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Peds > endocrine (3) > Flashcards

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
Q

what do electrolytes look like in DI

A

increased sodium

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26
Q

pharm treatment of central DI

A

DDAVP (desmopressin acetate)

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27
Q

pharm treatment of nephrogenic DI

A
  • thiazide diuretics
  • indomethacin and amiloride
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28
Q

intervention of DI in hospital

A
  • daily weights
  • monitor I&O
  • check urine specific gravity
  • monitor dehydration!!!
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29
Q

what is the early appearance of secondary sexual characteristics?

A

precocious puberty

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30
Q

which gender is precocious puberty seen in more?

A

girls

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31
Q

describe causes of precocious puberty in girls vs. boys?

A

in girls its mostly idiopathic, in boys its usually neuro

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32
Q

describe age requirements to classify precocious puberty in girls vs. boys

A

before 8 y.o. in girls, before 9 y.o. in boys

33
Q

what is activated to secrete GnRH to cause precocious puberty

A

hypothalamus

34
Q

what kind of tumors can cause precocious puberty`

A

ovary, adrenal gland, pituitary gland

35
Q

which rare genetic condition can cause precocious puberty

A

McCune-Albright syndrome

36
Q

clinical manifestations for precocious puberty

A
  • advanced bone age
  • appear unusually tall for age
  • growth ceases prematurely, short stature
  • mood swings
  • emotional instability
37
Q

what diagnostic tests are used for precocious puberty

A
  • lab tests
  • GnRH stimulation
  • x-rays
38
Q

which test diagnoses precocious puberty

A

GnRH stimulation

39
Q

treatment of precocious puberty

A
  • if caused by tumor= surgery, chemo, rad
  • GnRH agonist
40
Q

how long does treatment for precocious puberty last?

A

until a normal puberty age

41
Q

what organ does DM effect?

A

pancreas

42
Q

which race is more likely for DM1

A

caucasion

43
Q

peak age for DM1

A

7-15 y.o.

44
Q

s/sx of DM1

A
  • 3Ps
  • fatigue
  • lethargy
  • headaches
  • significant weight loss
45
Q

autoimmune destruction of insulin producing beta cells in individuals who are genetically predisposed

A

DM1

46
Q

diagnostic tests for DM1

A
  • hgb A1C
  • fasting plasma glucose
  • 2 hour plasma glucose
  • random plasma glucose
47
Q

what is the diagnostic level of fasting plasma glucose for DM1

A

> 126 mg/dl

48
Q

what is the level of plasma glucose needed to diagnose DM1

A

> 200 mg/dl

49
Q

describe insulin administration times in DM1

A
  • basal insulin (long acting) once per day using very long acting insulin
  • bolus of rapid acting insulin administered with each meal
50
Q

what factors can influence insulin needs

A

stress, infection, illness

51
Q

what is the goal A1C level for DM1

A

< 7.5%

52
Q

what complications result from DM1

A
  • retinopathy
  • heart disease
  • renal failure
  • peripheral vascular disease
53
Q

when do complications occur after DM1 diagnosis

A

2-3 yrs after diagnosis

54
Q

s/sx of DKA

A
  • 3 polys
  • abd / chest pain
  • n/v
  • hypotension
  • dehydration/weight loss
  • tachycardia
  • kussmaul resos
  • fruity breath
  • LOC change
  • hyperglycemia, glycosuria, ketonuria
55
Q

what kind of fluids treat DKA

A

isotonic fluid with electrolytes
short acting inculin over pump

56
Q

what should be looked for in urine for DKA?

A

glucose and ketones

57
Q

how are fluids given in DKA?

A

bolus

58
Q

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

A
  • nervousness
  • rapid
  • hunger
  • sweating
  • pallor
  • tremors
  • seizures
59
Q

what glucose levels classify hypoglycemia

A

<70

60
Q

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?

A
  • lethargy
  • gradual
  • hunger
  • dry skin
  • flushed skin
  • sleepiness
  • shock
61
Q

which DM has vague, long-standing symptoms that develop gradually

A

2

62
Q

signs of DM2

A
  • obesity
  • glucose in urine w/ or w/o ketones
  • ketoacidosis possible
  • hypertension
  • androgen mediated problems
  • excessive weight gain / fatigue
63
Q

which type of DM has acanthis nigricans “dark pits”

A

DM2

64
Q

diagnostic tests/signs of DM2

A
  • obesity
  • acanthosis nigricans
  • glucose above 200 mg/dl w/o fasting
  • high BP
  • possible dyslipidemia
65
Q

treatment of DM2

A
  • normalize glucose and A1C
  • decrease weight
  • inc exercise
  • normalize lipid profile and BP
  • metformin
66
Q

describe hormones in gynecomastia

A

estrogen > testosterone

67
Q

what is associated with gynecomastia

A

kleinfelter syndrome, tumors, testes trauma, viral, drugs

68
Q

how is gynecomastia treated?

A

tamoxifen or surgery

69
Q

what is a lack of menstruation

A

amenorrhea

70
Q

what is menstrual cramping, ans also the leading cause of school absence in adolescent females

A

dysmenorrhea

71
Q

what is a deficiency of liver enzyme that breaks down phenylalanine to tyrosine

A

phenylketonuria (PKU)

72
Q

how is PKU passed genetically

A

autosmal recessive

73
Q

what does PKU lead to?

A

brain damage, severe intellectual disability, seizures

74
Q

clinical manifestations of PKU?

A
  • musty/mpusey odor to body/urine
  • vomit
  • irritable / hyperactive
  • eczema-like rash
  • seizures
  • lighter complexion
  • hypertonic/hyperreflexive deep tendon reflexes
75
Q

diagnostic tests of PKU

A

screened via blood in newborn period

76
Q

how old do newborns need to be for PKU tests

A

48 hours

77
Q

what are the nutritional requirements for PKU testing

A

on breast milk or formula for at least 2 days

78
Q

treatment of PKU

A
  • special formula or breastfed
  • diet low in ohenylalanine
  • avoid high protein and aspartame
  • use elemental medical foods
79
Q

normal level of phenylalanine

A

2-6 mg/dl

Peds (30 decks)

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