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CPNP AC flash cards > endocrine disorders > Flashcards

endocrine disorders Flashcards

1
Q

SIADH

-____ excess
-increased w___ a____
-decreased u___ o____

A

ADH
water absorption
urine output

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2
Q

Diabetes insipidus

-____ deficit
-decreased w___ a____
-increased u___ o____
-d____
-high s____

A

ADH
water absorption
urine output
dehydration
sodium

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3
Q

Cerebral salt wasting
-increased a____ n____ hormone
-u___ s____ excretion
-di____
-h____
-e____ or h_____

A

atrial natriuretic hormone
urine sodium
diuresis
hyponatremia
euvolemia
hypovolemia

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4
Q

SIADH management
–restrict ____
–restrict ____
–monitor __/___ and e____
–administer d___ use 0.9 % ___

A

sodium
fluids
I/Os and electrolytes
diuretics–NS

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5
Q

DI management
–administer v___ first then d___
–give f___ r____
–monitor f__ and e____

A

vasopressin
DDAVP
fluid replacement
fluid and electrolytes

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6
Q

DKA presentation
h____, k___ formation, l___ a___, g___ m___ a___

A

hyperglycemia
ketone
lactic acidosis
gap metaboic acidosis

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7
Q

Key DKA exam finding?

A

kusmmal respirations

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8
Q

DKA urine ketone diagnostic level is > ___ mmol/L

A

3

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9
Q

DKA management
1) __ mg/kg b____ (slow replacement)
2)__ x M___ in the first 24 hours
–then decrease to __-___ x m___
3) i___ infusion
—___ units/kg/hr

A

10 ml/kg bolus
2 X MIVF
—1-1.5 X MIVF

insulin
0.1 units/kg/hr

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10
Q

Once glucose in a child with DKA decreased to 250-300, add g____

A

glucose

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11
Q

DKA management
–use a 2-bag system, if glucose decreases faster than ___ dL/hr

A

100

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12
Q

In DKA replenish
p___ and p____

A

potassium
phosphorus

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13
Q

DKA management
–convert to SQ insulin once __ and ___ are normal

A

pH and HCO3

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14
Q

DKA cerebral edema presents with cushings triad = H____, b___, r__ d___

A

hypertension
bradycardia
respiratory depression

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15
Q

Assess for DKA cerebral edema with a ?

A

CT

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16
Q

DKA cerebral edema management
1)m____ __-__ gm/kg
2)__% h___ s____

A

mannitol 0.5-1gm/kg
3% hypertonic saline

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17
Q

adrenal insufficiency usually presents during times of s___
s/s include
h___, h___, we___, an____, __/___

A

stress
hypotension, hypoglycemia, weakness, anorexia, n/v

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18
Q

adrenal insufficiency management is with g____

A

glucocorticoids

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19
Q

adrenal crisis is rapid and overwhelming
It presents with
h____, fa____, vo____, mu___ pa___, an___, and we___ lo____

*management is with g_____

A

hypotension
fatigue
vomiting
muscle pain
anorexia
weight loss

–glucorticoids

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20
Q

What is the most common 21-hydroxylase deficiency?
co____ ad_____ h____

A

congenital adrenal hyperplasia

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21
Q

Congenital adrenal hyperplasia presents in newborns with
a___ g____, sa____ w___, sh____, decreased co____ and al_____

A

ambiguous genitalia
salt wasting
shock
cortisol and aldosterone

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22
Q

congenital adrenal hyperplasia lab findings include
h____
h____ and d_____

A

hyperkalemia
hyponatremia
dehydration

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23
Q

Congenital adrenal hyperplasia management
–administer f____
–give h______

A

fluids
hydrocortisone

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24
Q

Thyroid storm (due to untreated hyperthyroidism) is a life-threatening condition presenting with
h____, fe____, ta___, and sw_____
—-at biggest risk for c___ and pu___ ed____

A

hypertension
fever
tachycardia
sweating

CHF
pulmonary edema

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25
Q

Hyperthyroidism and thyroiditis treatment is with
P___ and. me____

A

PTU (propylthiourcacil)
methimazole

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26
Q

Hypothyroidism is often associated with other disorders such as
t____
d___ and
a______ disease

A

trisomy 21
diabetes
autoimmune disorders

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27
Q

in hypothyroidism
T4 will be
and
TSH will be

A

low
high

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28
Q

Sick euthyroid occurs during times of critical illness
management is s____

A

supportive
–resolves once critical illness passes

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29
Q

polyhydramnios is associated with c___ a____ and s_____

A

congenital anomalies
syndromes

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30
Q

oligohydramnios is associated with I____

A

IUGR

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31
Q

What is the leading cause of deafness and blindness?
C_____ s___

A

CHARGE syndrome
–autosomal dominant
—CDH7 mutation

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32
Q

C___ of the e____
H____ defects
A___ of n____
R_____ of growth and development
G_____ abnormalities
E___ abnormalities/d___

A

coloboma of eye
heart defects
atresia of nares
retardation
genitourinary
ear/deafness

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33
Q

Adolescents with CHARGE syndrome may require _____ replacements

A

hormone

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34
Q

Children with Trisomy 21 are at increased risk for a___-a____ i____ leading to s___ c___ i____

—-for symptomatic kids obtain c__ r___

A

atlantoaxial instability
spinal cord injury

cervical radiographs

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35
Q

50% of children with down syndrome will have a____ v____ c____ defects

A

atrial ventricular canal defects

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36
Q

turner syndrome most commonly affects?

