endocrine disorders Flashcards by Celene Lopez

SIADH

-____ excess
-increased w___ a____
-decreased u___ o____

ADH
water absorption
urine output

How well did you know this?

Not at all

Perfectly

Diabetes insipidus

-____ deficit
-decreased w___ a____
-increased u___ o____
-d____
-high s____

ADH
water absorption
urine output
dehydration
sodium

How well did you know this?

Not at all

Perfectly

Cerebral salt wasting
-increased a____ n____ hormone
-u___ s____ excretion
-di____
-h____
-e____ or h_____

atrial natriuretic hormone
urine sodium
diuresis
hyponatremia
euvolemia
hypovolemia

How well did you know this?

Not at all

Perfectly

SIADH management
–restrict ____
–restrict ____
–monitor __/___ and e____
–administer d___ use 0.9 % ___

sodium
fluids
I/Os and electrolytes
diuretics–NS

How well did you know this?

Not at all

Perfectly

DI management
–administer v___ first then d___
–give f___ r____
–monitor f__ and e____

vasopressin
DDAVP
fluid replacement
fluid and electrolytes

How well did you know this?

Not at all

Perfectly

DKA presentation
h____, k___ formation, l___ a___, g___ m___ a___

hyperglycemia
ketone
lactic acidosis
gap metaboic acidosis

How well did you know this?

Not at all

Perfectly

Key DKA exam finding?

kusmmal respirations

How well did you know this?

Not at all

Perfectly

DKA urine ketone diagnostic level is > ___ mmol/L

How well did you know this?

Not at all

Perfectly

DKA management
1) __ mg/kg b____ (slow replacement)
2)__ x M___ in the first 24 hours
–then decrease to __-___ x m___
3) i___ infusion
—___ units/kg/hr

10 ml/kg bolus
2 X MIVF
—1-1.5 X MIVF

insulin
0.1 units/kg/hr

How well did you know this?

Not at all

Perfectly

Once glucose in a child with DKA decreased to 250-300, add g____

glucose

How well did you know this?

Not at all

Perfectly

DKA management
–use a 2-bag system, if glucose decreases faster than ___ dL/hr

100

How well did you know this?

Not at all

Perfectly

In DKA replenish
p___ and p____

potassium
phosphorus

How well did you know this?

Not at all

Perfectly

DKA management
–convert to SQ insulin once __ and ___ are normal

pH and HCO3

How well did you know this?

Not at all

Perfectly

DKA cerebral edema presents with cushings triad = H____, b___, r__ d___

hypertension
bradycardia
respiratory depression

How well did you know this?

Not at all

Perfectly

Assess for DKA cerebral edema with a ?

How well did you know this?

Not at all

Perfectly

DKA cerebral edema management
1)m____ __-__ gm/kg
2)__% h___ s____

mannitol 0.5-1gm/kg
3% hypertonic saline

How well did you know this?

Not at all

Perfectly

adrenal insufficiency usually presents during times of s___
s/s include
h___, h___, we___, an____, __/___

stress
hypotension, hypoglycemia, weakness, anorexia, n/v

How well did you know this?

Not at all

Perfectly

adrenal insufficiency management is with g____

glucocorticoids

How well did you know this?

Not at all

Perfectly

adrenal crisis is rapid and overwhelming
It presents with
h____, fa____, vo____, mu___ pa___, an___, and we___ lo____

*management is with g_____

hypotension
fatigue
vomiting
muscle pain
anorexia
weight loss

–glucorticoids

How well did you know this?

Not at all

Perfectly

What is the most common 21-hydroxylase deficiency?
co____ ad_____ h____

congenital adrenal hyperplasia

How well did you know this?

Not at all

Perfectly

Congenital adrenal hyperplasia presents in newborns with
a___ g____, sa____ w___, sh____, decreased co____ and al_____

ambiguous genitalia
salt wasting
shock
cortisol and aldosterone

How well did you know this?

Not at all

Perfectly

congenital adrenal hyperplasia lab findings include
h____
h____ and d_____

hyperkalemia
hyponatremia
dehydration

How well did you know this?

Not at all

Perfectly

Congenital adrenal hyperplasia management
–administer f____
–give h______

fluids
hydrocortisone

How well did you know this?

Not at all

Perfectly

Thyroid storm (due to untreated hyperthyroidism) is a life-threatening condition presenting with
h____, fe____, ta___, and sw_____
—-at biggest risk for c___ and pu___ ed____

hypertension
fever
tachycardia
sweating

CHF
pulmonary edema

How well did you know this?

