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M6 13-005
Exam 12: Peds Endocrine System
| Question | Answer |
|---|---|
| Early signs of an inborn error of metabolism in the newborn | (1) Lethargy. (2) Failure to thrive. (3) Vomiting. |
| What are the two major systems that control and monitor the functions of the body? | The nervous system and the endocrine system. |
| Hypopituitarism | : a primary disorder associated with deficient secretion of GH (somatotropin). |
| Hypopituitarism may be the result of a variety of conditions | Developmental defects. Destructive lesions from tumors on the pituitary, birth trauma (head injury) or vascular abnormalities (aneurysms). Hereditary disorders. Functional disorders such as anorexia nervosa or psychosocial dwarfism. |
| Endocrine studies are done to detect evidence of other abnormalities such as: | Hypothyroidism. Hypersecretion of cortisol. (Cushing Syndrome). Gonadal aplasia. |
| Diabetes Insipidus (DI) | occurs as a result of the hyposecretion of the antidiuretic hormone or vasopressin which produces a state of uncontrolled diuresis. |
| Primary causes of DI | Familial. Idiopathic. |
| Secondary Causes of DI | Trauma. Tumors. Granulomatous disease. Infections. Vascular anomalies. |
| DI Manifestations | Polyuria. Polydipsia. The first sign usually is enuresis. With infants: the initial symptoms include irritability that is relieved with feedings of water, not milk. |
| vasopressin (Pitressin) | alleviate the polyuria and polydipsia |
| The usual treatment requires daily replacement of vasopressin using | desmopressin acetate (DDAVP), which is a synthetic form of vasopressin |
| DDAVP: Signs of overdose | Water intoxication. Anorexia. Nausea. Stomach cramps. Irritability. Changes in personality. Seizures. Changes in level of consciousness. |
| Treatment for DI is | Lifelong |
| syndrome of inappropriate antidiuretic hormone secretion (SIADH). | Hypersecretion of vasopressin |
| SIADH is commonly caused by | (1) Infections. (2) Tumors. (3) Trauma of the central nervous system. |
| SIADH manifestations | Increased fluid volume. Low sodium levels. Anorexia. Nausea. Stomach cramps. Irritability. Personality changes. Changes in level of consciousness. Seizures. |
| Hypothyroidism | Hypothyroidism occurs when there is a deficiency in the secretions of the thyroid gland. May be congenital or acquired. It is one of the most common disorders of the endocrine system in children. |
| The thyroid gland controls the rate of metabolism in the body by producing | thyroxine (T4) and triiodothyronine (T3) |
| Hypothyroidism Manifestations | Infant is sluggish and sleeps a lot. Tongue becomes enlarged, causing noisy respiration. Skin is dry. Hands and feet are cold. Infant feels floppy when handled. Hypotonic bowels. Hair dry and brittle. irreversible mental retardation. If untreated. |
| Children with Hypothyroidism may experience with treatment. synthetic hormone sodium levothyroxine (Synthroid or Levothroid). | Reversible Hair loss. Insomnia. Aggressiveness. Schoolwork may decline during first few months of therapy. |
| Synthetic hormone sodium levothyroxine (Synthroid or Levothroid) signs of overdose. | 1) Rapid pulse. 2) Dyspnea. 3) Irritability. 4) Fever. 5) Sweating. 6) Weight loss. |
| Synthetic hormone sodium levothyroxine (Synthroid or Levothroid) signs of inadequate medication | Fatigue. Sleepiness. Decreased Appetite. Constipation. |
| Hyperthyroidism. | Graves disease is associated with an enlarged thyroid gland and exophthalmos. It is thought to be caused by a serum thyroid-stimulating immunoglobulin, but no specific etiology has been identified. |
| hyperthyroidism manifestations | Emotional Liability. Physical restlessness. Voracious appetite with weight loss. Tachycardia, HTN and widened pulse pressure. Dyspnea on exertion. Exopthalmos. Goiter. Heat intolerance. Systolic Murmurs. Acute Thyroid storm. |
| Thyroid Storm | Severe irritability and restlessness. Vomiting and diarrhea. Hyperthermia. HTN and severe tachycardia. |
| Therapy is directed toward retarding the rate of hormone secretion. There are three ways to do this | (a) Antithyroid drugs. (b) Subtotal thyroidectomy. (c) Ablation with radioiodine. |
| Chvostek’s sign | facial muscle spasms elicited by tapping the facial nerve. |
| Trousseau sign | carpal spasm elicited by pressure applied to nerves of the upper arm. |
| Tetany | involuntary contraction of muscles |
| Diabetes Mellitus | a chronic metabolic condition in which the body is unable to use carbohydrates properly because of a total or partial deficiency of insulin. |
| Type I DM: | most common endocrine disorder of children. characterized by destruction of the pancreatic beta cells which produce insulin. This leads to absolute insulin deficiency. |
| Type II Dm: | usually arises because of insulin resistance, where the body fails to use insulin properly in addition to an insulin deficiency. This occurs primarily in adults. |
| Diabetes Mellitus Genetic Factors | 1) Type I DM is not inherited, but heredity has a role in its etiology. 2) Type II DM has a strong correlation to heredity with a 90 to 100% concordance. |
| Diabetes Mellitus Autoimmune Mechanisms | 1) An autoimmune process is involved in persons who develop type I DM. 2) There is also a strong association between type I DM and other autoimmune endocrine disorders such as thyroiditis and Addison’s disease. |
| Ketoacidosis: | When insulin is absent, glucose is unavailable for cellular metabolism and the body chooses other sources of energy, mainly fat. |
| DM Diagnostic Evaluation | Fasting blood glucose. Glucose Tolerance Test. |
| Management of DKA | 1) Rapid assessment. 2) Adequate insulin to reduce the elevated blood glucose levels. 3) Fluids to overcome the dehydration. 4) Electrolyte replacement. |
Created by:
jtzuetrong
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