A

girls
–will have a normal lifespan

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37
Q

Turner syndrome is associated with
*in_____
*h___ and v____ problems
*co____ of a____
*ho___ ki_____
*ly_____ in babies

A

infertility
hearing and vision
coarctation of aorta
horseshoe kidneys
lymphedema

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38
Q

What is the most common form of inherited intellectual disability?

A

Fragile X
–will have a normal lifespan
–Begin behavioral therapy early

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39
Q

Trisomy 18 (Edwards)
*____ predominance
*profound i___ d____
*managed with p___ c___ and/or h____

A

female
intellectual disability
Palliative care and/or hospice
—50% are stillborn
—-10% dont survive past 1 YOA

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40
Q

Achondroplasia (dwarfism)
**monitor for s___ deformities
**managed h____
**monitor for o___

A

spinal
hydrocephalus
OSA

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41
Q

Marfan syndrome is a connective tissue disorder, these children are at high risk for
**ao___ di____
**re___ de____
**sp___ pn_____

A

aortic dilation
retinal detachment
spontaneous pneumothorax

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42
Q

Marfan syndrome management
**b__ b___ therapy
**e___ restriction
**serial E____

A

beta-blocker therapy
exercise restriction
serial ECHOs

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43
Q

22q112 deletion =

A

DiGeorge syndrome
–delayed
–low ears absent kidneys
–conductive hearing loss prone

44
Q

Children with DiGeorge syndrome (velocardiofacial syndrome) are at greatest risk for
**i______
**h_____

A

immunodeficiency
–low T-cell

hypocalcemia
—need daily calcium

45
Q

DiGeorge syndrome management
**c____ administration
**monitor for recurrent r___ i__
**@ 4 YOA begin c__/s___ f___

A

calcitrol
respiratory infections
cervial/spinal films

46
Q

What is the first clue of Vacterl syndrome diagnosis?

si____ u____ a____

A

single umbilical artery

47
Q

Williams syndrome is associated with
**se__ defects
**h___
**st___ ir____

A

septal defects
–Cardiac involvement determines life expectancy

hyperkalemia
starburst irisi

48
Q

Dog, cat, human bite management
**first-line outpatient =a ____
**first line inpatient= =a____-su____

A

augmentin
ampicillin-sulbactam

49
Q

Snakebite management
**a____ if indicated
**t____ v____ administration

A

anti-venom
tetanus vaccine

50
Q

Brown recluse spider bite
—ongoing monitoring for the development of t___ n____

A

tissue necrosis

51
Q

black widow bite management
—acute p____
–obtain c___ studies and an E___

A

pain
coagulation
EKG

52
Q

Necrotizing fascitis organisms include?

A

group a strep and staph
—severe toxic appearance with skin edema (monitor for compartment syndrome)

53
Q

Stevens-Johnson (erythema multiform) is characterized by b___ and f____

A

blistering and fever

54
Q

What medications most often cause Stevens-Johnson (erythema multiform)
an_____
su___
au____
ba___
N____

A

antiepileptics
sulfonamides
augmentin
bactrim
NSAIDs

55
Q

Stevens-Johnson (erythema multiform) management
*p___ control
*bl___ prevention

A

pain control
blindness

56
Q

bullous impetigo treatment
–au____ + ce____

A

augmentin
cephalosporins
—large blisters in armpit, groin, fingers, toes

57
Q

UTI txt
1)b___
2)c___ (k___)

A

bactrim
keflex

58
Q

Pyelonephritis
–identify the organism in. the b____
–monitor for r___ s____

A

bloodstream
renal scarring

59
Q

Testicular torsion diagnostic test is via an _____

A

ultrasound

60
Q

Males with testicular torsion present with
s___ onset of p___ in one t____

A

sudden onset of pain in one teste
—surgical emergency

ovarian torsion also an emergency

61
Q

renal tubular acidosis =
m___ a____ + n___ a___ g___

A

metabolic acidosis
normal anion gap

62
Q

renal tubular acidosis management
**replace b____

A

bicarb

-Prevent renal failure

63
Q

What is the most common type of renal failure?

A

pre-renal failure

–seen in trauma and shock
–reversible

64
Q

intrinsic renal failure labs
–elevated c___, p___, u__ a___

A

calcium
phosphorus
uric acid

65
Q

nephrotoxic medications
g____
a_____

A

gentamycin
acyclovir

66
Q

postrenal failure is due to o___ t___ o____

A

outflow tract obstruction
–anything that obstructs kidneys

67
Q

Indications for dialysis include
h____
severe f___ o___
a____

A

hyperkalemia
fluid overload
azotemia

68
Q

Nephrotic syndrome presents with a___ and p_____

A

albuminuria
proteinuria

69
Q

Txt nephrotic syndrome with?

