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Child Health Care > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Hypopituitarism Sx

A

-Short (< 3% on chart)
-Delayed tooth eruption
-“Baby face”
-Delayed sexual development
-No intelligence issues
-Low IGF-1

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2
Q

Hypopituitarism Dx

A

-Evaluate any child 2-3 SD below mean height or who is falling off the growth chart
-XR, MRI, growth hormone testing

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3
Q

Hypopituitarism Tx

A

-Growth hormone replacement (SQ)
-Expensive (social support)
-Monitor for SE
-Foster independence
-Emotional support

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4
Q

Hyperpituitarism Sx

A

-Child’s predicted height exceeds parental height
-Acromegaly
-High IGF-1

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5
Q

Hyperpituitarism Tx

A

-Surgical removal of tumor/pituitary gland
-Radiation therapy
-High doses of sex steroids
-Make sure there’s no tumor of hypothalamus

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6
Q

Diabetes Insipidus Sx

A

-Posterior pituitary gland
-Low ADH
-Tubules do not reabsorb water
-3P’s
-Increased serum Na, Osmolality
-Dehydrated
-Low vasopressin/anti-diuretic hormone
-Irritable
-Failure to thrive
-Lethargic
-N/V
-Constipation
-Caused by brain or kidneys

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7
Q

Diabetes Insipidus Tx

A

-DDAVP (oral desmopressin acetate) results in reduced UOP, decreased thirst and nocturia
-Kidneys: thiazide diuretics
-Monitor Na and K levels
-Monitor I/Os
-Replace fluids (oral or IV)
-Educate for monitoring Sx, medication use, diet, daily weight

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8
Q

SIADH

A

-Water intoxication
-Low Na
-Cellular edema
-Hypertension
-Distended JV
-Lung crackles
-Weight gain w/o edema
-High urine osmolality, urine specific gravity
-Low BUN

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9
Q

SIADH Tx

A

-Restrict fluids
-Diuretics
-Demeclocycline blocks action of ADH at renal collecting tubules
-Hypertonic fluids
-Seizure risk due to hyponatremia
-Monitor Na, LOC, I/Os, labs

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10
Q

Precocious Puberty Sx

A

-early puberty (8F, 9M)
-premature hormone secretion
-Short stature in adulthood
-Dx: LH, FSH, Testosterone

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11
Q

Precocious Puberty Tx

A

-Support for the child concerning body image and sexuality
-Can be treated with surgery, radiation, chemo or medications
-Medication therapy
-Luteinizing releasing factor to slow down the progression of puberty

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12
Q

Hypothyroidism Sx

A

-Screening 2-6d after birth
-T4 < 3
-TSH > 40
-Jaundice
-Constipation
-Feeding problems
-Cold skin
-Decreased crying
-Hypotonia (spazzed out arms)
-Large fontanel
-Thick tongue

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13
Q

Hypothyroidism Tx

A

-Monitor growth and development
-Education on medications
-Infant stimulation programs
-Teach parents to take a pulse
-Vitamin D
-Levothyroxine 10-15mcg/kg/day (Synthroid)
-Sx of OD: irritability, rapid pulse, dyspnea, sweating, fever

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14
Q

Hyperthyroidism Sx

A

-Causes: Grave’s disease
-High T3, T4
-Low TSH
-Tachycardia
-Tremor
-Excessive perspiration
-Irritability
-Weight loss
-Diarrhea
-Increased appetite
-Muscle weakness
-Fatigue
-Exophthalmos
-Non tender, big thyroid gland

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15
Q

Hyperthyroidism Tx

A

-Monitor Sx
-Methimazole (Tapazole)
-PTU
-TID
-Propranolol
-Rest
-Diet
-Cool environment
-Radiation or surgery

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16
Q

Hyperparathyroidism Sx

A

-Fatigue
-Exhaustion
-Lethargy
-Constipation
-High Ca, PTH

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17
Q

Hyperparathyroidism Tx

A

-Resection of parathyroid
-Hypercalcemia prevention
-F/E monitoring and replacement
-Monitor Ca, P
-Educate signs of hypocalcemia

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18
Q

Hypoparathyroidism Sx

A

-Low Ca
-High P
-Hyperirritability
-Muscle rigidity
-Seizures
-N/V
-ABD distention
-Dental/enamel hypoplasia
-Chvostek sign

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19
Q

Hypoparathyroidism Tx

A

-High Ca foods
-Low P foods

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20
Q

Cushing Syndrome Sx

A

-Causes: tumor
-Weight gain
-Moon face
-Buffalo hump
-Red striae on skin
-HTN
-Acne
-Deep voice
-High cortisol

21
Q

Cushing Syndrome Tx

A

-Radiation
-Drug therapy
-Surgery

22
Q

Congenital Adrenal Hyperplasia

A

-Causes: ambiguous genitalia
-Tall then short in adulthood
-Hypoglycemia
-N/V
-dehydration
-low BP
-low Na
-High ACTH

