PEDIA 2 LE 1.1

Endocrine, toxicology, evironmental tox

The following are hypothalamic hormones that control Growth Hormone, EXCEPT:

c. Dopamine

Iodine organification of tyrosine residues leads to formation of monoiodotyrosine (MIT) and diiodotyrosine (DIT). This process is catalyzed by:

B. Thyroid peroxidase

What is the most potent hormone secreted from the thyroid gland?

C. T3

Which statement is true regarding vasopressin?

A. Principal regulator of tonicity

Laron syndrome is most like a hypopituitarism

A. Longitudinal growth deceleration

Serum osmolality diagnostic of Diabetes Insipidus:

c. 300 mOsm/kg H2O

Grave's disease is caused by accumulation of these types of cells in the dense lymphoid aggregates.

B. T helper cells

A.A. is suffering from ophthalmopathy secondary to Graves disease. What is the most likely underlying mechanism?

B. Presence of antibodies against antigen shared by thyroid and eye muscle

A.A. is suffering from ophthalmopathy associated with Graves’ disease. What is the most likely underlying mechanism?

B. Presence of antibodies against antigen shared by thyroid and eye muscle

The following are clinical characteristics of congenital hypothyroidism EXCEPT:

B. Prone to develop RDS

What is the predominant antibody present in Hashimoto thyroiditis?

a) Anti-thyroid peroxidase (anti-TPO) antibody

17, F consulted for an anterior neck mass associated with exophthalmos. What is the most likely diagnosis?

C. Grave’s Disease

15y/o diagnosed with diabetic ketoacidosis. What is the main factor that triggers this metabolism?

c. release stress hormone

Urinary frequency and progressive weight loss. Possible diagnosis is DM. Value of non fasting glucose that support

D. 200

15 yo diabetic boy presents in ER with pallor, dizziness, sweat and tremors. What is the priority at ER?

D. Give glucose immediately

best explains increased blood glucose levels in the early morning hours due to overnight secretion of growth hormone and increased insulin clearance?

A. Dawn phenomenon

Metabolic state that intermediate between normal glucose homeostasis and diabetes

A. Impaired glucose tolerance

RR 18 year old previously known to have Type 1 DM was brought to the ER due to generalized seizures. He was dehydrated, had kussmaul breathing and was only responsive to stimuli. Blood sugar 780 mg/dl and serum osmolality is 308 msOm

c. Nonketotic hyperosmolar Coma

True of Autoimmune Addison's disease, EXCEPT:

C. Autosomal recessive

The most frequent cause of secondary adrenal insufficiency?

A. Abrupt cessation of exogenous steroids

B.B. was diagnosed with a form of acquired primary adrenal insufficiency. This condition is most commonly due to.

C. Autoimmune Addison Disease

What accumulates in 21-hydroxylase deficiency?

B. Progesterone & 17-OH-Progesterone

Clinical presentation of pheochromocytoma arises from excessive secretion of:

c. catecholamines

A clinical test for hypocalcemia is done by inflating a sphygmomanometer cuff above the systolic blood pressure for several minutes. This test is known as:

D. Trousseau’s sign

elicited by tapping the facial nerve just anterior to the ear → ipsilateral contraction of facial muscles (also a test for latent tetany, but less specific)adduction

Chvostek’s sign

historical test in poliomyelitis

Kenny sign

Congenital hypothyroidism failure to follow up Consult Expected Result

A.Bone Deformities

Ochratoxin is said to be nephrotoxic, hepatotoxic,immunotoxic, neurotoxic, mutagenic, teratogenic and carcinogenic. But which is the main target organ for OTA toxicity.

C. Kidney

best describes the pathophysiology of Laron Syndrome?

A. Peripheral resistance to growth hormone due to GH receptor mutation

A first-year college student was brought to the ER due to musculoskeletal injury due to falling from the top of a double bed. Seems very excited to talk despite his injury with weight loss from the past 30 days. He even jokingly said that he could fly. What is the differential diagnosis?

A. Mephenramine intoxication

Which substance abuse is associated with hyperthermia, increased heart rate and logorrhea (speech diarrhea)?

D. Ecstasy

What drug of abuse — depression, hallucination, dilated pupils

B. Cocaine intoxication

Which drug of abuse has tetrahydrocannabinol which causes disruption of coordination and balance

A. marijuana

Ms G., 18y teenage mom, who lives in a squatter's area. She went to the health center for her first prenatal check-up. What should the health provider prioritize to prescribe given her limited source of finances?

B) Iron, iodine

Which of the following is not a poisonous substance provided by a living organism?

C. Bisphenol A

A 4 month old male, his water is Wilkins distilled water, though his mom sometimes forgets to unload the water bottle from the car & remains there for a few days. What chemical substance could the baby still be exposed to?

A. Phthalates
B. Bisphenol A

Daniel 15 yr old went to the ER with his parents at 7:30 pm after he was seen huffing spray paint. He admitted that for several months, he has been buying spray paint at the local hardware to get high. Least manifestation

B. Logorrhea

The following mineral and vitamins are given as supplements for lead toxicity except?

C. VITAMIN E

Which best explain why children are disproportionately vulnerable to poisoning

Children's immature organ and exploratory behavior increase risk

A woman is heavily exposed to lead in childhood and later becomes pregnant. What mechanism BEST explains fetal risk?

D. Lead store in bone can mobilize during pregnancy and transfer to fetus.

A 10-year-old has hyperthermia, tachycardia, agitation, mydriasis, diaphoresis from unknown pills. What toxidrome is most likely?

B. Sympathomimetic

Which statement about antibiotics and corticosteroids in time of heart disease is most accurate?

C. Neither antibiotics nor corticosteroids are recommended unless specifically indicated.

A 3 year old ingested kerosene with cough but stable vitals. Which is NOT recommended

C. Activated charcoal

The statements about antibiotics and corticosteroids in hydrocarbon pneumonitis is MOST accurate

C. Neither are routinely recommended

Antidote for Methanol Toxicity

B. Fomepizole

Which of the following deposition or referral plan is the most appropriate is all caustic ingestion?

D. Refer to pediatric GI for endoscopy

8 y/o w possible ingestion of paracetamol 8-9 hours ago. What is the next best step?

B. Give NAC while waiting for labs and monitoring

3 y/o ingested a 40mg/kg Iron tablet. Which best describes the expected clinic outcomes?

B. Severe abdominal pain, vomiting, diarrhea: dose is potentially serious

Which of the ff factors best predicts the severity of mucosal injury after acid ingestion?

A. Volume ingested, concentration, time

What is the sequela after type II circumferential alkali burn in a child?

D. High risk for esophageal constriction