Endocrine

Question 1

A syndrome with disordered metabolism and inappropriate hyperglycemia due to either an absolute deficiency in insulin secretion or a reduction in its biological effectiveness

Answer 1

Diabetes Mellitus

Question 2

Type 1 diabetes has an _____ onset and is caused by destruction of pancreatic ____ cells. _______ can be found in the blood and urine.

Answer 2

Acute onset
Islet cells
Ketones found in the blood and urine

Question 3

Classic s/sx of type 1 diabetes

Answer 3

3 P’s: polyuria, polydipsia, and polyphagia

Question 4

Children with type 1 diabetes have weight _____ but ______ hunger.

Answer 4

loss

increased

Question 5

In advanced type 1 diabetes, an ophthalmic exam may reveal microaneurysms, or ______ _____ ______.

Answer 5

cotton wool spots

Question 6

Deep tendon reflexes are _______ in advanced disease of type 1 diabetes.

Answer 6

diminished

Question 7

Diagnostic criteria for type 1 diabetes requires a serum fasting BG of greater than ____ on 2 separate occasions.

Answer 7

126 mg/dl

Question 8

If BG is greater than ___ mg/dl AND there is polydipsia, polyuria, and weight loss are present, then the diagnosis must be confirmed by ______ studies.

Answer 8

200

Fasting

Question 9

Hemoglobin A1c is elevated. The normal HgA1c is _ to _%

Answer 9

4-6%

Question 10

Management includes obtaining baseline fasting _______, _____, ______ studies and EKG

Answer 10

triglycerides
cholesterol
renal studies

Question 11

What should the total carbohydrate intake be for a type 1 diabetic?

Answer 11

50 to 60% of total caloric intake

Question 12

Total fats should make up what percent of total caloric intake?

Answer 12

25-30%

Question 13

Total fiber should have ____ grams/1000 calories.

Answer 13

25

Question 14

Protein should make up what percent of total caloric intake?

Answer 14

10 to 20%

Question 15

What does of insulin should a patient presenting with ketones be started on?

Answer 15

0.5 units/kg/day

Question 16

This results when nocturnal hypoglycemia stimulates a surge of counter regulatory hormones that raise blood sugar. This patient is HYPOGLYCEMIC at 3 am and rebounds with an elevated blood sugar at 7 am.

Answer 16

The Somogyi effect

Question 17

This results when tissue becomes desensitized to insulin nocturnally. Blood sugar gets progressively highter throughout the night and is elevated at 7 am. This desensitization is due to presence of growth hormone, which spikes at night.

Answer 17

Dawn Phenomenon

Question 18

What is the treatment for the Somogyi effect?

Answer 18

reduce or eliminate night dose of insulin

Question 19

What is the treatment for the Dawn Phenomenon

Answer 19

Add or increase the dose of night time insulin

Question 20

Type 2 diabetes has an _____ onset

Answer 20

insidious

Question 21

Type 2 diabetes s/sx include darkened neck skin called ______ _____.

Answer 21

Acanthosis nigricans

Question 22

What is typically the first symptom in women with type 2 diabetes?

Answer 22

recurrent vaginitis

Question 23

Name four signs that are associated with insulin resistance:

Answer 23

Acanthosis Nigricans
Hypertension
Dyslipidemia
Polycystic ovarian disease

Question 24

Screening for DM2 should be completed if there is a _____ history of DM2, race (AA, NA, Hisp, A/PI), or signs are present consistent with DM2.

Answer 24

family

Question 25

What age should screening for DM2 begin? Age ___ or onset of _____, then every __ years.

Answer 25

Age 10 or onset of puberty then every 2 years

Question 26

What drug is approved by the FDA for treatment of DM2 in children?

Answer 26

metformin (glucophage)

Question 27

How does metformin work?

Answer 27

It reduces gluconeogenesis

Question 28

A series of clinical disorders associated with increased circulating levels of free thyroxine or triiodothyronine.

Answer 28

Hyperthyroidism

Question 29

Most common in children and is associated with diffuse enlargement of thyroid, hyperactivity of the gland, presence of antibodies against different fractions of the thyroid gland.

Answer 29

Grave's disease

Question 30

Hyperthyroidism is more common in ____ , with a ratio of 8:1

Answer 30

females

Question 31

Onset of hyperthyroidism is between ages __ and __

Answer 31

12 and 14

Question 32

Deep tendon reflexes are _________ in hyperthyroidism.

Answer 32

Hyperactive

Question 33

In hyperthyroidism, TSH is ______ and T3/T4 are _______

Answer 33

TSH is decreased | T3 and T4 are increased

Question 34

What can be given as a treatment that can reduce the vascularity of the thyroid gland?

Answer 34

Lugol's solution

Question 35

What medication is helpful for symptomatic relief in hyperthyroidism?

Answer 35

Propranolol 10-80 mg QID

Question 36

A condition resulting in lack of circulating thyroid hormone

Answer 36

Hypothyroidism

Question 37

Hypothyroidism is most often due to __________ ________.

Answer 37

Autoimmune thyroiditis

Question 38

______ ________ is a cause of juvenile thyroiditis.

Answer 38

Hashimoto's thyroiditis

Question 39

In neonates, there may be no obvious signs in the first month of life. Then you begin seeing poor _____, _____ and ______.

Answer 39

Poor feeding Bradycardia Hypotonia

Question 40

For hypothryoidism, think of the old lady....the brake pedal is stuck so you have....

Answer 40

constipation, weight gain, weakness, delayed bone age/growth, dry skin thinning hair and brittle nails

Question 41

In hypothyroidism, TSH is ______ while T3/T4 are _____

Answer 41

``` TSH = elevated T3/T4 = decreased ```

Question 42

What drug is helpful in the treatment of hypothyroidism?

Answer 42

Synthroid (which is better than levothyroxine--the generic)

Question 43

A child is considered to have short stature if the height falls more than ___ standard deviations below the mean

Answer 43

Two

Question 44

Failure to grow more than ___ cm/year also is present in short stature children

Answer 44

4 cm/yr

Question 45

If a patient is considered short stature, the primary provide should always assess for ______.

Answer 45

Neglect