 5 feet, 9 inches tall, and continued to grow in height during college. The boy’s vital signs are normal. His height trends along the 4th percentile and his weight along the 4th percentile. His body mass index is 17 kg/m2 (24th percentile). He has a sexual maturity rating of 2 for pubic hair and genital development. The remainder of his physical examination findings are unremarkable. A bone age radiograph is read as 11 years.
Of the following, the MOST likely diagnosis for this boy is
A.constitutional delay B.familial short stature C.growth hormone deficiency D.insufficient caloric intakeA.constitutional delay
Clinical manifestations of Cushing syndrome
Moon facies, buffalo hump formation and obesity, poor height velocity, hypertension
A child with severe head injury 3 days ago now has severe hyponatremia; what is 1 etiology you should consider?
SIADH
Diagnostic criteria for diabetes insipidus
Diagnostic criteria for diabetes insipidus include a serum osmolality of >300 mOsm/kg when the urine osmolality is <300 mOsm/kg. A water deprivation test may be required to make the diagnosis.
Definition of delayed puberty in boys
Defined as lack of testicular growth to 4 mL in volume (2.5 cm in length) by age 14 years in boys.
In GH deficiency, there is a ________ in growth velocity and ________ bone age
In GH deficiency, there is a decrease in growth velocity and delayed bone age
A 7-year-old girl is seen for concerns about rapid growth. She has not had headaches, vision changes, increased thirst, or increased urination. Her family has not noted any breast development, vaginal bleeding, or vaginal discharge. Review of the girl’s growth chart shows that she had been growing along the 25th percentile for height for age, but in the last year, her height increased to the 95th percentile. Her weight is at the 60th percentile and body mass index is at the 15th percentile. On physical examination, her heart rate is 140 beats/min and her blood pressure is 120/50 mm Hg. She appears tall, thin, and “jittery.” Her neck appears full. Sexual maturity rating is 1 for breast development and pubic hair. The remainder of her physical examination findings are normal.
Of the following, the test MOST likely to reveal this girl’s diagnosis is a/an
A.17-hydroxyprogesterone level B.insulin-like growth factor 1 level C.luteinizing hormone level D.thyroid-stimulating hormone levelD. thyroid-stimulating hormone level
How is rickets diagnosed?
X-ray: wrist or knee - growth plate changes
A previously healthy, 11-year-old boy is brought to the emergency department for nausea and vomiting for the past day. He has had polyuria and polydipsia for the past 2 weeks. On physical examination, the boy’s temperature is 37°C, heart rate is 110 beats/min, blood pressure is 108/64 mm Hg, respiratory rate is 26 breaths/min, and oxygen saturation is 98% on room air. His weight of 28 kg is down 4 kg from his health supervision visit 2 months ago. He appears tired but is interactive, taking deep breaths, and has a fruity smell to his breath. His capillary refill time is 3 seconds. The remainder of his physical examination findings are unremarkable.
Laboratory data are shown: Blood Glucose 640 mg/dL Sodium 146 mEq/L Potassium 3.6 Bicarbonate 8 mEq/L Venous pH 7.1 Urine Ketones: Large
Of the following, the BEST next step in this boy’s management is to administer intravenously:
A.0.9% sodium chloride, 10 mL/kg bolus, over 1 hour B.0.9% sodium chloride with potassium, at twice maintenance rate C.regular insulin, 0.1 unit/kg bolus D.regular insulin, 0.1 unit/kg per hour
A. 0.9% sodium chloride, 10 mL/kg bolus, over 1 hour
What treatment for Klinefelter syndrome is recommended at 11-12 years old?
Administration of long acting testosterone
A 12-year-old girl is seen for a preparticipation examination to attend summer camp. Her medical history is significant for Turner syndrome associated with a mosaic 45,X/46,XX karyotype and a bicuspid aortic valve. She has been treated with recombinant human growth hormone since 6 years of age. The girl and her mother are concerned that she has not yet developed any signs of puberty. The girl’s mother and older sister had menarche at age 13 years, and her father had typical pubertal timing. Her height is at the 2nd percentile and weight is at the 10th percentile. Her ears are low set and posteriorly rotated, and she has a high-arched palate. Her sexual maturity rating is 1 for breast and pubic hair development. The remainder of her physical examination findings are unremarkable.
Of the following, the BEST next step is to
A.obtain gonadotropin levels B.order pelvic ultrasonography C.provide reassurance that her development is normal D.start a combined oral contraceptive pill
A.obtain gonadotropin levels
Most common endocrine disease in dogs
Cushing's Disease
Most common endocrine disease in cats
Hyperthyroidism