Pituitary Disease and Diabetes Insipidus in Children — Board-Style Questions

What this deck covers

Pituitary, Diabetes Insipidus and Miscellaneous Endocrinology 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 paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Drinking day and night
2. Deprived, and still dilute
3. Giving what was absent
4. The injection changed nothing
5. A party and a seizure
6. Yesterday floods, today a trickle
7. Low salt, concentrated urine
8. Two conditions, one number
9. The opposite of what it looks like
10. The order that matters
11. A bright spot in the wrong spot
12. Milk, headaches and lost vision
13. Growing far beyond the family
14. Three relatives, three glands
15. A third gland joins in
16. Four years after treatment
17. High signals, small gonads
18. A rash and a hole in the skull

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Habitual excessive drinking, He cannot concentrate his urine when dehydrated, The deprivation test result must have been wrong, In the pituitary production of the hormone, A recurrence of the underlying pituitary lesion, The diabetes insipidus has resolved permanently, Excessive intravenous fluid given during transfer, He is volume depleted rather than euvolaemic, His kidneys would fail without additional potassium, All three together at full replacement doses, A tumour arising within the pituitary gland, A prolactin-secreting pituitary tumour, A familial pattern of very tall stature, Reassurance, since the conditions are unrelated.

Clinical pearls from this deck

• High sodium with dilute urine is the whole diagnosis. Check a glucose before anything else.
• Stop the test at five per cent weight loss. It is a supervised test, not an endurance one.
• Every child with confirmed cranial disease needs a pituitary scan. The diagnosis is not the end of it.
• An infant cannot ask for a drink. Recurrent unexplained high sodium is how they tell you.
• The dangerous direction on treatment is a LOW sodium. Build a daily break into the day.
• Three phases after pituitary surgery. The middle one catches people out and it drops the sodium.

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.