Not at all

Perfectly

Hyperthyroidism and thyroiditis treatment is with P___ and. me____

PTU (propylthiourcacil) methimazole

Hypothyroidism is often associated with other disorders such as t____ d___ and a______ disease

trisomy 21 diabetes autoimmune disorders

in hypothyroidism T4 will be and TSH will be

low high

Sick euthyroid occurs during times of critical illness management is s____

supportive --resolves once critical illness passes

polyhydramnios is associated with c___ a____ and s_____

congenital anomalies syndromes

oligohydramnios is associated with I____

IUGR

What is the leading cause of deafness and blindness? C_____ s___

CHARGE syndrome --autosomal dominant ---CDH7 mutation

C___ of the e____ H____ defects A___ of n____ R_____ of growth and development G_____ abnormalities E___ abnormalities/d___

coloboma of eye heart defects atresia of nares retardation genitourinary ear/deafness

Adolescents with CHARGE syndrome may require _____ replacements

hormone

Children with Trisomy 21 are at increased risk for a___-a____ i____ leading to s___ c___ i____ ----for symptomatic kids obtain c__ r___

atlantoaxial instability spinal cord injury cervical radiographs

50% of children with down syndrome will have a____ v____ c____ defects

atrial ventricular canal defects

turner syndrome most commonly affects?

girls --will have a normal lifespan

Turner syndrome is associated with *in_____ *h___ and v____ problems *co____ of a____ *ho___ ki_____ *ly_____ in babies

infertility hearing and vision coarctation of aorta horseshoe kidneys lymphedema

What is the most common form of inherited intellectual disability?

Fragile X --will have a normal lifespan --Begin behavioral therapy early

Trisomy 18 (Edwards) *____ predominance *profound i___ d____ *managed with p___ c___ and/or h____

female intellectual disability Palliative care and/or hospice ---50% are stillborn ----10% dont survive past 1 YOA

Achondroplasia (dwarfism) **monitor for s___ deformities **managed h____ **monitor for o___

spinal hydrocephalus OSA

Marfan syndrome is a connective tissue disorder, these children are at high risk for **ao___ di____ **re___ de____ **sp___ pn_____

aortic dilation retinal detachment spontaneous pneumothorax

Marfan syndrome management **b__ b___ therapy **e___ restriction **serial E____

beta-blocker therapy exercise restriction serial ECHOs

22q112 deletion =

DiGeorge syndrome --delayed --low ears absent kidneys --conductive hearing loss prone

Children with DiGeorge syndrome (velocardiofacial syndrome) are at greatest risk for **i______ **h_____

immunodeficiency --low T-cell hypocalcemia ---need daily calcium

DiGeorge syndrome management **c____ administration **monitor for recurrent r___ i__ **@ 4 YOA begin c__/s___ f___

calcitrol respiratory infections cervial/spinal films

What is the first clue of Vacterl syndrome diagnosis? si____ u____ a____

single umbilical artery

Williams syndrome is associated with **se__ defects **h___ **st___ ir____

septal defects --Cardiac involvement determines life expectancy hyperkalemia starburst irisi

Dog, cat, human bite management **first-line outpatient =a ____ **first line inpatient= =a____-su____

augmentin ampicillin-sulbactam

Snakebite management **a____ if indicated **t____ v____ administration

anti-venom tetanus vaccine

Brown recluse spider bite ---ongoing monitoring for the development of t___ n____

tissue necrosis

black widow bite management ---acute p____ --obtain c___ studies and an E___

pain coagulation EKG

Necrotizing fascitis organisms include?

group a strep and staph ---severe toxic appearance with skin edema (monitor for compartment syndrome)

Stevens-Johnson (erythema multiform) is characterized by b___ and f____

blistering and fever

What medications most often cause Stevens-Johnson (erythema multiform) an_____ su___ au____ ba___ N____

antiepileptics sulfonamides augmentin bactrim NSAIDs

Stevens-Johnson (erythema multiform) management *p___ control *bl___ prevention

pain control blindness

bullous impetigo treatment --au____ + ce____

augmentin cephalosporins ---large blisters in armpit, groin, fingers, toes

UTI txt 1)b___ 2)c___ (k___)

bactrim keflex

Pyelonephritis --identify the organism in. the b____ --monitor for r___ s____

bloodstream renal scarring

Testicular torsion diagnostic test is via an _____

ultrasound

Males with testicular torsion present with s___ onset of p___ in one t____

sudden onset of pain in one teste ---surgical emergency ovarian torsion also an emergency

renal tubular acidosis = m___ a____ + n___ a___ g___

metabolic acidosis normal anion gap

renal tubular acidosis management **replace b____

bicarb -Prevent renal failure

What is the most common type of renal failure?

