Endocrine Disorders Flashcards
what is precocious puberty
early sexual development
boys
average age of puberty development for boys
12
average age of puberty in girls
- 2 years of age (Caucasian)
9. 6 years of age (African-American)
most of the time the cause of precocious puberty is unknown, t or f
true
precocious puberty in girls increases risk for what?
cancer (breast)
age of youngest documented mother in history
5 years old
dx of precocious puberty
GnRH stimulation test (definitive) - increase in testosterone, estrogen
x-ray of bone in wrist compared to others the same age (>2 years will receive dx)
if child is less than 6 yrs old with dx of precocious puberty will likely have a dx of what
tumors
why treat precocious puberty
body image issues preserve adult height to stop development prevent pregnancy trt underlying cause
what do we treat precocious puberty with
lupron - given IM, or yearly implant
around the time of normal puberty (11-12 y.o.) what will we do?
stop lupron - may stop sooner (16 months before puberty starts naturally)
when can a child handle giving themselves injections
around 9 y.o.
type 1 diabetes is typically seen in this age group
childhood and adolescence
2 peak incidences in type 1 diabetes
4-6
10-14
s/s of type 1 diabetes
abd pain
fatigue
bed-wetting
3 “polys” of diabetes
polyphagia
polydipsia
polyuria
children are typically in dka when they are dx as type 1, t or f
true
at what age can a child stick their finger for blood glucose
as early as age 4-5
when can a child draw up dose of insulin
age 11-12
teach a child to carry this with them w/type 1 diabetes
candy, sugar cubes
mgmt for toddlers with type 1 diabetes
timed meal plan w/snacks 3 times/day offer choices (which finger do you want to use)
when a child is hypo or hypoglycemic what will they present with
irritability - temper tantrum
can a toddler recognize their sugar is low, yes or no
no
develop a code word with preschoolers when they feel their blood sugar is low, t or f
true
what happens to blood sugar with increased activity
blood sugar will go down - decrease dose
dx with type 1 diabetes with fasting blood glucose of
126 or >
this age group has the most difficulty adjusting to dx of type 1 diabetes
adolescents - don’t want to be different from peers
what happens to sugar when teens drink alcohol with type 1 diabetes
lowers blood sugar - especially w/binge drinking (hypoglycemic)
will children with type 1 diabetes wear a medical alert bracelet, yes or no
yes
are adolescent girls with type 1 diabetes at a high risk for developing eating disorders
yes, concerned with weight
when does congenital adrenal hyperplasia occur
a congenital condition that happens in utero - cause unknown
in congenital adrenal hyperplasia there is a deficiency in the synthesis of
cortisol (21-hydroxylase) and aldosterone
two conditions with CAH
mild and complete loss of cortisol
CAH can be a life threatening condition with complete loss of cortisol and aldosterone t or f
true - can go into hypovolemic shock
if you produce too many androgen’s (male hormones) in the fetus what will happen if its a female
development of external male characteristics (clitoris may look like a penis)
s/s of adrenal insufficiency
ambiguous genitalia tall stature for age precocious puberty hypo-tension hypoglycemia metabolic acidosis dehydration vomiting
dx CAH
difficult to assign sex in some cases
US
trt for CAH
give cortisone (PO) - suppresses ACTH secretion/slows linear growth females may need reconstructive surgery of genitalia
is cortisone trt a life-long trt in CAH
yes
when do we need to increased amount of cortisone in CAH
stress, infection/illness
trt for complete dx of CAH
cortisone along with aldosterone (Florinef)
mgmt of CAH
watch fluid balance
provide parental support
