What this deck covers
Congenital Adrenal Hyperplasia and Adrenal Insufficiency in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.
Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.
The 18 cases, in order
- Second week collapse in a boy
- A uterus, but virilised
- One fault, two problems
- What the blood spot detects
- Proving the mineral side
- The first two things to give
- What he goes home on
- A fever at home
- Vomiting and cannot swallow
- Round face and slow growth
- Growing fast and smelling grown up
- Presenting as a teenager
- Androgens without the salt problem
- Dark creases and salt craving
- Stopped the tablets too fast
- Failing at school and going dark
- Making the gland prove itself
- Going to theatre
Diagnoses and management options tested
Across the 18 cases you are asked to choose between options such as: A salt-losing adrenal crisis, A chromosomal abnormality of the sex chromosomes, The adrenal gland makes too much aldosterone, Serum cortisol, A low sodium with a high potassium and high renin, Fludrocortisone by mouth immediately, Hydrocortisone alone, Stop the dose until the fever settles, Give the intramuscular hydrocortisone they carry, A second endocrine condition has developed, Over-treatment with too much steroid, The classical salt-losing form, Simple virilising, with salt handling intact, A functioning tumour of the adrenal gland.
Clinical pearls from this deck
- A low sodium with a HIGH potassium in a second-week baby is adrenal until proved otherwise.
- The genitalia are the question the family asks. The sodium is the one that can kill.
- One block, three consequences: no cortisol, no aldosterone, and nowhere for the precursor to go but androgen.
- Screening exists for the boys. The girls are usually found by looking at them.
- Renin moves first. A normal sodium on day nine does not mean she is safe in week two.
- Fluid and hydrocortisone go in together, and neither one waits for a laboratory result.
Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.
More from this system: all Endocrinology Board Questions case decks · pediatric reference values.