pre-renal failure --seen in trauma and shock --reversible

intrinsic renal failure labs --elevated c___, p___, u__ a___

calcium phosphorus uric acid

nephrotoxic medications g____ a_____

gentamycin acyclovir

postrenal failure is due to o___ t___ o____

outflow tract obstruction --anything that obstructs kidneys

Indications for dialysis include h____ severe f___ o___ a____

hyperkalemia fluid overload azotemia

Nephrotic syndrome presents with a___ and p_____

albuminuria proteinuria

Txt nephrotic syndrome with?

corticosteroids

Nephrotic syndrome s/s e___ we___ g___ fl___ r____ pr____ fa____

edema weight gain fluid retention proteinuria fatigue

HIV testing requires?

parental consent

To determine risk for opportunistic infections in HIV + children, obtain c___ measurements

CD4 ---vaccinate during high CD4 counts

JIA is diagnosed when arthritis s/s are present for > ___ weeks

In a child with JIA, what lab determines uveitis risk?

+ ANA

First line JIA management is with?

NSAIDs followed by steroids

The risk for SLE increases in?

adolescent females

Kawasaki imaging -obtain an?

ECHO

In a child with Kawasaki obtain an EchO at time of diagnosis --__ weeks post dxs and --_-__ weeks posts dxs

2 6-8

evaluate for cardiomegaly with a?

chest x-ray

Kawasaki management 1) I___ 2) A____

IVIG Aspirin

Initial Kawasaki aspirin dosing is __-__ mg/kg/day --Once afebrile decrease aspirin dosing to __-__ mg/kg/day for __-__ weks

80-100 mg/kg/day 3-5 mg/kg/day 6-8 weeks

In a child with Kawasaki, aspirin is continued indefinitely if c___ a____ abnormalities are present

coronary artery

GI decontamination activated charcoal dose __ g/kg ---Repeat doses are dosed at __ g/kg

1 gm/kg 0.5 g/kg --contraindicated if the airway unprotected or it pt has an abnormal gi tract

Whole bowel irrigation = m___ or g___ administration

miralax or golytley -contraindicated for obstruction or perforation

Whole bowel irrigation is used for i___ tablet ingestion po____ ingestion li___ ingestion

iron potassium lithium

Alcohol/ethanol ingestion impairs g____ -children may become h___ as far at __ hours post ingestion

gluconeogenesis hypoglycemic 6

facial flushing, vomiting, diaphoresis, hypotension, hypothermia, hypoglycemia, lethargy, slurred speech, ataxia, seizures, respiratory depression, stupor, coma = a____/____ ingestion

alcohol/ethanol ingestion

ethylene glycol ingestion (antifreeze) complications may occur __-___ hours post ingestion

6-12

ethylene glycol ingestion (antifreeze) complications a___ g___ m___ a____ re___ t___ i____ h_____

anion gap metabolic acidosis renal tubular injuries hypocalcemia

In a child with ethylene glycol ingestion (antifreeze) GIVE -____ or et____

4MP ethanol

Treat a child with ethylene glycol ingestion (antifreeze) with dialysis when ethylene glycol level is > ____mg/dL or if the patient is refractor to txt

isopropyl ingestion (found in rubbing alcohol) had no antidote. When IPA level is > ____ mg/dL begin dialysis

500

Methanol (found in antifreeze, paint strippers) antidote = fo____ or et____

fomepizole ethanol

Kids with tylenol ingestion recover within __-__ days s/p ingestion

5-7

Acetaminophen overdose **> _____ mg/kg in kids less than 6 YOA **___ gm in teens

200 10g

The Tylenol antidote N-acetylcysteine is most effective is given within ___ hours of ingestion TXT regimens 1) ___ hours of oral therapy 2)___ hours of IV therapy

8 72 21

salicylate ingestion s/s ti____ + ar____

tinnitus arrhythmias

Refer a child with salicylate ingestion to ER if > ___ mg/kg or ___ grams of aspirin was ingested

> 150 65

iron ingestion toxicity s/s --within __ hours, children develop __/__/__, and b__ s___

6 n/v/d bloody stools

iron toxicity likely when > ___-___ mg/kg is ingested

40-60 mg/kg

Iron ingestion management --o___ l___ within 1 hour

orogastric lavage

iron antidote =

deferoxamine

opiod ingestion s/s triad c___ depression, r___ depression, m___

CNS respiratory miosis

organophosphate (insecticide) ingestion txt pra____ ch___ and at____

pralidoxime` chloride atropine

beta blocker ingestion is fatal due to decreased?

contractility

endocrine disorders Flashcards

(105 cards)