Endocrinology — Prometric Style Questions, Set 2

What this deck covers

Endocrinology – Prometric Style Questions, Set 2 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. Refusing food during an illness
2. Low hours after the match
3. He no longer feels them
4. Ketones in four hours
5. Needing less every week
6. Control that makes no sense
7. What the annual review adds
8. Lumps where she injects
9. Prescriptions that do not add up
10. Order of the first hour
11. A goitre with a bruit
12. A firm gland and a family history
13. One lump in a child’s neck
14. Her gland was removed years ago
15. Thyroxine around theatre
16. Short but not thin
17. The late developer
18. The small baby who stayed small
19. A fall that was not real
20. Tall, with blurred vision
21. Developing at six
22. Hair, but nothing else
23. Irregular since they began
24. No puberty and no smell
25. Patches with ragged edges
26. No periods at sixteen
27. A question that has to wait
28. Why the gonads matter
29. Two findings together
30. Who else will know
31. Hungry since the first year
32. Liver tests in an obese teenager
33. Knee pain from the hip
34. Not diabetic yet
35. He was sick after the tablet
36. Growing too fast on treatment
37. Coming off after eight months
38. Asking about her future
39. Steroid cover for theatre
40. Drinking through the night
41. Low sugar and a small penis
42. Headaches and a stalled height
43. Low sodium with a wet chest
44. Pouring out urine after surgery
45. Shocked after two days of diarrhoea
46. The order of the drugs
47. Too much of a supplement
48. A big baby who will not hold his sugar
49. A vomiting boy at six weeks
50. Calcium that will not come up

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Omit insulin until he begins eating again, Deliberate omission of insulin, Annual echocardiography for cardiomyopathy, Fluid resuscitation before insulin, Reassurance, as nodules are common in children, Familial short stature, Arrange growth hormone stimulation testing, Premature adrenarche, Central precocious puberty, The gonads will cause virilisation at puberty, Excessive calorie intake alone, Start insulin treatment immediately, Stop abruptly, as the condition has resolved, A random urine osmolality.

Clinical pearls from this deck

• Not eating is not a reason to stop insulin. It is the sentence that puts children in intensive care.
• The hypo comes hours after the final whistle. Plan the night, not the match.
• Let his glucose run high for a few months on purpose. The warning symptoms come back, and that matters more than the number.
• On a pump, high glucose plus ketones means the pump is guilty until proved otherwise. Inject, then investigate.
• Warn them it will end. A family told this is improvement experiences the next few months as a relapse they caused.
• Glucose that makes no sense in a child doing everything right is often the gut, not the insulin.

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.