23
Q

Congenital Adrenal Hyperplasia Tx

A

-Adrenal secretion suppression
-Support

24
Q

Addison Disease Sx

A

-Shock if untreated
-Low cortisol
-Weakness/fatigue
-Emotional lability
-Salt craving
-Hyperpigmentation
-Irritability
-N/V
-Diarrhea
-ABD pain
-Fever
-Anorexia
-Hypoglycemia

25
Q

Addison Disease Tx

A

-Replace deficient hormones
-Fluids

26
Q

Pheochromocytoma Sx

A

-Adrenal gland tumor
-High NE, E
-HTN
-Tachycardia
-Arrhythmias
-Triad: HTN, DM, HTN crisis

27
Q

Pheochromocytoma Tx

A

-Removal of identified tumors

28
Q

DM Type 1 Sx

A

-fasting glucose > 120
-3P’s
-fatigue
-confusion
-dry skin
-loss of DTR
-weight loss
-ketonuria

29
Q

DM Type 1 Tx

A

-IV fluids to regulate acidosis
-Strick I/Os
-Monitor BG
-Low fat/carb diet
-HgbA1C q3 months
-Normal 4-7%
-High = DM
-Insulin: room temp, discard after 1m, SQ, IV for regular only

30
Q

DM Type 1 Complications

A

-Retinopathy
-Heart Disease
-Renal failure
-Peripheral vascular disease

31
Q

DKA

A

-Type 1
-BG > 250
-pH < 7.3
-Bicarb < 15
-Ketonuria
-High BUN, Cr, K, Cl
-Low Na, P, Ca, Mg
-3P’s
-Weight loss
-ABD pain
-N/V
-Tachycardia
-Dehydration
-Flushed face
-Kussmaul
-Fruity breath
-AMS
-Hypotension

32
Q

DKA Tx

A

-IV insulin
-NS until BG hits 250-300, then D5 1/2 to prevent hypoglycemia
-Replace K

33
Q

Hypoglycemia Sx

A

-Causes: too much insulin, missed meals, strenuous exercise w/o nutrition
-BG < 70
-Diaphoresis
-Tremors
-Hunger
-Weakness
-Pallor
-coma
-Seizures
-Death

34
Q

Hypoglycemia Tx

A

-Replace glucose
-Juice/soda
-Severe: cake frost, glucagon

35
Q

DM Type 2

A

-gradual onset
-fasting glucose > 120
-Acanthosis Nigricans
-Obesity
-no 3P’s
-HTN
Lipid disorders

36
Q

DM Type 2

A

-Normalize blood glucose and HbA1c levels (<6.5%)
-Decrease weight
-Increase exercise
-Normalize lipid profile and blood pressure
-Nutrition education, emotional support
-Metformin improves sensitivity of target cells to insulin
-GLP-1 SQ - 10-12+ years old

37
Q

Gynecomastia Sx

A

-Enlarged breast tissue in men
-Estrogen > testosterone
-Lasts 1-2 years
-Causes: Klinefelter, drugs that increase circulating concentration of prolactin

38
Q

Amenorrhea Sx

A

-Lack of periods
-Primary: no growth/development at 14.5y/o
-Secondary: growth/development at 16y/o

39
Q

Amenorrhea Tx

A

-OC
-High caloric diet
-Ca supplement

40
Q

Turner Syndrome Sx

A

-Missing X chromosome in women
-oocytes gone by 2y/o
-Peripheral lymphedema
-Webbed neck
-Low hairline
-Short

41
Q

Turner Syndrome Tx

A

-Monitor growth
-Growth hormone therapy
-Low dose estrogen and progesterone therapy

42
Q

Klinefelter Syndrome Sx

A

-Extra X chromosome in men
-Low androgen
-Sexual dysfunction
-Tall
-Delayed language
-Delayed auditory
-Decreased testicular size
-Gynecomastia

43
Q

Klinefelter Syndrome Tx

A

-Testosterone therapy

44
Q

Phenylketonuria

A

-High phenylalanine
-Musty body/urine odor
-Irritable
-N/V
-Hyperactivity
-Hypertonia
-increased DTR
-Seizures
-Rash
-Lighter skin tone
-Dx: Guthrie screening

45
Q

Phenylketonuria Tx

A

-Low protein diet
-No bread, cheese, eggs, flour, meat, poultry, fish, nuts, milk, legumes, aspartame
-Frequent urine/blood tests

46
Q

Galactosemia Sx

A

-low GALT (liver enzyme)
-high galactose in eyes, liver, kidneys, brain
-Failure to gain weight
-Untreated = sepsis, death after 1m

47
Q

Galactosemia Tx

A

-Lactose/galactose free formula
-No dairy, food coloring, lactose

48
Q

Maple Syrup Urine Disease

A

-poor appetite
-lethargy
-N/V
-variable muscle tone
-irritability
-sweet odor in bodily fluids

49
Q

Maple Syrup Urine Disease Tx

A

-Special diet w/ 3 amino acids removed

Child Health Care (7 decks)

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