A

corticosteroids

70
Q

Nephrotic syndrome s/s
e___
we___ g___
fl___ r____
pr____
fa____

A

edema
weight gain
fluid retention
proteinuria
fatigue

71
Q

HIV testing requires?

A

parental consent

72
Q

To determine risk for opportunistic infections in HIV + children, obtain c___ measurements

A

CD4

—vaccinate during high CD4 counts

73
Q

JIA is diagnosed when arthritis s/s are present for > ___ weeks

A

6

74
Q

In a child with JIA, what lab determines uveitis risk?

A

+ ANA

75
Q

First line JIA management is with?

A

NSAIDs

followed by steroids

76
Q

The risk for SLE increases in?

A

adolescent females

77
Q

Kawasaki imaging
-obtain an?

A

ECHO

78
Q

In a child with Kawasaki
obtain an EchO at time of diagnosis
–__ weeks post dxs and
–_-__ weeks posts dxs

A

2

6-8

79
Q

evaluate for cardiomegaly with a?

A

chest x-ray

80
Q

Kawasaki management
1) I___
2) A____

A

IVIG
Aspirin

81
Q

Initial Kawasaki aspirin dosing is
__-__ mg/kg/day

–Once afebrile decrease aspirin dosing to
__-__ mg/kg/day for __-__ weks

A

80-100 mg/kg/day

3-5 mg/kg/day
6-8 weeks

82
Q

In a child with Kawasaki, aspirin is continued indefinitely if c___ a____ abnormalities are present

A

coronary artery

83
Q

GI decontamination activated charcoal dose
__ g/kg

—Repeat doses are dosed at
__ g/kg

A

1 gm/kg

0.5 g/kg

–contraindicated if the airway unprotected or it pt has an abnormal gi tract

84
Q

Whole bowel irrigation = m___ or g___ administration

A

miralax or golytley

-contraindicated for obstruction or perforation

85
Q

Whole bowel irrigation is used for
i___ tablet ingestion
po____ ingestion
li___ ingestion

A

iron
potassium
lithium

86
Q

Alcohol/ethanol ingestion impairs g____
-children may become h___ as far at __ hours post ingestion

A

gluconeogenesis

hypoglycemic
6

87
Q

facial flushing, vomiting, diaphoresis, hypotension, hypothermia, hypoglycemia, lethargy, slurred speech, ataxia, seizures, respiratory depression, stupor, coma = a____/____ ingestion

A

alcohol/ethanol
ingestion

88
Q

ethylene glycol ingestion (antifreeze)

complications may occur __-___ hours post ingestion

A

6-12

89
Q

ethylene glycol ingestion (antifreeze) complications
a___ g___ m___ a____
re___ t___ i____
h_____

A

anion gap metabolic acidosis
renal tubular injuries
hypocalcemia

90
Q

In a child with ethylene glycol ingestion (antifreeze)

GIVE
-____ or et____

A

4MP
ethanol

91
Q

Treat a child with ethylene glycol ingestion (antifreeze) with dialysis when ethylene glycol level is > ____mg/dL or if the patient is refractor to txt

A

50

92
Q

isopropyl ingestion (found in rubbing alcohol) had no antidote.

When IPA level is > ____ mg/dL begin dialysis

A

500

93
Q

Methanol (found in antifreeze, paint strippers)
antidote =
fo____ or et____

A

fomepizole
ethanol

94
Q

Kids with tylenol ingestion recover within __-__ days s/p ingestion

A

5-7

95
Q

Acetaminophen overdose
**> _____ mg/kg in kids less than 6 YOA

**___ gm in teens

A

200

10g

96
Q

The Tylenol antidote N-acetylcysteine is most effective is given within ___ hours of ingestion

TXT regimens
1) ___ hours of oral therapy
2)___ hours of IV therapy

A

8

72

21

97
Q

salicylate ingestion s/s
ti____ + ar____

A

tinnitus
arrhythmias

98
Q

Refer a child with salicylate ingestion to ER if
> ___ mg/kg or ___ grams of aspirin was ingested

A

> 150
65

99
Q

iron ingestion toxicity s/s
–within __ hours, children develop
__/__/__, and b__ s___

A

6
n/v/d
bloody stools

100
Q

iron toxicity likely when
> ___-___ mg/kg is ingested

A

40-60 mg/kg

101
Q

Iron ingestion management
–o___ l___ within 1 hour

A

orogastric lavage

102
Q

iron antidote =

A

deferoxamine

103
Q

opiod ingestion s/s triad
c___ depression, r___ depression, m___

A

CNS
respiratory
miosis

104
Q

organophosphate (insecticide) ingestion txt
pra____ ch___ and at____

A

pralidoxime` chloride
atropine

105
Q

beta blocker ingestion is fatal due to decreased?

A

contractility

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