Endocrine

Question 1

Poor growth and short stature caused by the failure of the pituitary to produce sufficient growth hormone

Answer 1

Growth hormone deficiency

Question 2

When is the growth hormone mostly secreted?

Answer 2

During sleep

Question 3

What causes a growth hormone deficiency?

Answer 3

Injury
Brain tumors
Infection
Radiation
Idiopathic

Question 4

Growth hormone deficiency sx

Answer 4

Deteriorating/absent rate of growth
High wt to ht ratio and a delayed bone age
^ fat in trunk area
Childlike face w/ large prominent forehead
^ pitched voice
Hypoglycemia
Small penis/testes
Delayed sexual maturation
Delayed dentition

Question 5

Growth hormone deficiency tx

Answer 5

Administer growth hormone SQ 6-7 days per week or IM depot injection every 2-4 weeks

Question 6

Cretinism

Answer 6

Congenital hypothyroidism

Question 7

Causes of Congenital hypothyroidism

Answer 7

Low levels of T3, T4

Question 8

Congenital hypothyroidism sx

Answer 8

Pallor
Hypothermia
Enlarged tongue
Hypotonia/Large underactive baby
Feeding difficulties/ Poor suck
Delayed mental responsiveness
Cool, dry scaly skin
Swollen eyelids

Question 9

What is essential for the growth and development of the CNS?

Answer 9

Thyroid hormone

Question 10

Thyroid hormone tx

Answer 10

Synthroid for life

Bl. test q2-3 weeks until dose is established (based on wt)

Question 11

The Islets of Langerhans fail to produce adequate insulin

Answer 11

Diabetes Mellitus

Question 12

What is impaired with diabetes mellitus?

Answer 12

Carb and lipid metabolism

Question 13

Type 1 diabetes

Answer 13

Common in children

Question 14

Type 2 diabetes

Answer 14

Use to only occur in adults, not its common in children

Question 15

Diabetes sx

Answer 15

Polyuria
Polydipsia
Polyphagia
Weight Loss
Dehydration

Question 16

Diabetes diagnosis

Answer 16

Sx

Bl. glucose levels

Question 17

Diabetes tx

Answer 17

Insulin therapy
Bl. glucose monitoring
Monitor hg A1C

Question 18

Hg A1C

Answer 18

Reflects average bl. glucose control over the past 8-12 weeks
Ms. the amt. of glucose that attaches to protein in the RBC

Question 19

The greater the amount of glucose in the blood…

Answer 19

The ^ the hg A1C will be

Question 20

Hg A1C values

Answer 20

8-8.5% in children < 7

< 8% in older children/adults

Question 21

What do high A1C levels prevent?

Answer 21

Eye, kidney and nerve disease

Question 22

Diabetes nutrition

Answer 22

No longer excludes foods
Exercise potentiates the hypoglycemic effects of insulin
Regular exercise may help w/ glucose control

Question 23

Blood glucose below 60

Answer 23

Hypoglycemia

Question 24

What causes hypoglycemia?

Answer 24

Too much insulin
Too little food
Too much exercise

Question 25

Hypoglycemia tx

Answer 25

Carbs

Question 26

Primary reason for rehospitalization or emergency care in diabetes

Answer 26

Diabetic ketoacidosis

Question 27

Diabetic ketoacidosis sx

Answer 27

Fruity breath
Alert-> coma
pH < 7.30
Glucose > 200

Question 28

Diabetic ketoacidosis tx

Answer 28

Fl. deficit
El. imbalances
Acid-base disturbances
Insulin deficiency

Question 29

Type of fluids for diabetic ketoacidosis

Answer 29

PRIORITY (hypovolemic shock could happen)

Isotonic

Question 30

Diabetic ketoacidosis electrolyte replacement

Answer 30

Correct imbalances
Potassium is depleted
Once evidence of renal output, can add potassium to IV

Question 31

Diabetic ketoacidosis acid base balance

Answer 31

May infuse bicarb to correct acid-base balance

Question 32

Diabetic ketoacidosis insulin deficiency

Answer 32

Insulin given by infusion

Usually regular insulin

Question 33

Diabetic ketoacidosis consequences

Answer 33

Cerebral edema
Confusion
HA
Tach/Brady
Dif. arousing child
Widening pulse pressure