Endocrine - Thyroid + Adrenal Flashcards
Disorders of thyroid function
hyper/hypo thryroid
thyroid hormones
aid in growth + development
-metabolizes nutrients + energy
Congenital Hypo - thyroid
- genetic mutation
- failure of feedback loop to develop
- iodine deficiency
Acquired Hypo - thyroid
Hashimoto thyroiditis
-autoimmune
Congenital Hypo - thyroid
manifestations
- thick tongue
- hypotonia
- large fontanelles
Acquired Hypo - thyroid
manifestations
- sensitivity to cold
- goiter
- change in growth pattern
- decr height velocity
- delayed bone + dental age
- hypotonia w poor muscle tone
- delayed puberty
congenital hypothyroidism is usually detected by…
newborn screening
Hypo - thyroid
treatment + education
levothyroxine T4
-teach to assess for tachycardia
tachycardia w levothyroxine could indicate…
too much TSH
Hyper - thyroid
Graves disease
-autoimmune
most common etiology of hyper-thyroid in kids
graves disease autoimmune
Hyper - thyroid
manifestation
hyperactive SNS
- tachycardia
- HTN
- goiter (enlarged thyroid gland)
- bulging eyes (exophthalmus)
- heat intolerance
thyroid crisis aka thyrotoxicosis
manifestations
- weakness
- diaphoresis
- tachycardia
- tremor
- palpitations
- diarrhea
- irritability
- nervousness
- anxiety
Hyper - thyroid
treatment
- thyroidectomy + radiation
- lifelong thyroid replacement if radiation/surgery is performed
Hyper - thyroid
education
- wear med alert ID
- easily fatigued, need scheduled rest periods at home/school
- kids are easily fatigued, need scheduled rest periods at home/school
Disorders of Adrenal Function [3]
1 Cushing Syndrome/Disease
2 Adrenal Insufficiency
3 Pheochromocytoma
Cushing Syndrome + Disease aka
adrenocortical hyperfunction
> > excess glucocorticoid hormones esp cortisol
Cushing Syndrome + Disease causes
INFANTS: adrenocortical tumor
7yo+: pituitary tumor (adenoma) secreted excess ACTH
ADENOMA
pituitary tumor
- cause cushings
- secretes excess ACTH
- causes bilateral adrenal hyperplasia
Cushing
manifestations
- cushingoid features
- delayed puberty
- irregular menses
- pathologic fractures
- hyper glycemia
- symptoms mimicked by corticoid admin
cushingoid features
- moon face
- hirsutism
- acne
- deepening of voice
Cushing treatment of choice
surgical removal of pituitary adenoma
Cushing education
admin injectible cortisone when vomiting, diarrhea, or cannot take oral med
**failure to give med when child is ill can lead to severe illness or cardiovasc collapse
Adrenal Insufficiency aka Addison Disease
glucorticoid/cortisol + mineralcorticoid deficiency
-usually autoimmune process
Adrenal Crisis
caused by stressors (surgery, infectn, trauma)
-treat w fluids, IV glucose, IV glucocorticoids
avoid adrenal crisis by…
increase dose during periods of stress
**admin triple strength dose steroid (hydrocortisone) Q6-8hr while stressors are present
Pheochromocytoma
tumor in adrenal gland
**cause excess release of catecholamines
Pheochromocytoma/excess catecholamines
manifestations
- HTN
- palpitations
- sweating
- anxiety
- tremor
- headache
Pheochromocytoma
treatment
curative surgical removal of all tumors
|»_space;>may trigger release of epinephinr + norepinephrine leading to Pheochromocytoma crisis
Pheochromocytoma Crisis
manifestations
- HTN
- tachycardia
Pheochromocytoma Crisis
treatment
alpha-adrenergic blocking agents
