1.8.15 - Endocrine Cases

Question 1

systemic sluggish reflexes

Answer 1

diabetes

Question 2

treatment of chapmans

Answer 2

anterior point
posterior point
then recheck anterior point

Question 3

sympathetics to thyroid

Answer 3

vasomotor

T1 - often flexed

Question 4

cervical ganglia

Answer 4

superior
middle
inferior

Question 5

superior cervical ganglion

Answer 5

C2-3

Question 6

middle cervical ganglion

Answer 6

C6 transverse process

Question 7

inferior cervical ganglion

Answer 7

C7 and rib

aka stellate

Question 8

VSR

Answer 8

more rubbery end feel

-no HVLA usually

Question 9

abdmonial ganglia

Answer 9

celiac
SMA
IMA

Question 10

focus on treating SD

Answer 10

don’t chase the pain

Question 11

labs for hypothyroid

Answer 11

TSH and free T4

Question 12

liver

Answer 12

activates T4 > T3

Question 13

TSH repeat

Answer 13

6 weeks untils table

6-12 months once stable

Question 14

sleep apnea

Answer 14

predispose for heart disease

Question 15

metabolic syndrome diagnosis

Answer 15

3 of 5

1 - abdominal obesity
men >102cm
women >88cm
2 - BP >130/85
3 - TG > 150
4 - HDL - men 100

Question 16

adrenal fatigue

Answer 16

subclinical addisons disease

Question 17

ketoconazole, etomidate

Answer 17

possible etiology of addisons

Question 18

low cortisol and high ACTH

Answer 18

addisons disease

normal cortisol - adrenal fatigue

Question 19

adrenal crisis

Answer 19

5 S’s

salt, sugar, steroids, support, and search (for precipitating illness)

Question 20

tx of addisons

Answer 20

managed with hydrocortisone, fludrocortisone, and DHEA

Question 21

in utero

Answer 21

growth depends on maternal factors

Question 22

after birth

Answer 22

growth depends on genetics

Question 23

first 18 months

Answer 23

catch up or catch down growth

before reach genetic growth velocity

18-24 months - kids grow along same percentile

Question 24

constitutional delay of growth and puberty

Answer 24

temporary delay of growth but catch up mid puberty

Question 25

growth failure

Answer 25

loss of two or more major percentile lines

Question 26

short stature

Answer 26

height 2 SD below average

or below 2.5 percentile

Question 27

familial short stature

Answer 27

short compared to age matched population but consistent with family genetics

Question 28

non-familial short stature

Answer 28

short compared to population and family

Question 29

history with short stature

Answer 29

pregnancy/birth history
fam hx
previous growth

Question 30

webbed neck, low ears, broad chest

Answer 30

turner syndrome

Question 31

webbed neck, double curve scoliosis, rib deformity

Answer 31

noonan syndrome

Question 32

triangular face, clinodactyly, blue sclera, lack of subQ fat

Answer 32

russel silver

Question 33

multiple fractures, missing collar bone, underdeveloped joints

Answer 33

skeletal dysplasia

Question 34

lab for short stature

Answer 34

BMP
CBC
ESR
LFT - liver function test
urinalysis
bone age and Xray - left hand and wrist

Question 35

multiple syndromic or dysmorphic features

bone age <2SDs

Answer 35

referral indicated

Question 36

GH stimulation test positive

Answer 36

GH deficiency

tx GH injection to puberty

Question 37

somatosensory mapping

Answer 37

develop through motion

best time to influence biomechanics and somatosensory map
-just before growth spurts

Question 38

common compensatory pattern

Answer 38

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