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Exam 1 PNP > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

important physical measurement in peds

A

short stature

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2
Q

first question with low growth measurement

A

“how was this done” / re-check

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3
Q

normal growth rate by year

A
  • birth - 1 year: 10in / 25cm
  • 1 -4 years: 4in / 10cm per year
  • school age - 12: 2in / 5cm per year
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4
Q

causes of short stature

A
  • genetics
    • familial (mid-parental height helpful)
    • disorders (Downs, Turner)
  • constitutional growth delay
    • bone age vs. actual age
  • malnutrition
  • endocrine causes
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5
Q

evaluation of child w/ short stature

A
  • PE
    • wheezing, masses, etc
  • CBC, ESR
    • chronic dz
  • electrolytes, LFTs, BUN, Cr, UA
    • metabolic and renal fx
  • stools to eval. fat metabolism
  • celiac dz screening
  • thyroid function (hypo- growth cessation)
  • growth hormone testing
  • genetic testing
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6
Q

physical sign indicating need for GH testing

A

under-tall and overweight

  • insuline-like growth factor (IGF-1) and IGF binding protein 3 (IGFBP-3) tested
  • idiopathic causes MC
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7
Q

folllow-up if IGF and IGFBP-3 levels low

A
  • can be low nutrition and disease state
  • MRI of brain to r/o brian tumor (craniopharyngioma)
  • bone age to check maturity with chronological age
  • hospitalize for GH stimulation test - induced hypoglycemia fails to stimulate GH (+ test)
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8
Q

Tx of GH deficiency

A

recombinant HGH

  • single dose SQ daily
  • track height q3m
  • follow bone age - stop when epiphyses fused (prevent acromegaly)
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9
Q

production of adrenal hormones

responsible for pubertal development

(occurs before pubertal changes seen)

A

adrenarche

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10
Q

pituitary stimulation causing adrenarche

dev. of pubic & axillary hair, oiliness, acne, odor

(produced by something other than gonads)

A

pubarche

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11
Q

secretion of sex hormones secondary to maturation of hypothelamic-pituitary-gonadal axis

(testosterone/estrogen production -

pubertal growth spurt)

A

gonadarche

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12
Q

normal delayed puberty

A

constitutional growth delay

  • often family hx of delayed puberty
  • bone age delayed: puberty begins at bone age 12-13
  • offer reassurance
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13
Q

abnormal delayed puberty d/t

deficiency of pituitary hormones for gonadarche

(FSH/LH)

A

hypo-gonadotropic hypogonadism

(causes: hypopituitarism, CNS tumor, anorexia nevosa, athletic hypopituitarism, hypothyroidism)

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14
Q

abnormal delayed puberty d/t

ovarian/testicular failure

(gonads not responding to FSH/LH)

A

hyper-gonadotropic hypogonadism

(causes: Turner (XO) in females, Kleinfelter (XXY) in males)

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15
Q

ages of precocious pubery

A

secondary sexual characteristics

before age 9 in boys, age 8 in girls

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16
Q

2 types of precocious puberty

A
  • central
    • premature maturation of hypothalamic-pituitary-gonadal axis (pituitary)
  • peripheral
    • premature start of ovaries/testicles
17
Q

what tested for precoscious puberty

A

adrenal androgens - 17-OH serum progesterone

18
Q

different but normal - what do you do

  • premature thelarche
  • premature pubarche
  • gynecomastia
A
  • prem. thelarche- isolated breast development in girls ages 6mo - 3y
    • no testing or treatment
  • prem. thelarche- isolated development of pubic hair
    • r/o adrenal hyperplasia
  • gynecomastia- normal in pubertal boys
    • monitor for Kleinfelter or high estrogen
19
Q

cause of genital development

A

male/female from same embryonic tissue

testosterone virilizes embryo at weeks 9-13

no testosterone- female genetalia develop

20
Q

ambiguous genitalia - 2 types

A
  • XX psuedohermaphrodite
    • ovaries w/ virilized genitalia
  • XY psueodhermaphrodite
    • testes w/ undervirilized genitalia
21
Q

must screen for this deadly dz associated

with ambiguous genitalia

A

adrenal insufficiency

critically ill in first few days of life - can die from acidosis and hypotensive shock

22
Q

2 adrenal gland diseases

A
  • Addison’s
    • autoimmune destruction of adrenal gland
    • lifelong replacement of glucocorticoids
  • Cushing’s
    • too much cortisol
    • central obesity, growth failure, buffalo hump, striae
23
Q

female athlete triad

A
  • amenorrhea
  • eating disorder
  • low bone mineral density

Exam 1 PNP (21 decks)

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