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Endocrine Disorders in Children

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
show Phenylketonuria (PKU) not an endocrine disease  
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____ is needed to form melanin, epinephrine and thyoxine   show
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show brains and CNS  
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show caucasian  
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Diagnostic test for PKU includes ___ blood test   show
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show 4  
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clinical manifestations of PKU   show
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show True  
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show 20-30mg of phenylalanine  
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show False - as long as the mother is careful about monitoring her diet  
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show low-protein breads and pasta, veggies, fruits and juices  
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show chicken, steak, pork chops, hamburger, milk, eggs, cheese, refried beans, nuts and peanutbutter  
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show NutraSweet, Equal and some meds with artificial sweetner  
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show True - even after brain is fully developed  
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show congenital hypothyroidism  
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Most congenital hypothyroidism is due to ____   show
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Congenital hypothyroidism is due to ____ recessive trait   show
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show poor feding, lethargy, prolonged neonatal jaundice, resp difficulty and bradycardias, constipation, hoarse cry, and large fontanels  
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manifestations of congenital hypothyroidism after 6 weeks of age:   show
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Diagnosis of congenital hypothyroidism includes a blood test to measure ___ levels   show
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show True  
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show prevent progressive deterioration of the nervous system and MR  
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show thyroid hormone - Synthetic Levothyroxine Sodium (Synthroid or Levothyroid)  
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Prognosis of congenital hypothyroidism if hormone replacement is started shortly after birth   show
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show irritability or nervous, tremor or insomnia, loose stools, wt loss, increase appetite, fever, sweating, tachycardia and palpitations  
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show fatigue, sleepiness, decreased appetite and constipation  
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show pituitary  
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show panhypopituitarism - result of trauma, hypoplasia, tumor, irradiation and all hormones of the pituitary need to be replaced  
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show short stature  
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Diagnosis of Growth Hormone Deficiency - Any child who is only as tall as children ____ or more years younger or who falls away from previously normal growth curve should be evaluated by a doctor preferable a pediatric endocrinologist.   show
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The diagnostic evaluation of growth hormone deficiency is aimed at identifying any ____ cause for the problem.   show
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A diagnostic evaluation for short stature includes ____ surveys including epiphyseal maturation and bone age   show
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What percentage of growth hormone is produced during sleep   show
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show no growth hormone is present or that the amount of growth hormone is not enough  
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show 80%  
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show epiphyseal  
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show 25-50mcg/kg  
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show 4-4.8" 1st yr then 2.7-3.5" following year  
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show precocious puberty - being reevaluated for girls to age 7 caucasian and 6 for african american  
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show hault the progress of sexual development  
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Drug used to block the body's production of the sex hormone to treat precocious puberty   show
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LHRH and synthetic hormones to treat precocious puberty is discontinued when   show
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T/F a child with precocious puberty should dress appropriate for their development   show
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show sexual, even though the child is fertile  
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show contraception - unless sexually active  
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Congenital Adrenal Hyperplasia causes increases of what three hormones from the adrenal gland   show
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Adrenals normally synthesize ____ from cholesterol to secrete the hormones   show
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show The only thing being produced by the fetal adrenal gland is androgens so an excess is produced resulting with femal ambiguous genitalia  
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show ambiguous genitalia from congenital adrenal hyperplasia  
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show females present with ambiguous genitalia at birth, both male and female present with a salt-losing adrenal crisis in the first weeks - shock, dehydration, and elevated K+ levels  
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Non-classic salt wasting of congenital adrenal hyperplasia signs include   show
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show girls do not have ambiguous genitalia, less severly affected infants with variable manifestations  
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show stress  
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show 17-ketosteroid  
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Tx for congenital adrenal hyperplasia   show
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Hydrocortisone (cortisol) treats congenital adrenal hyperplasia by   show
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show stress, surgery, infection, and illness  
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Medications for Salt-Losers with congenital adrenal hyperplasia   show
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show masculization  
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show dwarfed adults  
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males without tx for congenita adrenal hyperplasia will be ____ as an adult   show
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show 17 months (old enough to experience surgery but before aware of abnormal genitalia)  
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show Type 1 diabetes  
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Type 1 diabetes is more prominent in ____ and an absolute ____ deficience   show
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factors behind type 1 diabetes is ____ predisposition and ____ factors such as viral illness, toxins, & cows milk which trigger an autoimmune response   show
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Incidence of type 2 diabetes has increased in recent years due to   show
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show Non-european  
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show 3P's (polyuria, polydipsia, polyphasia) weight loss, ketonuria, hyperglycemia, fatigue, and irritability  
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clinical manifestations of type 2 diabetes   show
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90% of children with type 2 diabetes have ____ nigricans which is a velvety hyperpigmented area in skin folds   show
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___ is the only oral diabetic agent approved for youths   show
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show life style and risk factors of the entire family  
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Diagnosis of diabetes in children fasting blood sugar on two occasions   show
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____ - administration of glucose to determine how quickly it is cleared from the blood is one of the diagnosis used for type 1 diabetes   show
