Endocrine - Pituitary Flashcards
endocrine system is responsible for ___ during FETAL dvlpt
sexual differentiation
endocrine system is responsible for ___ during childhood + adolescence
stim growth + development
purberty duration + onset
duration: 4.5 y
girls: 9y
boys: 11y
Disorders of Pituitary Function [5]
1 hypopituitarism 2 hyperpituitarism 3 diabetes insipidus 4 syndrome of inappropriate ADH 5 precocious puberty
anterior pituitary secretes…. [5]
1 GH 2 TSH 3 ACTH 4 FSH 5 LH
posterior pituitary secretes [2]
1 ADH
2 oxytocin
growth hormone related disorders
hypo/hyperpituitarism
ADH related disorders
diabetes insipidus
syndrome of inappropriate ADH [SIADH]
hypo - pituitarism
GH deficiency
- low birth wt + lenght
- below 3rd percentile by 1y.o
hypo - pituitarism diagnositcs
decr IGF-1
GH stimulation
skeletal maturity x-ray
GH stimulation
process
1 NPO + limitd activity
2 baseline blood sample at 600+800
3 admin med to trigger GH release
4 blood sample Q30 min for 3 hr
skeletal maturity x-ray process
<3 yo
-hands + wrists of older chidlren
hypo - pituitarism
treatment
SOMATROPIN
- watch for incr risk of slipped capital femoral epiphysis
- subQ injectn 6-7days/wk
hyper - pituitarism
excess GH
- RARE
- incr growth rate
hyper - pituitarism
treatment
surgical removal of tumor or pituitary gland
removal of pit gland will require…
lifelong pituitary hormone replacement
DIABETES INSIPIDUS
unable to concentrate urine in kidneys
2 types: central + nephrogenic
CENTRAL DIABETES INSIPIDUS
inadequate production of vasopressin/ADH
NEPHROGENC DIABETES INSIPIDUS
ineffective action of vasopressin/ADH
DIABETES INSIPIDUS
clinical manifestations
- polyuria
- polydipsia
- dehydration
- HYPER-Na
- urine cannot be concentrated no matter how dehydrated child becomes
DIABETES INSIPIDUS
diagnosis
- urine osmolality (decr)
- spec gravity (decr)
- fluid deprivatn test
Fluid Deprivation Test
when fluids are withheld, follow changes in :
- weight
- UOP
- UA
DIABETES INSIPIDUS
treatment for CENTRAL
desmopressin [DDAVP]
>decr UO
DIABETES INSIPIDUS
treatment for NEPHROGENIC
thiazide diuretics
»promotes Na excretion
»stim proximal tubule water reabsorption
DIABETES INSIPIDUS
education
inform school re unrestricted access to water + restroom
SIADH
excessive ADH
excessive water reabsorption w low serum osmolality
SIADH
clinical manifestations
WATER INTOXICTN + HYPO-Na
- HTN
- JVD
- crackles
- wt gain w/o edema
- decr UO
SIADH
diagnosis
labs show:
- HIGH URINE OSMOLALITY
- HIGH SPECIFIC GRAVITY
SIADH
treatment
- fluid restriction
- diuretics
SIADH
education
refer to dietician to help ID hidden sources of water + fluids
Precocious Puberty
early release of GONADOTROPIN-RELEASING HORMONE
Precocious Puberty
manifestations
secondary sex characteristics before 8 yrs in girls, 9 yrs in boys
-early growth spurt that ends earlier as well
