Endocrine

Question 1

Growth Hormone Deficiency - Cause

Answer 1

often due to hypothalamic dysfunction and decreased pituitary activity

Question 2

Growth Hormone Deficiency - Clinical Signs:

Answer 2

Normal birth size but slow growth (<5 cm/year) below 3rd percentile by age 1.

Question 3

Growth Hormone Deficiency Other Symptoms:

Answer 3

Hypoglycemic seizures, micropenis, undescended testes, neonatal jaundice

Question 4

Growth Hormone Deficiency Diagnosis:

Answer 4

GH level tests, hand x-rays for bone growth, endocrine studies, family history

Question 5

Growth Hormone Deficiency Treatment:

Answer 5

GH Injections, possibly other hormone replacements (thyroid, cortisone, sex hormones)

Question 6

Growth Hormone Deficiency Considerations:

Answer 6

Bedtime injections for better effect, family support for body image and cost concerns.

Question 7

Hypothyroidism Causes:

Answer 7

Primary (thyroid failure) or central (pituitary/hypothalamic dysfunction).

Question 8

Hypothyroidism Symptoms in Infants:

Answer 8

Thick tongue, hypotonia, constipation, hoarse cry, large fontanelles

Question 9

Hypothyroidisms Symptoms in Children:

Answer 9

Dry Skin
hair loss
bradycardia
cold intolerance
goiter
Depressed deep tendon reflexes
decreased appetitie

Question 10

Hypothyroidism Diagnosis:

Answer 10

Increased TSH
decreased T3/T4.

Question 11

Hypothyroidism Treatment:

Answer 11

Lifelong levothyroxine with dose adjustments.

Question 12

Hypothyroidism Newborn Screening:

Answer 12

Prevents intellectual disability and growth delay.

Question 13

Precocious Puberty Definition:

Answer 13

Early puberty (<9 in boys, <8 in girls).

Question 14

Precocious Puberty Causes:

Answer 14

Adrenal/gonadal tumors
early activation of GnRH
No known cause 80% of boys, 50% of girls

Question 15

Precocious Puberty Symptoms:

Answer 15

Tall for age
early secondary sex characteristics
advanced bone age

Question 16

Precocious Puberty Treatment:

Answer 16

GnRH analogs (Lupron) to slow early puberty. Failure to treat can result in stunted growth as children with this have advanced bone age. Removing tumor

Question 17

Precocious Puberty Concerns:

Answer 17

Advanced bone age leads to short adult stature if untreated.

Question 18

Precocious Puberty Family Education:

Answer 18

Emphasize normal emotional development despite early physical changes, promote positive body image, family education

Question 19

Precocious Puberty Assessment

Answer 19

tanner staging
height/weight
psychosocial - body image

Question 20

Type 1 DM Cause:

Answer 20

Autoimmune destruction of beta cells. Hyperglycemia resulting from defects in insulin secretion and or action

Question 21

Type 1 DM Peak Ages:

Answer 21

4-6 years
10-14 years.

Question 22

Type 1 DM Symptoms:

Answer 22

Polyuria
polydipsia
Weight Loss
Fatigue
Ketoacidosis

Question 23

Type 1 DM Treatment:

Answer 23

Insulin therapy
glucose monitoring
Diet Control

Question 24

Type 1 DM Insulin:

Answer 24

Given subcutaneously (abdomen, arms, thighs). Rapid-acting before meals.

Question 25

Type 1 DM Insulin Dosing I/C Ratio:

Answer 25

Carbs/insulin ratio (e.g., 1:20 means 1 unit insulin per 20g carbs).

Question 26

Type 1 DM Insulin Dosin Correction Factor (CF)

Answer 26

Correction Factor (CF): Adjusts for high blood sugar (e.g., CF 50 means every 50 mg/dL above target, 1 extra unit of insulin).

