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endocrine (3) Flashcards

1
Q

what system regulates and integrates metabolic processes

A

endocrine system

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2
Q

how long does puberty last

A

4 and a half yrs on avergae

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3
Q

what is the term for the onset of adrenal andrigen production, acne, pubic hair, BO

A

adrenarche

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4
Q

what is the term for menstruation

A

menarche

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5
Q

when does menarche normally start

A

12 or 12 and a half years old

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6
Q

what is the “master gland”

A

anterior pituitary

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7
Q

what kind of hormones does the anterior pituitary make?

A

hormones that regulate other hormones

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8
Q

the posterior pituitary releases _________ and produces _______

A

releases ADH and produces oxytocin

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9
Q

where is ADH and oxytocin stored?

A

hypothalamus

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10
Q

what problem is caused by decreased activity in the pituitary gland

A

growth hormone deficiency

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11
Q

characteristics of growth hormone deficiency

A
  • below 3rd percentile at 1 year
  • hypoglycemic seizures
  • hyponatremia
  • neonatal jaundice
  • micropenis, undescended testes
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12
Q

clinical manifestations of growth hormone deficiency

A
  • appear “cherubic”
  • higher pitched voices
  • delayed dentition
  • delayed skeletal maturation
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13
Q

what are the 3 tests used for growth hormone deficiency

A
  • wrist x-ray
  • provocative growth hormone tests
  • IGF-1
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14
Q

what diagnostic test for growth hormone deficiency shows bone age and predicts future height

A

wrist x-ray

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15
Q

what levels of IGF-1 indicate growth hormone deficiency

A

decreased IGF-1

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16
Q

treatment of growth hormone deficiency

A

daily SQ injections of GH
**expensive

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17
Q

what is the inability of the kidneys to concentrate urine due to hyposeretion of ADH

A

diabetes insipidus

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18
Q

what are the 2 kinds of diabetes insipidus

A
  1. central DI
  2. nephrogenic DI
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19
Q

causes of central DI

A
  • brain tumors
  • brain trauma
  • CNS infection
  • neurosurgery
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20
Q

What kind of DI is neurogenic and involves inadequate vasopression

A

central DI

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21
Q

What kind of DI is caused by drug toxicity, adverse drug rxn, or illness, has ineffective vasopressin

A

nephrogenic DI

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22
Q

describe vasopressin in central DI and nephrogenic DI?

A

central= inadequate vasopressin
nephrogenic= ineffective vasopressin

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23
Q

clinical manifestations of DI

A
  • polyuria
  • polydipsia
  • enuresis
  • irritability
  • dehydration
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24
Q

