Endocrine/Metabolic Conditions (2-3 ques)

Question 1

Hyperthyroidism (Graves Disease) - complication

Answer 1

Thyrotoxicosis = thyroid storm ==> medical emergency
- sudden symptoms = incr HR, blood pressure, incr temp

Give anti-thyroid drug

Question 2

Cushing Syndrome

Answer 2

• central obesity (chest, back, face)
• rounded (moon) face
• ** susceptibility to infection and poor wound healing
• HTN

Question 3

Cushing Syndrome - treatment

Answer 3

Depends on etiology:
1. taper steroid treatment
OR
2. surgical removal of tumor
 - steroid replacement therapy
 - give in am to mimic normal cortisol secretion

Question 4

Diabetes Insipidus

Answer 4

“high and dry” == high Na and dehydration

• poyuria
• polydipsia

Treatment:

• PO and IV fluids
• oral or nasal DDAVP (exogenous vasopressin)

Question 5

Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

Answer 5

” low and too much H2O” == low Na and too much H2O

• decr urine output, wt gain, hyponatremia, muscle weakness, lethargy, confusion
• seizures == cerebral edema == neuro checks

Treatment:

• correct hyponatremia
• *** neuro checks
• fluid restrictions
• *** seizure precautions

Question 6

Type 1 Diabetes - hyperglycemia s/s

Answer 6

“warm and dry, sugar high”

• incr urination
• incr thirst
• incr hunger
• child appears thin, malnourished
• acetone breath odor (DKA)

HgbA1c goal = < 6.5%

Question 7

Type 1 Diabetes - hypoglycemia s/s

Answer 7

“cold and clammy, need some candy”

• change in LOC
• BG < 70 mg/dL
• sweaty, shaky, tachy

Question 8

Type 1 Diabetes - intervention

Answer 8

• monitor BG frequently (before meals, snacks, and physical activity
• carb, fat and protein counting
• insulin
• promote exercise and healthy weight
• premeal goal == 80-130 mg/dL

Question 9

Rapid acting insulin

Answer 9

Lispro/Humalog
onset - 10-15 min
peaks - 30-90 min

Question 10

Fast acting insulin

Answer 10

Regular
onset - 30 min
peak - 2-4 hours

Question 11

Intermediate acting insulin

Answer 11

NPH
onset - 2-4 hours
peak - 8 hours

Question 12

Long acting

Answer 12

Lantus
Basal needs; no peaks
not related to meals

Question 13

Type 2 Diabetes assessment

Answer 13

• overweight/obesity
• Acanthosis Nigricans – 90% of kids w/type 2 have – cutaneous thickening and hyperpigmentation
• HTN
• hyperlipidemia
• sleep apnea