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PEDS > Endocrine & Metabolic 1 > Flashcards

Endocrine & Metabolic 1 Flashcards

1
Q

what does the endocrine system do

A
  • releases hormones that…
  • affects cellular activity
  • cell response depends on quantity and timing of hormone
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2
Q

major organs/glands of endocrine

A
  • pineal in hypothalamus
  • pituitary in hypothalamus
  • parathyroid glands in thyroid
  • medulla and cortex in adrenal
  • pancreas (islets of langerhans)
  • ovary and testes
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3
Q

the endocrine system is responsible for what in kids

A
  • sexual differentiation in fetal development

- stimulating growth and development

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4
Q

pediatric differences in endocrine system

A
  • childhood, production of sex hormones is low
  • puberty occurs when gonads secrete increased amounts of sex hormones
  • menstruation onset: 11-13 yrs (signals sexual maturity)
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5
Q

hormone functions in kids

A
  • responsible for fetal development
  • regulate CNS
  • responsible for maturation of reproductive organs
  • maintain homeostasis
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6
Q

important childhood hormones for growth and maturation

A
  • growth
  • thyroid
  • adrenal
  • gonadal
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7
Q

important childhood hormones for metabolic function

A
  • ADH
  • parathyroid
  • insulin
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8
Q

endocrine diagnostic tests

A

-ACTH stimulation
-ACTH suppression
-bone age
-CT
-fluid deprivation
-karyotype
-MRI
RAIU scan

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9
Q

lab tests done for endocrine

A

-fasting plasam glucose
-hemoglobin A1C
-hormone levels
-ICF-1 and IGFBP-3
-newborn metabolic screen
provocative GH testing
-thyroid antibodies

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10
Q

endocrine disorder signs: changes in..

A
  • growth rate
  • cognitive development
  • sexual development
  • metabolic regulation (fluids, electrolytes, glucose)
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11
Q

what are the hormones of the anterior pituitary

A

growth hormone, TSH, ACTH, FSH, LH, MSH

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12
Q

what are the hormones of the posterior pituitary

A

ADH, oxytocin, beta endorphins

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13
Q

what are the hormones of they thyroid

A

T4 and T3, thyrocalcitonin

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14
Q

hormone of the parathyroid

A

parathyroid

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15
Q

hormones of the adrenal gland

A

aldosterone, cortisol, epi, androgens

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16
Q

hormones of pancreas

A

insulin, glucagon, somatostatin

17
Q

hormones of ovaries

A

progesterone and estrogen

18
Q

hormone of testes

A

testosterone

19
Q

describe diabetes mellitus

A
  • most common metabolic disease in children
  • disorder of pancreatic function
  • disorder of hyperglycemia d/t defects in insulin secretion, action or both
  • leads to abnormalities in carbohydrates, protein, fat metabolism
20
Q

most oral meds are used to treat which type of diabetes

A

type 2 BUT NOT FDA approved for children

21
Q

when are you at risk for diabetes complications

A

until 5 yrs or more after diagnosis and onset of puberty

22
Q

describe type 1 diabetes

A
  • peak incidence is 7-15 yrs
  • higher incidence in Caucasian
  • genetic predisposition followed by autoimmune response
  • pancreatic beta cell destruction results in absolute insulin deficiency
  • abrupt onset, Ketosis (prone)
23
Q

manifestations of type 1 (classic signs)

A
  • polyuria (excessive urination)
  • polydipsia (excessive thirst)
  • polyphagia (excessive appetite with significant wt loss)
24
Q

other signs of type 1 (not the classic 3)

A
  • unexplained fatigue/lethargy
  • headaches
  • stomachaches
25
Q

focus of clinical therapy of type 1

A

-glycemic control by combining insulin, nutritional management to support growth

26
Q

clinical therapy of type 1

A
  • maintain blood glucose at near normal levels
  • exercise regimen
  • psychological support
  • multiprofessional approach (endocrinologist, diabetic educator, nutritionist)
27
Q

mechanisms of type 1

A

destruction of alpha and beta cells in the islets of langerhans produces multiple metabolic changes

28
Q

diagnostic tests of type 1

A
  • presence of classic signs
  • hemoglobin AIC > 6.5% and one of the following:
  • fasting plasma glucose >126 mg/dL, no caloric intake for at least 8 hrs
  • 2 hr plasma glucose >200 mg/dL during oral glucose tolerance test
  • random plasma glucose concentration > 200 mg/dL
29
Q

what is important to rememeber about basal insulin

A
  • *cannot be mixed with other insulin
  • basal bolus has increased glycemic control in pediatric diabetic pop
  • basal administered once a day using long acting
30
Q

describe short duration insulin (rapid acting)

A
  • Lispro, Aspart
  • onset: 10-30 min
  • peak: 0.5-2.5 hrs
  • duration: 3-6 hrs
31
Q

describe short duration insulin (slower acting)

A
  • regular-acting
  • onset: 30-60 min
  • peak: 1-5 hrs
  • duration: 6-10 hrs
32
Q

describe intermediate duration insulin

A
  • NPH
  • onset: 60-120 min
  • peak: 6-14 hrs
  • duration: 16-24 hrs
33
Q

describe long duration insulin

A
  • ultralente
  • onset: 240-360 min
  • peak: 14-24 hrs
  • duration: 24-36 hrs
34
Q

describe basal duration insulin

A
  • Lantus (glargine) & Levemir (detemir)
  • onset: 60-120 min
  • peak: none
  • duration: 24 hr
  • ***do NOT mix with other insulins

PEDS (24 decks)

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