Endocrine - Pituitary

Question 1

endocrine system is responsible for ___ during FETAL dvlpt

Answer 1

sexual differentiation

Question 2

endocrine system is responsible for ___ during childhood + adolescence

Answer 2

stim growth + development

Question 3

purberty duration + onset

Answer 3

duration: 4.5 y
girls: 9y
boys: 11y

Question 4

Disorders of Pituitary Function [5]

Answer 4

1 hypopituitarism
2 hyperpituitarism
3 diabetes insipidus
4 syndrome of inappropriate ADH
5 precocious puberty

Question 5

anterior pituitary secretes…. [5]

Answer 5

1 GH
2 TSH
3 ACTH
4 FSH
5 LH

Question 6

posterior pituitary secretes [2]

Answer 6

1 ADH

2 oxytocin

Question 7

growth hormone related disorders

Answer 7

hypo/hyperpituitarism

Question 8

ADH related disorders

Answer 8

diabetes insipidus

syndrome of inappropriate ADH [SIADH]

Question 9

hypo - pituitarism

Answer 9

GH deficiency

• low birth wt + lenght
• below 3rd percentile by 1y.o

Question 10

hypo - pituitarism diagnositcs

Answer 10

decr IGF-1
GH stimulation
skeletal maturity x-ray

Question 11

GH stimulation

process

Answer 11

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

Question 12

skeletal maturity x-ray process

Answer 12

<3 yo

-hands + wrists of older chidlren

Question 13

hypo - pituitarism

treatment

Answer 13

SOMATROPIN

• watch for incr risk of slipped capital femoral epiphysis
• subQ injectn 6-7days/wk

Question 14

hyper - pituitarism

Answer 14

excess GH

• RARE
• incr growth rate

Question 15

hyper - pituitarism

treatment

Answer 15

surgical removal of tumor or pituitary gland

Question 16

removal of pit gland will require…

Answer 16

lifelong pituitary hormone replacement

Question 17

DIABETES INSIPIDUS

Answer 17

unable to concentrate urine in kidneys

2 types: central + nephrogenic

Question 18

CENTRAL DIABETES INSIPIDUS

Answer 18

inadequate production of vasopressin/ADH

Question 19

NEPHROGENC DIABETES INSIPIDUS

Answer 19

ineffective action of vasopressin/ADH

Question 20

DIABETES INSIPIDUS

clinical manifestations

Answer 20

• polyuria
• polydipsia
• dehydration
• HYPER-Na
• urine cannot be concentrated no matter how dehydrated child becomes

Question 21

DIABETES INSIPIDUS

diagnosis

Answer 21

• urine osmolality (decr)
• spec gravity (decr)
• fluid deprivatn test

Question 22

Fluid Deprivation Test

Answer 22

when fluids are withheld, follow changes in :

• weight
• UOP
• UA

Question 23

DIABETES INSIPIDUS

treatment for CENTRAL

Answer 23

desmopressin [DDAVP]

>decr UO

Question 24

DIABETES INSIPIDUS

treatment for NEPHROGENIC

Answer 24

thiazide diuretics
»promotes Na excretion
»stim proximal tubule water reabsorption

Question 25

DIABETES INSIPIDUS

education

Answer 25

inform school re unrestricted access to water + restroom

Question 26

SIADH

Answer 26

excessive ADH

excessive water reabsorption w low serum osmolality

Question 27

SIADH

clinical manifestations

Answer 27

WATER INTOXICTN + HYPO-Na

• HTN
• JVD
• crackles
• wt gain w/o edema
• decr UO

Question 28

SIADH

diagnosis

Answer 28

labs show:

• HIGH URINE OSMOLALITY
• HIGH SPECIFIC GRAVITY

Question 29

SIADH

treatment

Answer 29

• fluid restriction

- diuretics

Question 30

SIADH

education

Answer 30

refer to dietician to help ID hidden sources of water + fluids

Question 31

Precocious Puberty

Answer 31

early release of GONADOTROPIN-RELEASING HORMONE

Question 32

Precocious Puberty

manifestations

Answer 32

secondary sex characteristics before 8 yrs in girls, 9 yrs in boys

-early growth spurt that ends earlier as well