Endocrinology Prometric Style Questions – 50 Cases with Answers

What this deck covers

Endocrinology — Prometric Style Questions, Set 1 in 50 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 50 cases, in order

1. The shortest boy in the class
2. Small like her parents
3. Crossing the lines downwards
4. Short, and no breasts at thirteen
5. What comes first in girls
6. The earliest change in boys
7. Breast buds and first hair
8. Six years old and developing
9. Virilised, but small testes
10. Breasts at two, nothing else
11. No puberty and no sense of smell
12. Naming can wait
13. The vomiting newborn who collapsed
14. Virilised with a high pressure
15. Virilising at puberty
16. Screening the newborn
17. Why the screen was abnormal
18. Growing slowly and always cold
19. Losing weight and always warm
20. The jittery week-old baby
21. Weight up, height stopped
22. Obese, but is it hormonal?
23. The dark velvet on his neck
24. Before the tumour comes out
25. Two tumours and brown patches
26. Collapsing after stopping tablets
27. The slower of the defences
28. The genes behind the risk
29. Thirsty, thin and wetting again
30. Headache during the treatment
31. High every morning
32. An objective look at the months
33. The sample you only get once
34. Low sugar after a fast
35. Tingling and carpal spasm
36. Bow legs and swollen wrists
37. Bowing with normal calcium
38. A fit on day three
39. Putting the bones right
40. Diet has not been enough
41. Midline signs in a newborn
42. Drinking all night
43. Low sodium with meningitis
44. Breast tissue at thirteen
45. When to operate on a cyst
46. A lump and a family history
47. The big jittery newborn
48. Confused with a stony pain
49. Grew early, then stopped
50. Diabetes without antibodies

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Familial short stature with a low target height, Growth hormone provocation testing, Stage I, prepubertal, Reassurance and review, Serum aldosterone alone, Free T4 alone, Graves disease, The presence of striae, Down syndrome, HLA-B27, The dawn phenomenon from a growth hormone surge, Ketotic hypoglycaemia, Nutritional rickets, Continue diet alone for another year.

Clinical pearls from this deck

• Two points on a chart beat one measurement every time. Height alone tells you where a child is; velocity tells you whether anything is wrong.
• Plot the parents before you investigate the child. A height that matches the target range is usually an explanation, not a problem.
• Short and fat is endocrine until proved otherwise. Short and thin is nutrition or chronic disease. It sorts most referrals in one glance.
• Send a karyotype on any short girl whose gonadotrophins are high, however unremarkable she looks. Many have no webbed neck at all.
• Girls sprint early and stop soon after their first period. Tell families this before they expect another ten centimetres.
• Measure the testes or you will miss the start of puberty entirely. Virilisation with small testes always means the androgen came from elsewhere.

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 case decks · pediatric reference values.