Pediatrics endocrinology Flashcards
s/s of general DM
polyuria, polydipsia, polyphagia
etiology of t1DM vs t2DM
- Type 1: near complete or total absence of circulating insulin
- Type 2: due to insulin resistance, decreased insulin, or increased hepatic glucose production
s/s of T1DM
- weight loss
- postural hypotension
- ketoacidosis
- poor wound healing
- blurred vision
normal A1C range
4.0-5.6%
target A1C goal
7
Prediabetic A1C range
5.7-6.5%
best way to dose insulin
basal-bolus
Examples of long acting insulin
- glargine (Lantus)
- detemir (Levemir)
Examples of rapid acting insulin
- Lispro (Humalog)
- Aspart (Novolog)
- Glulisine (Apidra)
Examples of intermediate acting insulin
NPH (Humulin N, Novolin N)
Dawn phenomenon
nocturnal release of cortisol leads to increased glucose due to inadequate insulin levels so the bedtime insulin needs to be increased
Somogyi effect
patient experiences rebound hyperglycemia due to excess insulin levels causing hypoglycemia while sleeping so the bedtime insulin needs to be decreased
1st line medication for T2DM
Metformin
s/s of hypoglycemia
- light headed
- nauseous
- dizzy
- weak
management of hypoglycemia
- conscious: oral intake of glucose
- unconscious: IV dextrose, injectable glucagon
MCC of hypercalcemia
Malignancy and hyperparathyroidism
s/s of hypercalcemia
- bones
- stones
- groans
- psych overtones
management of hypercalcemia
- treat underlying condition
- IV NS
- lasix
MCC of thyrotoxicosis
graves disease
antibody present in graves disease
TSI
s/s of hyperthyroidism
- fatigue
- anxiety
- palpitations
- heat intolerance
- sweating
- weight loss
- restlessness
manifestations of grave disease
- exophthalmos
- pretibial myxedema
- digital clubbing
graves disease in pregnancy
tend to have remission around the late second trimester
thyroid storm
severe, life threatening thyrotoxicosis triggered by illness
s/s of thyroid storm
- delirium
- tachycardia
- vomiting
- diarrhea
- dehydration
- high fever
MCC of hypothyroidism
- worldwide: iodine deficiency
- US: hashimotos
s/s of hypothyroidism
- fatigue
- dry skin
- hair loss
- weight gain
- depression
- dysphagia
- cold intolerance
treatment of hyperthyroidism
- methimazole
- PTU
- radioactive destruction of thyroid
- surgery
myxedema crisis
severe, life threatening hypothyroidism triggered by illness
manifestations of myxedema crisis
- hypothermia
- hypoventilation
- hyponatremia
- hypoglycemia
- hypotension
treatment of hypothyroidism
Levothyroxine (synthroid)
prader willi s/s
- almond shaped eyes
- short stature
- strabismus
- hypogonadism
- small hands and feet
- tapered fingers
- obesity
- hypotonia
- obsessive hyperphagia
treatment of prader willi
growth hormone
s/s of turner syndrome
- webbed neck
- short stature
- shield chest
- amenorrhea
- hypogonadism
treatment of turners syndrome
hormone replacement
