ch 28

Question 1

Diagnostic Evaluation of GH Deficiency

Answer 1

Skeletal survey in children younger than 3 years of age

Hand–wrist x-ray to examine for centers of ossification

Question 2

Therapeutic Management of Precocious Puberty

Answer 2

Central variety is treated with leuprolide acetate (Lupron Depot)
Slows prepubertal growth to normal rates

Question 3

Juvenile Hypothyroidism

Answer 3

Congenital
Congenital hypoplastic thyroid gland

Acquired
Partial or complete thyroidectomy for cancer or thyrotoxicosis
Following irradiation for Hodgkin disease or other malignant disease

Question 4

Lymphocytic Thyroiditis

Answer 4

Most common cause of thyroid disease in children and adolescents
Accounts for the largest percentage of cases of juvenile hypothyroidism
Occurs more frequently after age 6 years

Question 5

Hyperthyroidism and Graves Disease

Answer 5

Most common cause of hyperthyroidism in childhood is Graves disease

Enlarged thyroid gland and exophthalmos
Peak incidence is at 12 to 14 years of age, but it may be present at birth

Treatments
Antithyroid drugs (propylthiouracil [PTU] and methimazole)
Subtotal thyroidectomy
Ablation with radioiodine

Question 6

Hyperparathyroidism

Answer 6

Primary disease: Adenoma of the gland
Secondary disease: Chronic renal disease; congenital anomalies of the urinary tract
Common factor is hypercalcemia