Endocrine

Question 1

phenylketonuria (PKU)

Answer 1

Absence of phenoalanine hydroxylase enzyme

Question 2

dx PKU

Answer 2

Newborn screening’s

Question 3

tx PKU

Answer 3

diet free in Meat, Limited fruits/veggies and grains

phenylalanine free formula
breast feed

Question 4

Galactosemia

Answer 4

Lack of enzyme that converts galactose to glucose

Lactose intolerant

Question 5

tx galactosemia

Answer 5

Lactose free diet
Soy formula
Calcium supplements
No breast-feeding

Question 6

which medication should you be cautious in taking with galactosemia?

Answer 6

Penicillin
Some vitamins

Question 7

what is the number one concern with hypothyroidism

Answer 7

Airway protection

Question 8

tx hypothyroidism

Answer 8

Oral thyroid hormone replacement for life
Synthroid

Question 9

med. Administration precautions.

Answer 9

Avoid heat exposure
Don’t mix with soy formula

Question 10

treatment for hyperthyroidism

Answer 10

propylthiouracil
Subtotal thyroidectomy
High calorie diet
Limit activities/stress

Question 11

what is a complication from PTU

Answer 11

agranulocytosis/leukopenia

Sore throat and fever

Question 12

what should be done with agranulocytosis?

Answer 12

Placed in isolation and start antibiotics

Question 13

where does the growth hormone deficiency condition occur?

Answer 13

Anterior pituitary
Hypofunction

Question 14

sx growth hormone deficiency

Answer 14

skeletal proportions are normal for age

Retarded bone age

Question 15

tx growth hormone deficiency

Answer 15

Daily sub Q injection’s
very expensive
Cortisone

Question 16

when should the injections be taken throughout the day?

Answer 16

At night
Mimics natural tendency

Question 17

Will children be giants after growth hormone injections

Answer 17

No, reassure parents

Question 18

precocious puberty

Answer 18

Before nine in boys
Before eight in girls

Question 19

True precocious puberty

Answer 19

normal puberty but earlier

Question 20

pseudo, precocious puberty

Answer 20

Thelarche – early breast
Pubarche – early pubic, under arm hair
Menarche - period

Question 21

what is the treatment for precocious puberty?

Answer 21

Monthly injection of Lupron
Take until normal age of starting puberty

Question 22

congenital, adrenal hyperplasia

Answer 22

Overproduction of adrenal androgens

Decreased production of cortisol and aldosterone

Question 23

sx of CAH in males

Answer 23

Precocious genitalia development

Question 24

sx CAH in females

Answer 24

Ambiguous genitalia

Question 25

sx of both gender for CAH

Answer 25

decrease stress response Hypoglycemia Hyponatremic, dehydration Increased inflammatory response Hypo tension Salt tasting skin

Question 26

treatment for CAH

Answer 26

Lifelong Cortizone injections Reconstructive surgery

Question 27

type one diabetes

Answer 27

Body doesn’t produce insulin Auto immune destruction of pancreatic beta cells

Question 28

type 2 DM symptoms in children

Answer 28

Weight gain Fatigue Frequent infections. – yeast acanthosis nigrocans – leathery patch in body folds

Question 29

can type one diabetic children eat any type of carbs as long as they replace with insulin?

Answer 29

Yes, no restrictions Try to avoid high sugar

Question 30

carb free sources

Answer 30

Meat Cheese Sugar, free options

Question 31

Rapid insulin

Answer 31

Lispro, aspart Onset 15 minutes Peak one hour Duration 3 to 4 hours

Question 32

Long acting insulin

Answer 32

Glargine onset 4 to 6 hours No peak Lasts 24 hours

Question 33

when to monitor blood glucose

Answer 33

Before meals Bedtime Sick Before exercise

Question 34

when to monitor urine ketones

Answer 34

Blood glucose greater than 240 on two separate occasions Pump therapy greater than 240 on any occasion

Question 35

DM management with toddlers

Answer 35

differentiate between misbehavior Report funny feeling Food jags expected/refusal Give choices

Question 36

DM management with preschoolers

Answer 36

Reassure not a punishment Participate in simple tasks Report Lows and what to eat then

Question 37

DM management with school-age

Answer 37

Educate personnel Encourage independence and continuation in clubs and exercise All activities supervised

Question 38

DM management with adolescents

Answer 38

Self-care More willing to inject Continued parental support

Question 39

what to teach with adolescents drinking alcohol

Answer 39

Eat while drinking

Question 40

should you continue to give insulin as scheduled on a sick day?

Answer 40

Yes, check glucose before eating

Question 41

hypoglycemia

Answer 41

Blood sugar less than 60 Hunger, headache Confusion, shaky, dizzy Sweating

Question 42

rule of 15

Answer 42

15 g of fast acting carbs recheck in 15 minutes

Question 43

severe hypoglycemia treatment

Answer 43

Patient is unable to swallow Glucagon 1 mg sub Q/IM Place on side

Question 44

options for rule of 15

Answer 44

Honey Skittles One half cup juice One cup milk – white Cake icing

Question 45

hyperglycemia

Answer 45

Blood glucose greater than 180 Increased thirst Frequent urination

Question 46

should you give diabetic patients caffeinated fluids for hyperglycemia?

Answer 46

No

Question 47

DKA

Answer 47

access ketone bodies from fat metabolism Blood glucose greater than 300

Question 48

what is the most serious symptom with DKA?

Answer 48

Cerebral edema leads to death

Question 49

treatment for DKA

Answer 49

1st hour: Fluids, NS 2nd hour: add electrolytes and start Insulin drip and continue Observation

Question 50

how to control descent

Answer 50

Don’t drop blood sugar lower than 52, 100 per hour

Question 51

What to do after blood glucose reaches 250 to 300

Answer 51

Add dextrose, and half normal saline to insulin drip

Question 52

when is the child able to eat throughout this resuscitation?

Answer 52

Anytime as long as they are tolerating it

Question 53

how to know when DKA is resolved

Answer 53

PH and anion gap are within normal limits Patient is able to eat and drink

Question 54

When to discontinue insulin drip

Answer 54

patient tolerates oral fluids Sub Q insulin administration