endocrine (3) Flashcards
what system regulates and integrates metabolic processes
endocrine system
how long does puberty last
4 and a half yrs on avergae
what is the term for the onset of adrenal andrigen production, acne, pubic hair, BO
adrenarche
what is the term for menstruation
menarche
when does menarche normally start
12 or 12 and a half years old
what is the “master gland”
anterior pituitary
what kind of hormones does the anterior pituitary make?
hormones that regulate other hormones
the posterior pituitary releases _________ and produces _______
releases ADH and produces oxytocin
where is ADH and oxytocin stored?
hypothalamus
what problem is caused by decreased activity in the pituitary gland
growth hormone deficiency
characteristics of growth hormone deficiency
- below 3rd percentile at 1 year
- hypoglycemic seizures
- hyponatremia
- neonatal jaundice
- micropenis, undescended testes
clinical manifestations of growth hormone deficiency
- appear “cherubic”
- higher pitched voices
- delayed dentition
- delayed skeletal maturation
what are the 3 tests used for growth hormone deficiency
- wrist x-ray
- provocative growth hormone tests
- IGF-1
what diagnostic test for growth hormone deficiency shows bone age and predicts future height
wrist x-ray
what levels of IGF-1 indicate growth hormone deficiency
decreased IGF-1
treatment of growth hormone deficiency
daily SQ injections of GH
**expensive
what is the inability of the kidneys to concentrate urine due to hyposeretion of ADH
diabetes insipidus
what are the 2 kinds of diabetes insipidus
- central DI
- nephrogenic DI
causes of central DI
- brain tumors
- brain trauma
- CNS infection
- neurosurgery
What kind of DI is neurogenic and involves inadequate vasopression
central DI
What kind of DI is caused by drug toxicity, adverse drug rxn, or illness, has ineffective vasopressin
nephrogenic DI
describe vasopressin in central DI and nephrogenic DI?
central= inadequate vasopressin
nephrogenic= ineffective vasopressin
clinical manifestations of DI
- polyuria
- polydipsia
- enuresis
- irritability
- dehydration
diagnostic tests for DI
- serum electrolytes
- urinalysis (specific gravity dec., osmolality dec.)
- CT or MRI (to r/o tumor)
- water deprivation test
what do electrolytes look like in DI
increased sodium
pharm treatment of central DI
DDAVP (desmopressin acetate)
pharm treatment of nephrogenic DI
- thiazide diuretics
- indomethacin and amiloride
intervention of DI in hospital
- daily weights
- monitor I&O
- check urine specific gravity
- monitor dehydration!!!
what is the early appearance of secondary sexual characteristics?
precocious puberty
which gender is precocious puberty seen in more?
girls
describe causes of precocious puberty in girls vs. boys?
in girls its mostly idiopathic, in boys its usually neuro
describe age requirements to classify precocious puberty in girls vs. boys
before 8 y.o. in girls, before 9 y.o. in boys
what is activated to secrete GnRH to cause precocious puberty
hypothalamus
what kind of tumors can cause precocious puberty`
ovary, adrenal gland, pituitary gland
which rare genetic condition can cause precocious puberty
McCune-Albright syndrome
clinical manifestations for precocious puberty
- advanced bone age
- appear unusually tall for age
- growth ceases prematurely, short stature
- mood swings
- emotional instability
what diagnostic tests are used for precocious puberty
- lab tests
- GnRH stimulation
- x-rays
which test diagnoses precocious puberty
GnRH stimulation
treatment of precocious puberty
- if caused by tumor= surgery, chemo, rad
- GnRH agonist
how long does treatment for precocious puberty last?
until a normal puberty age
what organ does DM effect?
pancreas
which race is more likely for DM1
caucasion
peak age for DM1
7-15 y.o.
s/sx of DM1
- 3Ps
- fatigue
- lethargy
- headaches
- significant weight loss
autoimmune destruction of insulin producing beta cells in individuals who are genetically predisposed
DM1
diagnostic tests for DM1
- hgb A1C
- fasting plasma glucose
- 2 hour plasma glucose
- random plasma glucose
what is the diagnostic level of fasting plasma glucose for DM1
> 126 mg/dl
what is the level of plasma glucose needed to diagnose DM1
> 200 mg/dl
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
what factors can influence insulin needs
stress, infection, illness
what is the goal A1C level for DM1
< 7.5%
what complications result from DM1
- retinopathy
- heart disease
- renal failure
- peripheral vascular disease
when do complications occur after DM1 diagnosis
2-3 yrs after diagnosis
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
what kind of fluids treat DKA
isotonic fluid with electrolytes
short acting inculin over pump
what should be looked for in urine for DKA?
glucose and ketones
how are fluids given in DKA?
bolus
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
what glucose levels classify hypoglycemia
<70
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
which DM has vague, long-standing symptoms that develop gradually
2
signs of DM2
- obesity
- glucose in urine w/ or w/o ketones
- ketoacidosis possible
- hypertension
- androgen mediated problems
- excessive weight gain / fatigue
which type of DM has acanthis nigricans “dark pits”
DM2
diagnostic tests/signs of DM2
- obesity
- acanthosis nigricans
- glucose above 200 mg/dl w/o fasting
- high BP
- possible dyslipidemia
treatment of DM2
- normalize glucose and A1C
- decrease weight
- inc exercise
- normalize lipid profile and BP
- metformin
describe hormones in gynecomastia
estrogen > testosterone
what is associated with gynecomastia
kleinfelter syndrome, tumors, testes trauma, viral, drugs
how is gynecomastia treated?
tamoxifen or surgery
what is a lack of menstruation
amenorrhea
what is menstrual cramping, ans also the leading cause of school absence in adolescent females
dysmenorrhea
what is a deficiency of liver enzyme that breaks down phenylalanine to tyrosine
phenylketonuria (PKU)
how is PKU passed genetically
autosmal recessive
what does PKU lead to?
brain damage, severe intellectual disability, seizures
clinical manifestations of PKU?
- musty/mpusey odor to body/urine
- vomit
- irritable / hyperactive
- eczema-like rash
- seizures
- lighter complexion
- hypertonic/hyperreflexive deep tendon reflexes
diagnostic tests of PKU
screened via blood in newborn period
how old do newborns need to be for PKU tests
48 hours
what are the nutritional requirements for PKU testing
on breast milk or formula for at least 2 days
treatment of PKU
- special formula or breastfed
- diet low in ohenylalanine
- avoid high protein and aspartame
- use elemental medical foods
normal level of phenylalanine
2-6 mg/dl
