Yolaine St. Louis, M.D.
GOALS & OBJECTIVES
To acquire adequate knowledge for evaluation of endocrine conditions seen in
general pediatric practice.
To be able to give the differential diagnosis from presenting history and
physical exam.
To suggest initial work-up and management.
To understand commonly used endocrine tests and pediatric normal values.
Primary Goals for this Rotation
Prevention, Counseling and Screening
Understand the role of the pediatrician in preventing endocrine dysfunction,
and in counseling and screening individuals at risk for these diseases.
Identify the individual at risk for developing endocrine dysfunction through
routine endocrine counseling and screening of all patients and parents.
Provide preventive counseling to parents and patients with specific
endocrine conditions like; the need for influenza vaccination, the
association of chronic steroid use and decreased bone density, the
importance of diabetes control for prevention of long term complications
such as retinopathy, neuropathy, nephropathy, and gastroparesis and the
value of support groups and camps available for children with diabetes
mellitus.
Normal Versus Abnormal
Differentiate between normal, physiologic deviations from normal, and
pathological states related to endocrinology.
Describe the normal developmental patterns of statural growth and weight
gain, along with normal variations. Describe body proportions that can help
to differentiate proportionate from disproportionate short stature.
Perform Tanner staging (SMR) and explain the sequential physiologic events
associated with puberty.
Identify early puberty and differentiate it from premature thelarche and
premature adrenarche.
Undifferentiated Signs and Symptoms
Evaluate, treat, and/or refer patients who present with undifferentiated
signs and symptoms that may represent an endocrine disease process.
Diabetes Mellitus (Types I and II)
Diagnose and manage uncomplicated diabetes mellitus with or without the
assistance of an endocrinologist
Identify the risk factors for developing type 2 diabetes and provide routine
screening for those at elevated risk.
Differentiate Type I and Type II diabetes on the basis of findings from the
clinical history, physical examination, and laboratory tests.
Diagnose diabetes mellitus and diabetic ketoacidosis from presenting
symptoms and confirmatory lab tests.
Order appropriate confirmatory diagnostic serum and urine tests for diabetes
mellitus and accurately interpret the results.
Recognize immediate life threatening complications associated with the
diagnosis and treatment of diabetic ketoacidosis and steps for initial
treatment and stabilization. Refer for intensive care as indicated.
Thyroid Disorders
Understand the general pediatrician's role in the diagnosis and management
of patients with congenital and acquired hypothyroidism and hyperthyroidism.
Identify the thyroid function tests, including newborn screening, available
for detecting and diagnosing a thyroid disorder, and describe the
indications for ordering, limitations and interpretations.
Identify imaging studies available for patients with a thyroid disorder and
the indications for obtaining such studies.
Identify indicators for an endocrine referral of a child with a thyroid
disorder.
OUTLINE OF TOPICS
During the elective, we will aim to read through all of these topics in one
major textbook, as well as sample more detailed literature appropriate for
patients seen and cases discussed.
BRONX-LEBANON HOSPITAL CENTER