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show achieve glycemic control, promote normal growth and development, and prevent or delay complications  
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show 100-200  
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show B4 meals = 100-180, Bedtime 110-200, A1c 7.5% - 8.5%  
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show B4 meals 90-180, Bedtime 100-180, A1c less than 8%  
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show B4 meals 90-130, Bedtime 90-150, A1c less than 7.5%  
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The younger a pt is with diabetes the higher the rates of desired blood glucose levels due to thier ____   show
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Shortly after insulin therapy, the pancrease kicks in one last time and releases exogenous insulin for a period of time is called   show
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___ destruction will continue during the honeymoon period and continue to give low doses of insulin   show
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Rapid acting insulin - onset peak and duration   show
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show Regular insulin (Humulin R) (Novolin R) Onset30-90 minutes, Peak 2-4 hours, Duration 5-7 hours  
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Intermediate-acting insulin - onset, peak, duration   show
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Long-acting insulin - onset, peak and duration   show
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show Long-acting Insulin glargine (Lantus)  
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Insulin is given ____ injection at least ___ tims a day   show
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show multiple to cover food intake and once at night (Lantis) for bedtime basal control of 24 hours  
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show True  
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Advantages of the insulin pump   show
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The insulin pump allows for ____ baseline infusion with intermittent boluses as determined by user   show
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show blood sugar, activity and diet  
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How many times must blood sugar be monitored for a pt with an insulin pump   show
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show subcutaneous  
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How often are needles changed in an insulin pump   show
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show One hour per day  
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____ is the main food that raises blood sugar no matter its source and must be counted to determine how much insulin is needed   show
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show dietitian  
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One serving of starch, fruit, or milk is equal to ____ grams of carbohydrates   show
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T/F vegetables are counted as carbs   show
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show reasonable amounts  
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show prohibited  
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show 15  
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show exercise/Physical Activity  
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Exercise ____ blood sugar and helps ____ to enter the cell more readily   show
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show hypoglycemia  
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show 240, splitting ketones  
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How long after activity can glucose drop   show
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show decreases = hypoglycemia  
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Mild symptoms of hypoglycemia   show
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Moderate reactions of hypoglycemia   show
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show seizures, semi comatose or coma, slurred speech, staggering gait, combative, confused  
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show 10-15 grams of simple carbohydrates followed by complex carbs and retest blood sugar in 15-30 minutes  
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Severe tx of hypoglycemia   show
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show Hyperglycemia - b/c stress can cause the cells to reduce their sensitivity to insulin and the sugars can not be carried into the cells  
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show Hyperglycemia  
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Gradual onset of hyperglycemia includes   show
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Quick reference between manifestations of hyper and hypo glucemia   show
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show Puberty  
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show diabetic ketoacidosis  
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show diabetic ketoacidosis  
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Blood sugar above 240 and pH less than 7.3 is an indication of   show
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show ketosis, ketonuria, impaired consciousness, fruity odor to breath, Kussmal's respirations (quick and shallow), dehydration and electrolyte embalances  
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show insulin  
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How much fluid should a type 1 diabetic who is ill try to take   show
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How often should a type 1 diabetic check blood sugar when ill   show
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Notify healthcare provider if type 1 diabetic ill patient has blood sugar over ____ and is vomiting   show
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show Infancy -  
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____ issues can mask the polyuria sign of type 1 diaetics in toddlers   show
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At which stage is it a problem to correctly identify and treat hypoglycemic episodes   show
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show fear of sticks, finicky eating patterns and poor appitite, and temper tantrums  
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During the preschool stage the child may interpret diagnosis of diaetes as ____ for real or imagined offenses   show
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Preschool children may suffer a set back in ____ and need positive reinforcement   show
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Preschoolers also fear injections, and have unpredictable ____ and food intake which lead to hypoglycemic episodes   show
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show coordination  
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show active role in his own care with adult supervision  
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show dietary  
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Adolescense with diabetes deal with body image concerns and ____ pressure as well as behavioral experimentation, loss of control and ___ skills   show
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show nurses  
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show control  
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show Phenylketonuria (PKU) is an inborn error of metabolism caused by a deficiency or absence of the enzyme needed to metabolize the essential amino acid phenylalanine. Phenyketones are metabolites of phenylalanine, excreted in the urine.  
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Early diagnosis of CH and PKU is essential to prevent which of the following? A. Obesity B. Diabetes C. Mental retardation D. Respiratory distress   show
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show Type 1 has an abrupt onset unlike type 2. Ketoacidosis is more common in type 1 rather than in type 2. Type 1 diabetes typically has its onset before the age of 20 with a peak incidence between ages 10 & 15 yrs old. Oral agents are only used for type 2.  
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show Hallmarks of diabetes mellitus are polyuria, polydipsia, and polyphagia.  
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show B. Adrenal cortex  
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show S/S of hypoglycemia are treated with a rapid-releasing sugar source followed by a complex carbohydrate & protein. Milk supplies lactose & prolonged action from the protein. The bread is a complex carbohydrate, peanut butter provides a sustained action  
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show Exercise lowers blood glucose, reducing the need for insulin. Extra snacks are provided to maintain the blood glucose levels.  
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