Endocrine Disorders

Question 1

DM

Answer 1

caused by inadequate secretion, insulin resistance or both which leads to defective metabolism of carbohydrates, protein and fats. This leads to hyperglycemia

Question 2

Type 1 DM

Answer 2

Caused by an autoimmune destruction of pancreatic cells in the islets of Langerhans. This is thought to be triggered by environmental events in genetically susceptible individuals

Question 3

S/sx of Type 1 DM

Answer 3

30% of children present in DKA

Polyuria, Polyphagia, Polydipsia
Weight loss
Fatigue
Nocturia
Vaginal yeast infections

Question 4

If DKA is present may see

Answer 4

slow, labored kussmaul breathing
flushed cheeks/face
fruity smelling breath

if present at dx then patient should be admitted to the hospital for IV insulin (slowly), rehydration and careful monitoring to prevent cerebral edema

Question 5

Dx of Type 1 DM

Answer 5

Urine testing and blood glucose measurements

Urine will have glucose and ketones
metabolic screen for acid base status to exclude DKA
HbA1C > 6.5%
Blood glucose fasting > 126
Blood glucose random > 200 and symptomatic
Blood glucose 2Hours PP >200
Screen for presence of pancreatic autoantibodies

Question 6

Goals for management of Type 1 DM

Answer 6

maintain an A1C that is less than 7.5% for all youth

Question 7

Management of Type 1 DM

Answer 7

All children with Type 1 DM must be started on insulin at diagnosis.

Question 8

Thyroid Dysfunction

Answer 8

Hypothalamus produces TRH
TRH stimulates pituitary to secrete TSH
TSH causes thyroid to secrete T4

Affects metabolism, growth and development, metabolism of lipids, carbs and proteins

Question 9

Congenital Hypothyroidism

Answer 9

Part of newborn screening

Is the most common cause of preventable retardation

If untreated leads to brain damage, deafness, growth failure and death

Treat with 10-15/kg/day of thyroid replacement

Question 10

Most common acquired Hypothyroidism

Answer 10

Hashimotos (Autoimmune )