Endocrinology

Children in School Bus
Draft proposed by Dr Joanna Tung
Reviewed by Dr Frankie Cheng

Essential Skills

Domain 1 Professional Values & Behaviour

Domain 2 Communication

Domain 4 Patient Management

Additional desirable skills are listed in each proposal. These recommended skills are to be acquired as opportunity arises

Basic Training

Common growth and pubertal disorders

 Accurate measurement of height, weight, body proportions and head circumference.

 Assessment of pubertal development

 Utilization of growth charts and be familiar with the use of local and international growth standards.

 

Definition of normal and abnormal growth and puberty

General approach and initial management to

  • Precocious/delayed puberty

  • Short stature/tall stature

  • Failure to thrive/overgrowth

 

Diabetes mellitus

Recognition and initial management of type 1 and type 2 diabetes

Acute management of diabetic ketoacidosis

 

Hypoglycaemia

 Acute management and critical samples in hypoglycaemia

 

Disorders of sex development

 Approach and initial management of a neonate with ambiguous genitalia

Thyroid disorders

Recognition and initial management on common thyroid problems

  • Congenital hypothyroidism

  • Thyrotoxicosis

  • Goitre

 

Adrenal disorders

Recognition and acute management of adrenal crisis

Disorders of calcium, phosphate and vitamin D metabolism and metabolic

bone diseases

 Recognition and initial management on hypo/hypercalcaemia, hypo/ hyperphosphatemia and vitamin D deficiency

Disorders of the ovary and female sexual maturation

Recognition and initial workup on common causes, including Turner syndrome

 

Disorders of the testes and male pubertal development

Recognition and initial workup on common causes, including Klinefelter syndrome

 

Obesity

Epidemiology and basic principles of management

 

Fluid and electrolytes disorders

Recognition and initial management on:

  • Diabetes insipidus

  • Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

 

Neuroendocrine system of hypothalamus and pituitary

Recognition and initial workup on panhypopituitarism

Endocrine manifestations and late effect of systemic disease

Risk factors and manifestations of the late effects of systemic diseases, including cancer survivors

Lipid disorders

Cardiovascular risks of dyslipidaemia

Clinical manifestation of dyslipidaemia

Screening of high-risk children

Desirable skills 

  1. Interpretation of common endocrine investigations.

Higher Training

Common growth and pubertal disorders

 Further investigations and management of

  • Precocious/delayed puberty

  • Short stature/tall stature

  • Failure to thrive/overgrowth

 

Diabetes mellitus

Long term management of type 1 and type 2 diabetes

Basic understanding on monogenic diabetes

 

Hypoglycaemia

Management of:

  • Hyperinsulinaemic hypoglycaemia

 

Disorders of sex development (DSD)

 Further investigations and management of common DSD including congenital adrenal hyperplasia

 

Thyroid problems

Long term management on common thyroid problems

  • Congenital hypothyroidism

  • Thyrotoxicosis

  • Goitre

Recognition and initial stabilization of thyroid storm

 

Adrenal disorders

Participate in the management of:

  • Adrenal insufficiency

  • Less common adrenal disorders e.g., Adrenal hyperfunction, Cushing syndrome etc.

 

Disorders of calcium, phosphate and vitamin D metabolism and metabolic

bone diseases

 Further workup and management on disorders of calcium, phosphate and vitamin D metabolism and metabolic bone diseases, including hyperparathyroidism and inherited hypophosphatemic ricket

 

Disorders of the ovary and female sexual maturation

Long term management on common causes, including Turner syndrome

 

Disorders of the testes and male pubertal development

Long term management on common causes, including Klinefelter syndrome

 

Obesity

Simple obesity vs. obesity due to other pathological causes

Management strategies

Obesity prevention

 

Fluid and electrolytes disorders

The long-term management on:

  • Diabetes insipidus

  • Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

 

Neuroendocrine system of hypothalamus and pituitary

The long-term management on Panhypopituitarism

Endocrine manifestations and late effect of systemic disease

Surveillance on the late effects of systemic diseases e.g., cancer survivors

 

Lipid disorders

Management of dyslipidaemia

 

Desirable skills 

  1. Interpretation of endocrine function tests including the combined pituitary function tests, CRF test, water deprivation test, short and long synacthen stimulation tests, dexamethasone suppression test, oral glucose tolerance test, TRH and LHRH tests and other clinical endocrine tests and understand the common pitfalls in interpretation.

  2. Interpretation of endocrine imaging including CT scan, MRI, ultrasonogram, radioisotopic scanning of the endocrine organs and bone densitometry.