Question 27

Diabetic Ketoacidosis (DKA) Definition:

Answer 27

Blood sugar >200 mg/dL ketonemia PH <7.3

Question 28

Diabetic Ketoacidosis (DKA) Causes:

Answer 28

Missed Insulin illness Trauma

Question 29

Diabetic Ketoacidosis (DKA) Symptoms:

Answer 29

Dehydration fruity breath Kussmaul respirations

Question 30

Diabetic Ketoacidosis (DKA) Treatment:

Answer 30

IV fluids insulin Electrolyte replacement

Question 31

Diabetic Ketoacidosis (DKA) Complications:

Answer 31

Cerebral Edema

Question 32

Diabetic Ketoacidosis (DKA) Nursing Care:

Answer 32

Teach family about insulin ketone testing emergency care

Question 33

Addison’s Disease (Adrenal Insufficiency) Cause

Answer 33

Deficiency in cortisol and aldosterone.

Question 34

Addison’s Disease (Adrenal Insufficiency) Symptoms:

Answer 34

Fatigue, hyperpigmentation, low BP, hypoglycemia

Question 35

Addison’s Disease (Adrenal Insufficiency) Diagnosis:

Answer 35

ACTH stimulation test.

Question 36

Addison’s Disease (Adrenal Insufficiency) Treatment:

Answer 36

Corticosteroid replacement.

Question 37

Addison’s Disease (Adrenal Insufficiency) Nursing Considerations:

Answer 37

Monitor for adrenal crisis (severe hypotension, shock).

Question 38

Cushing’s Disease (Excess Cortisol) Cause:

Answer 38

Pituitary tumor (excess ACTH) or prolonged steroid use

Question 39

Cushing’s Disease (Excess Cortisol) Symptoms:

Answer 39

Moon face, truncal obesity, muscle wasting, striae.

Question 40

Cushing’s Disease (Excess Cortisol) Diagnosis:

Answer 40

24-hour urine cortisol, dexamethasone suppression test

Question 41

Cushing’s Disease (Excess Cortisol) Treatment:

Answer 41

Surgery or medication

Question 42

Cushing’s Disease (Excess Cortisol) Nursing Considerations:

Answer 42

Monitor for adrenal insufficiency after treatment

Question 43

Turner Syndrome (45, X) Symptoms

Answer 43

Short stature, webbed neck, heart defects, infertility

Question 44

Turner Syndrome (45, X) Treatment:

Answer 44

Growth hormone estrogen replacement.

Question 45

Klinefelter Syndrome (47, XXY) Symptoms

Answer 45

Tall, infertile, learning difficulties

Question 46

Klinefelter Syndrome (47, XXY) Treatment

Answer 46

Testosterone replacement

Question 47

What is considered the master controller?

Answer 47

Hypothalamus

Question 48

5 Horomones

Answer 48

GH (Growth) - Bones and muscles ACTH (Adrenocorticotropin) - Adrenal TSh (Thyroid) FSH, LH (Gonadotropic) - Testes and ovaries MSH (Melanocyte) - Skin

Question 49

Growth Hormone Deficiency (GHD) Prognosis

Answer 49

Successful in 80% treated children - 3 to 4 cm/yr BEFORE treatment and 8 to 9 after

Question 50

Hypothyroidism Nursing Considerations

Answer 50

Plot growth, education

Question 51

Euthyroid

Answer 51

Normal TSH/T4

Question 52

Hyperthyroidism

Answer 52

Low Tsh High T4

Question 53

Hypothyroidism

Answer 53

High TSH LowT4

Question 54

Type 1 DM - Patho

Answer 54

deficiency of insulin, glucose is unable to enter the cell and remains in blood causing hyperglycemia when glucose exceeds the renal threshold, spills into urine. Cell break down protein and fat for conversion to glucose by liver

Question 55

Type 1 DM Sick Day Rules

Answer 55

required insulin may need to be adjusted, don’t skip doses, fluids, urine for ketones

Question 56

Rapid Insulin

Answer 56

Give w/in 15 minutes of a meal - watch small kids who don't eat full meals

Question 57

Intermediate insulin

Answer 57

Not used often in children - cloudy

Question 58

Long Acting Insulin

Answer 58

Most common for type 1 - cant be used with any other insulin in same syringe