Endocrine Flashcards by Tammy Phan

Hypopituitarism Sx

-Short (< 3% on chart)
-Delayed tooth eruption
-“Baby face”
-Delayed sexual development
-No intelligence issues
-Low IGF-1

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Hypopituitarism Dx

-Evaluate any child 2-3 SD below mean height or who is falling off the growth chart
-XR, MRI, growth hormone testing

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Hypopituitarism Tx

-Growth hormone replacement (SQ)
-Expensive (social support)
-Monitor for SE
-Foster independence
-Emotional support

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Hyperpituitarism Sx

-Child’s predicted height exceeds parental height
-Acromegaly
-High IGF-1

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Hyperpituitarism Tx

-Surgical removal of tumor/pituitary gland
-Radiation therapy
-High doses of sex steroids
-Make sure there’s no tumor of hypothalamus

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Diabetes Insipidus Sx

-Posterior pituitary gland
-Low ADH
-Tubules do not reabsorb water
-3P’s
-Increased serum Na, Osmolality
-Dehydrated
-Low vasopressin/anti-diuretic hormone
-Irritable
-Failure to thrive
-Lethargic
-N/V
-Constipation
-Caused by brain or kidneys

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Diabetes Insipidus Tx

-DDAVP (oral desmopressin acetate) results in reduced UOP, decreased thirst and nocturia
-Kidneys: thiazide diuretics
-Monitor Na and K levels
-Monitor I/Os
-Replace fluids (oral or IV)
-Educate for monitoring Sx, medication use, diet, daily weight

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SIADH

-Water intoxication
-Low Na
-Cellular edema
-Hypertension
-Distended JV
-Lung crackles
-Weight gain w/o edema
-High urine osmolality, urine specific gravity
-Low BUN

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SIADH Tx

-Restrict fluids
-Diuretics
-Demeclocycline blocks action of ADH at renal collecting tubules
-Hypertonic fluids
-Seizure risk due to hyponatremia
-Monitor Na, LOC, I/Os, labs

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Precocious Puberty Sx

-early puberty (8F, 9M)
-premature hormone secretion
-Short stature in adulthood
-Dx: LH, FSH, Testosterone

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Precocious Puberty Tx

-Support for the child concerning body image and sexuality
-Can be treated with surgery, radiation, chemo or medications
-Medication therapy
-Luteinizing releasing factor to slow down the progression of puberty

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Hypothyroidism Sx

-Screening 2-6d after birth
-T4 < 3
-TSH > 40
-Jaundice
-Constipation
-Feeding problems
-Cold skin
-Decreased crying
-Hypotonia (spazzed out arms)
-Large fontanel
-Thick tongue

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Hypothyroidism Tx

-Monitor growth and development
-Education on medications
-Infant stimulation programs
-Teach parents to take a pulse
-Vitamin D
-Levothyroxine 10-15mcg/kg/day (Synthroid)
-Sx of OD: irritability, rapid pulse, dyspnea, sweating, fever

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Hyperthyroidism Sx

-Causes: Grave’s disease
-High T3, T4
-Low TSH
-Tachycardia
-Tremor
-Excessive perspiration
-Irritability
-Weight loss
-Diarrhea
-Increased appetite
-Muscle weakness
-Fatigue
-Exophthalmos
-Non tender, big thyroid gland

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Hyperthyroidism Tx

-Monitor Sx
-Methimazole (Tapazole)
-PTU
-TID
-Propranolol
-Rest
-Diet
-Cool environment
-Radiation or surgery

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Hyperparathyroidism Sx

-Fatigue
-Exhaustion
-Lethargy
-Constipation
-High Ca, PTH

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Hyperparathyroidism Tx

-Resection of parathyroid
-Hypercalcemia prevention
-F/E monitoring and replacement
-Monitor Ca, P
-Educate signs of hypocalcemia

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Hypoparathyroidism Sx

-Low Ca
-High P
-Hyperirritability
-Muscle rigidity
-Seizures
-N/V
-ABD distention
-Dental/enamel hypoplasia
-Chvostek sign

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Hypoparathyroidism Tx

-High Ca foods
-Low P foods

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Cushing Syndrome Sx

-Causes: tumor
-Weight gain
-Moon face
-Buffalo hump
-Red striae on skin
-HTN
-Acne
-Deep voice
-High cortisol

