Endocrine Disorders

Question 1

what is precocious puberty

Answer 1

early sexual development

boys

Question 2

average age of puberty development for boys

Answer 2

12

Question 3

average age of puberty in girls

Answer 3

10. 2 years of age (Caucasian)

9. 6 years of age (African-American)

Question 4

most of the time the cause of precocious puberty is unknown, t or f

Answer 4

true

Question 5

precocious puberty in girls increases risk for what?

Answer 5

cancer (breast)

Question 6

age of youngest documented mother in history

Answer 6

5 years old

Question 7

dx of precocious puberty

Answer 7

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)

Question 8

if child is less than 6 yrs old with dx of precocious puberty will likely have a dx of what

Answer 8

tumors

Question 9

why treat precocious puberty

Answer 9

body image issues
preserve adult height
to stop development 
prevent pregnancy
trt underlying cause

Question 10

what do we treat precocious puberty with

Answer 10

lupron - given IM, or yearly implant

Question 11

around the time of normal puberty (11-12 y.o.) what will we do?

Answer 11

stop lupron - may stop sooner (16 months before puberty starts naturally)

Question 12

when can a child handle giving themselves injections

Answer 12

around 9 y.o.

Question 13

type 1 diabetes is typically seen in this age group

Answer 13

childhood and adolescence

Question 14

2 peak incidences in type 1 diabetes

Answer 14

4-6

10-14

Question 15

s/s of type 1 diabetes

Answer 15

abd pain
fatigue
bed-wetting

Question 16

3 “polys” of diabetes

Answer 16

polyphagia
polydipsia
polyuria

Question 17

children are typically in dka when they are dx as type 1, t or f

Answer 17

true

Question 18

at what age can a child stick their finger for blood glucose

Answer 18

as early as age 4-5

Question 19

when can a child draw up dose of insulin

Answer 19

age 11-12

Question 20

teach a child to carry this with them w/type 1 diabetes

Answer 20

candy, sugar cubes

Question 21

mgmt for toddlers with type 1 diabetes

Answer 21

timed meal plan w/snacks 3 times/day
offer choices (which finger do you want to use)

Question 22

when a child is hypo or hypoglycemic what will they present with

Answer 22

irritability - temper tantrum

Question 23

can a toddler recognize their sugar is low, yes or no

Answer 23

no

Question 24

develop a code word with preschoolers when they feel their blood sugar is low, t or f

Answer 24

true

Question 25

what happens to blood sugar with increased activity

Answer 25

blood sugar will go down - decrease dose

Question 26

dx with type 1 diabetes with fasting blood glucose of

Answer 26

126 or >

Question 27

this age group has the most difficulty adjusting to dx of type 1 diabetes

Answer 27

adolescents - don't want to be different from peers

Question 28

what happens to sugar when teens drink alcohol with type 1 diabetes

Answer 28

lowers blood sugar - especially w/binge drinking (hypoglycemic)

Question 29

will children with type 1 diabetes wear a medical alert bracelet, yes or no

Answer 29

yes

Question 30

are adolescent girls with type 1 diabetes at a high risk for developing eating disorders

Answer 30

yes, concerned with weight

Question 31

when does congenital adrenal hyperplasia occur

Answer 31

a congenital condition that happens in utero - cause unknown

Question 32

in congenital adrenal hyperplasia there is a deficiency in the synthesis of

Answer 32

cortisol (21-hydroxylase) and aldosterone

Question 33

two conditions with CAH

Answer 33

mild and complete loss of cortisol

Question 34

CAH can be a life threatening condition with complete loss of cortisol and aldosterone t or f

Answer 34

true - can go into hypovolemic shock

Question 35

if you produce too many androgen's (male hormones) in the fetus what will happen if its a female

Answer 35

development of external male characteristics (clitoris may look like a penis)

Question 36

s/s of adrenal insufficiency

Answer 36

``` ambiguous genitalia tall stature for age precocious puberty hypo-tension hypoglycemia metabolic acidosis dehydration vomiting ```

Question 37

dx CAH

Answer 37

difficult to assign sex in some cases | US

Question 38

trt for CAH

Answer 38

``` give cortisone (PO) - suppresses ACTH secretion/slows linear growth females may need reconstructive surgery of genitalia ```

Question 39

is cortisone trt a life-long trt in CAH

Answer 39

yes

Question 40

when do we need to increased amount of cortisone in CAH

Answer 40

stress, infection/illness

Question 41

trt for complete dx of CAH

Answer 41

cortisone along with aldosterone (Florinef)

Question 42

mgmt of CAH

Answer 42

watch fluid balance | provide parental support