diagnostic tests for DI

A
  • serum electrolytes
  • urinalysis (specific gravity dec., osmolality dec.)
  • CT or MRI (to r/o tumor)
  • water deprivation test
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25
what do electrolytes look like in DI
increased sodium
26
pharm treatment of central DI
DDAVP (desmopressin acetate)
27
pharm treatment of nephrogenic DI
* thiazide diuretics * indomethacin and amiloride
28
intervention of DI in hospital
* daily weights * monitor I&O * check urine specific gravity * monitor dehydration!!!
29
what is the early appearance of secondary sexual characteristics?
precocious puberty
30
which gender is precocious puberty seen in more?
girls
31
describe causes of precocious puberty in girls vs. boys?
in girls its mostly idiopathic, in boys its usually neuro
32
describe age requirements to classify precocious puberty in girls vs. boys
before 8 y.o. in girls, before 9 y.o. in boys
33
what is activated to secrete GnRH to cause precocious puberty
hypothalamus
34
what kind of tumors can cause precocious puberty`
ovary, adrenal gland, pituitary gland
35
which rare genetic condition can cause precocious puberty
McCune-Albright syndrome
36
clinical manifestations for precocious puberty
* advanced bone age * appear unusually tall for age * growth ceases prematurely, short stature * mood swings * emotional instability
37
what diagnostic tests are used for precocious puberty
* lab tests * GnRH stimulation * x-rays
38
which test diagnoses precocious puberty
GnRH stimulation
39
treatment of precocious puberty
* if caused by tumor= surgery, chemo, rad * GnRH agonist
40
how long does treatment for precocious puberty last?
until a normal puberty age
41
what organ does DM effect?
pancreas
42
which race is more likely for DM1
caucasion
43
peak age for DM1
7-15 y.o.
44
s/sx of DM1
* 3Ps * fatigue * lethargy * headaches * significant weight loss
45
autoimmune destruction of insulin producing beta cells in individuals who are genetically predisposed
DM1
46
diagnostic tests for DM1
* hgb A1C * fasting plasma glucose * 2 hour plasma glucose * random plasma glucose
47
what is the diagnostic level of fasting plasma glucose for DM1
> 126 mg/dl
48
what is the level of plasma glucose needed to diagnose DM1
> 200 mg/dl
49
describe insulin administration times in DM1
* basal insulin (long acting) once per day using very long acting insulin * bolus of rapid acting insulin administered with each meal
50
what factors can influence insulin needs
stress, infection, illness
51
what is the goal A1C level for DM1
< 7.5%
52
what complications result from DM1
* retinopathy * heart disease * renal failure * peripheral vascular disease
53
when do complications occur after DM1 diagnosis
2-3 yrs after diagnosis
54
s/sx of DKA
* 3 polys * abd / chest pain * n/v * hypotension * dehydration/weight loss * tachycardia * kussmaul resos * fruity breath * LOC change * hyperglycemia, glycosuria, ketonuria
55
what kind of fluids treat DKA
isotonic fluid with electrolytes short acting inculin over pump
56
what should be looked for in urine for DKA?
glucose and ketones
57
how are fluids given in DKA?
bolus
58
which or which?? what are the symptoms of hypoglycemia * lethargy or nervousness * rapid or gradual onset * hunger or lack of appetite * sweating or dry skin * pallor or flushed skin * tremors or sleepiness * seizures or shock
* nervousness * rapid * hunger * sweating * pallor * tremors * seizures
59
what glucose levels classify hypoglycemia
<70
60
which or which? what are symptoms of hyperglycemia? * lethargy or nervousness * rapid or gradual onset * hunger or lack of appetite * sweating or dry skin * pallor or flushed skin * tremors or sleepiness * seizures or shock?
* lethargy * gradual * hunger * dry skin * flushed skin * sleepiness * shock
61
which DM has vague, long-standing symptoms that develop gradually
2
62
signs of DM2
* obesity * glucose in urine w/ or w/o ketones * ketoacidosis possible * hypertension * androgen mediated problems * excessive weight gain / fatigue
63
which type of DM has acanthis nigricans "dark pits"
DM2
64
diagnostic tests/signs of DM2
* obesity * acanthosis nigricans * glucose above 200 mg/dl w/o fasting * high BP * possible dyslipidemia
65
treatment of DM2
* normalize glucose and A1C * decrease weight * inc exercise * normalize lipid profile and BP * metformin
66
describe hormones in gynecomastia
estrogen > testosterone
67
what is associated with gynecomastia
kleinfelter syndrome, tumors, testes trauma, viral, drugs
68
how is gynecomastia treated?
tamoxifen or surgery
69
what is a lack of menstruation
amenorrhea
70
what is menstrual cramping, ans also the leading cause of school absence in adolescent females
dysmenorrhea
71
what is a deficiency of liver enzyme that breaks down phenylalanine to tyrosine
phenylketonuria (PKU)
72
how is PKU passed genetically
autosmal recessive
73
what does PKU lead to?
brain damage, severe intellectual disability, seizures
74
clinical manifestations of PKU?
* musty/mpusey odor to body/urine * vomit * irritable / hyperactive * eczema-like rash * seizures * lighter complexion * hypertonic/hyperreflexive deep tendon reflexes
75
diagnostic tests of PKU
screened via blood in newborn period
76
how old do newborns need to be for PKU tests
48 hours
77
what are the nutritional requirements for PKU testing
on breast milk or formula for at least 2 days
78
treatment of PKU
* special formula or breastfed * diet low in ohenylalanine * avoid high protein and aspartame * use elemental medical foods
79
normal level of phenylalanine
2-6 mg/dl

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