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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

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

Basic Training

Common growth disorders

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

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

 Utilization of condition-specific growth charts in children with conditions like Down’s syndrome and Turner’s syndrome

 Definition of normal and abnormal growth for local children

General approach and initial management of:

  • Short stature/tall stature

  • Failure to thrive

  • Obesity

 Epidemiology of obesity

 

Common pubertal disorders

Assessment of pubertal development

 Definition of normal and abnormal puberty for local children

 General approach and initial management of:

  • Precocious/delayed puberty

  • Thelarche/adrenarche

 Disorders of the ovary/testes and female/male sexual maturation

  • Recognition and initial workup on common disorders, including Turner syndrome, Klinefelter syndrome, constitutional delay in growth and puberty

 

Diabetes mellitus

Recognition, diagnosis and initial management of type 1 and type 2 diabetes

Acute management of diabetic ketoacidosis

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Hypoglycaemia

 Acute management and critical samples in hypoglycaemia in neonates and children

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Disorders of sex development

 Approach and initial management of a neonate with ambiguous genitalia

 

Thyroid problems

Recognition and initial management on common thyroid problems

  • Congenital hypothyroidism

  • Primary hypothyroidism

  • Thyrotoxicosis

  • Goitre and thyroiditis

Approach to thyroid nodules

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Adrenal disorders

Recognition and acute management of adrenal crisis

 Recognition on the need of stress dose steroid for children with adrenal insufficiency at times of acute illness or perioperatively

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Disorders of calcium, phosphate and vitamin D metabolism and metabolic bone diseases

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

 

 Fluid and electrolytes disorders

Recognition and initial management on:

  • Diabetes insipidus

  • Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

 

Lipid disorders

Cardiovascular risks of dyslipidaemia

Clinical manifestation of dyslipidaemia

Screening of high-risk children

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Desirable skills (optional for General Paediatric Training)

Interpretation of common endocrine investigations, namely baseline hormonal tests and and oral glucose tolerance test,

Higher Training

Common growth disorders

 Further investigations and appropriate referrals of:

  • Short stature/tall stature

  • Failure to thrive

  • Obesity

 Simple obesity vs. obesity due to other pathological causes

 Management strategies of obesity

 Screening for obesity related comorbidities

 Obesity prevention

 

Common pubertal disorders

 Further investigations and appropriate referrals of:

  • Precocious/delayed puberty

  • Thelarche/adrenarche

 

Disorders of the ovary/testes and female/male sexual maturation

  • Long term management on common causes, including Turner syndrome, Klinefelter syndrome, constitutional delay in growth and puberty

 Initial workup of primary amenorrhea, secondary amenorrhea, and oligomenorrhea

 

Diabetes mellitus

Long term management of type 1 and type 2 diabetes

Basic understanding on monogenic diabetes

 

Hypoglycaemia

Management of hyperinsulinaemic hypoglycaemia

 Diagnostic workup in children with hypoglycaemia

 

Disorders of sex development (DSD)

 Further investigations and management of common DSD including congenital adrenal hyperplasia and undervirilised male

 

Thyroid problems

Long term management on common thyroid problems

  • Congenital hypothyroidism

  • Primary hypothyroidism

  • Thyrotoxicosis

  • Goitre/thyroiditis

Recognition and timely consultation/referral of thyroid storm

Further investigation of thyroid nodules

 

Adrenal disorders

Participate in the diagnosis and 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, nutritional rickets and inherited hypophosphatemic rickets

Initial workup of recurrent fractures

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Fluid and electrolytes disorders

Long-term management on:

  • Diabetes insipidus

  • Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

 

Neuroendocrine system of hypothalamus and pituitary

Recognition and initial workup on panhypopituitarism

Long-term management on panhypopituitarism, craniopharyngioma and related pituitary disorders

 

Endocrine manifestations and late effect of systemic disease

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

 

Lipid disorders

Management of dyslipidaemia

 

 

Desirable skills (optional for General Paediatric Training)

Interpretation of common endocrine function tests including water deprivation test, growth hormone stimulation test, LHRH test and low dose short synacthen stimulation tests

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