Cushing Syndrome Tx

-Radiation
-Drug therapy
-Surgery

Congenital Adrenal Hyperplasia

-Causes: ambiguous genitalia
-Tall then short in adulthood
-Hypoglycemia
-N/V
-dehydration
-low BP
-low Na
-High ACTH

Congenital Adrenal Hyperplasia Tx

-Adrenal secretion suppression
-Support

Addison Disease Sx

-Shock if untreated
-Low cortisol
-Weakness/fatigue
-Emotional lability
-Salt craving
-Hyperpigmentation
-Irritability
-N/V
-Diarrhea
-ABD pain
-Fever
-Anorexia
-Hypoglycemia

Addison Disease Tx

-Replace deficient hormones -Fluids

Pheochromocytoma Sx

-Adrenal gland tumor -High NE, E -HTN -Tachycardia -Arrhythmias -Triad: HTN, DM, HTN crisis

Pheochromocytoma Tx

-Removal of identified tumors

DM Type 1 Sx

-fasting glucose > 120 -3P's -fatigue -confusion -dry skin -loss of DTR -weight loss -ketonuria

DM Type 1 Tx

-IV fluids to regulate acidosis -Strick I/Os -Monitor BG -Low fat/carb diet -HgbA1C q3 months -Normal 4-7% -High = DM -Insulin: room temp, discard after 1m, SQ, IV for regular only

DM Type 1 Complications

-Retinopathy -Heart Disease -Renal failure -Peripheral vascular disease

DKA

-Type 1 -BG > 250 -pH < 7.3 -Bicarb < 15 -Ketonuria -High BUN, Cr, K, Cl -Low Na, P, Ca, Mg -3P's -Weight loss -ABD pain -N/V -Tachycardia -Dehydration -Flushed face -Kussmaul -Fruity breath -AMS -Hypotension

DKA Tx

-IV insulin -NS until BG hits 250-300, then D5 1/2 to prevent hypoglycemia -Replace K

Hypoglycemia Sx

-Causes: too much insulin, missed meals, strenuous exercise w/o nutrition -BG < 70 -Diaphoresis -Tremors -Hunger -Weakness -Pallor -coma -Seizures -Death

Hypoglycemia Tx

-Replace glucose -Juice/soda -Severe: cake frost, glucagon

DM Type 2

-gradual onset -fasting glucose > 120 -Acanthosis Nigricans -Obesity -no 3P's -HTN Lipid disorders

DM Type 2

-Normalize blood glucose and HbA1c levels (<6.5%) -Decrease weight -Increase exercise -Normalize lipid profile and blood pressure -Nutrition education, emotional support -Metformin improves sensitivity of target cells to insulin -GLP-1 SQ - 10-12+ years old

Gynecomastia Sx

-Enlarged breast tissue in men -Estrogen > testosterone -Lasts 1-2 years -Causes: Klinefelter, drugs that increase circulating concentration of prolactin

Amenorrhea Sx

-Lack of periods -Primary: no growth/development at 14.5y/o -Secondary: growth/development at 16y/o

Amenorrhea Tx

-OC -High caloric diet -Ca supplement

Turner Syndrome Sx

-Missing X chromosome in women -oocytes gone by 2y/o -Peripheral lymphedema -Webbed neck -Low hairline -Short

Turner Syndrome Tx

-Monitor growth -Growth hormone therapy -Low dose estrogen and progesterone therapy

Klinefelter Syndrome Sx

-Extra X chromosome in men -Low androgen -Sexual dysfunction -Tall -Delayed language -Delayed auditory -Decreased testicular size -Gynecomastia

Klinefelter Syndrome Tx

-Testosterone therapy

Phenylketonuria

-High phenylalanine -Musty body/urine odor -Irritable -N/V -Hyperactivity -Hypertonia -increased DTR -Seizures -Rash -Lighter skin tone -Dx: Guthrie screening

Phenylketonuria Tx

-Low protein diet -No bread, cheese, eggs, flour, meat, poultry, fish, nuts, milk, legumes, aspartame -Frequent urine/blood tests

Galactosemia Sx

-low GALT (liver enzyme) -high galactose in eyes, liver, kidneys, brain -Failure to gain weight -Untreated = sepsis, death after 1m

Galactosemia Tx

-Lactose/galactose free formula -No dairy, food coloring, lactose

Maple Syrup Urine Disease

-poor appetite -lethargy -N/V -variable muscle tone -irritability -sweet odor in bodily fluids

Maple Syrup Urine Disease Tx

-Special diet w/ 3 amino acids removed