What are risk facotrs for Diabetes in children
family history
presence of DR3 and DR4 major hisocompatibility antigens
How is DM diagnosed
One of the following:
- random blood glucose levels >200mg/DL + diabetic symptoms
- 2 seperate fasting BG levels of >126mg/dL
- 2 hour plasma glucose of >200 on oral glucose tolerance test
- A1c >6.5
What is the Target glycated hemoglobin for children with DM
(A1c)
< 7.5
what are symptoms of hypercalcemia in neonates and infants
nonspecific but often discovered wtih chem panel due to failure to thrive
what is the initial approach to treating hypercalcemia
increase urinary excretion of calcium
what is the treatment for children with primary hyperparathyroidism
parathryoid surgery
What is the most common cause of hyperthryoidism in children
Graves Disease
what are symptoms of hyperthryoiridism
voracious appetite
heat intolerance
emotional lability
restlessness
excessive sweating
frequent loose stools
poor sleep
how is hyperthryoidism diagnosed
- elevated T4 levels
- elevated T3 levels
- Suppressed TSH levels
what is the treatment of hyperthryoridism
PTU, methimazole or radioiodine
how is neonatal graves controlled
propranolol +/- methimazone
most remit within 2-3 months
What is the most common cause of juvenile or acquired hypothyroidism
Hashimoto’s thyroiditis
what is another name for congenital hypothryoidism
Cretinism
what is the presentation of congenital hypothyroidism
hypotonia
lethargy
macroglossia
large fontanelles
dry skin
what sex is more commonly affected by hypothryoidism
Girls 4x > boys
when do symptoms of hypothryoidism typically occur and what are initial presenting symptoms
- generally appear after first year of life
- cold intolerance, diminished appetite, lethargy and constipation
how is hypothyroidism diagnosed
- Low T4 and T3, elevated TSH in primary hypothyroisims
how is hypothyroidism treated
levothyroxine
thyroid function tests should be monitored frequently
When does BMI calculation begin
2 years and older
What are normal causes of short stature
- familial short stature
- constitutional delay
what are pathologic causes of short stature
dispoportionate short stature
proportionate short stature
how is disporoportionate short stature characterized
short limbs but an average sized trunk
- rickets and achondroplasia (dwarfism)
what is achondroplasia
dwarfism
how is short stature diagnosed
Bone age (AP XR of left wrist)
Thyroid function tests
UA and renal function tests
CBC and SED rate
Albumin and total protein
