Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NP > Peds - Endo > Flashcards

Peds - Endo Flashcards

1
Q

Which type of diabetes is more commonly associated which ketones?

A

Type I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What markers are associated with Type I Diabetes?

A

HLA-DR3
HLA-DR4

human leukocyte antigens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What markers are associated with Type II Diabetes?

A

None

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the general pathophysiology of Type I Diabetes?

A

at symptom presentation most of the pancreatic ISLET cells have been destroyed and islet cell ANTIBODIES are detected (AUTOIMMUNE process)

What is the trigger?
infectious or toxic insult to pancreatic cells of genetically predisposed individual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Three P’s which are classic symptoms of Type I Diabetes?

A

Polydipsia
Polyphagia
Polyuria

seen less commonly in Type II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Other symptoms of Type I Diabetes? (6)

A 
o  weight LOSS, with INCREASED hunger
o  fatigue
o  weakness
o  paresthesia
o  irritability --> coma
o  nocturnal enuresis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Signs of advanced Type I Diabetes found on physical exam? (3)

A

EYES, VASCULATURE, NEURO (reflexes)

o ophthalmic exam – microaneurysms or cotton wool spots
o peripheral vascular insufficiency (sensation impaired)
o diminished deep tendon reflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Random blood sugar of ____ and what other symptoms indicated the need for fasting studies.

A 
Random blood sugar >/=200 mg/dL
AND
polydipsia
polyuria
weight loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Diagnostic laboratory study for Type I Diabetes?

A

Fasting blood sugar >/= 126 mg/dL on 2 occasions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Normal A1c?

A

5.5 to 7 %

target for good diabetic control? 6%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

A1c of 4.8% in a diabetic indicates what?

A

Blood glucose is too tightly controlled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is IMPAIRED GLUCOSE TOLERANCE and how is it measured?

A

can be thought of as “pre-diabetes” where fasting BG is elevated, but not to 126 threshold for Diabetes

FBG between 100 and 125 mg/dL

encourage exercise

bring back in 3 - 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What do ketones mean from a management perspective?

A

patients presenting with ketones must start INSULIN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the rule of thumb for initiating insulin?

A

0.5 units/kg/day with 2/3 in AM and 1/3 in PM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

NPH is ___ acting.

A

short

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Somogyi Effect and Dawn Phenomenon both result in:

A

HYPERglycemia in the morning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Somogyi Effect is characterized by what pattern? What is the cause?

A

HYPOglycemia around 3 AM and HYPERglycemia by 7 AM

nocturnal hypoglycemia stimulates a surge of counter regulatory hormones that raise blood sugar

(Somogyi is Tsunami - low then high)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Treatment for Somogyi Effect?

A

reduce or eliminate HS insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Dawn Phenomenon is characterized by what pattern? What is the cause?

A

Blood glucose rises through the night with HYPERglycemia at 7 AM

nocturnal desensitization of tissues to insulin as a result of night surge of growth hormone

(the Dawn slowly rises…)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Treatment for the Dawn Phenomenon?

A

Increase the dose of insulin at HS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is often the first sign of Type II Diabetes in females?

A

recurrent vaginitis

22
Q

Early disease may be asymptomatic and physical exam unremarkable in Type II Diabetes. If signs and symptoms do occur, what are they?

A 
o  acanthosis nigricans
o  chronic skin infections
o  pruritis
o  peripheral neuropathies
o  recurrent blurred vision
23
Q

Laboratory diagnostics in Type II Diabetes?

A

Same as Type I

except do not expect to see ketones in urine or blood

24
Q

Signs associated with insulin resistance?

A

o acanthosis nigricans
o hypertension
o dyslipidemia
o polycystic ovarian disease

25
Q

When should children be screened for Type II Diabetes?

A

In obese children, starting at the first of age 10 or puberty, and then every 2 years IF two or more of the following are present…
o family history
o minority race
o signs if insulin resistance

26
Q

Management of Type II Diabetes in children? (1+3)

A

Refer to endocrine for management and expect the following:
o weight management
o metformin/glucophage
o insulin therapy if severe

27
Q

How does Metformin work?

A

reduces gluconeogenesis

28
Q

What is a potential side effect of Metformin?

A

significant gastrointestinal upset

however, usually limited to ~2 weeks

29
Q

T3 is otherwise known as

A

Triidodthyronine

30
Q

T4 is otherwise known as

A

Thyroxine

31
Q

More important lab in HYPERthyroidism - T3 or T4

A

T3 / triiodothyronine (INCREASED)

T3 is very important to consider, right after TSH which is DECREASED

32
Q

Grave’s disease is an example of ____-thyroidism

A

HYPER

33
Q

HYPERthyroid is most commonly seen in:

A

girls between the ages of 12 and 14 years and can be associated with autoimmune diseases

34
Q

HYPERthyroid common symptoms

A

Everything is INCREASED/sped up
o heart rate
o nervousness
o metabolism (resulting in weight loss)

35
Q

FINE HAIR is associated with ____-thyroidism

A

HYPER

36
Q

Other than TSH, T3, and T4, what other lab test is elevated in HYPERthyroid?

A

Serum ANA (antinuclear antibodies) without evidence of lupus

37
Q

What medication is commonly used to treat the symptoms of HYPERthyroid?

A

Propranalol

38
Q

Three potential treatments of HYPERthyroid? (3)

A

o radioactive iodine
o thyroid surgery
o Lugol’s solution x 10 days to reduce vascularity

39
Q

WHERE is the problem in HYPOthyroidism? (3)

A

disease of thyroid itself

or decreased TSH from pituitary
or decreased TRH from hypothalmus (thyrotropin-releasing hormone)

40
Q

What is the underlying cause of HYPOthyroidism? (4)

A

o autoimmune most common
o iodine deficiency
o deficient pituitary
o destruction of the gland (surgery, radiation, trauma)

41
Q

Signs and symptoms of HYPOthyroidism in INFANTS?

A

o begin after first month of life
o lethargy
o poor feeding
o large fontanels

42
Q

What is the appearance of the tongue in HYPOthyroid?

A

thick tongue

43
Q

What is the appearance of the face in HYPOthyroid?

A

puffy eyes and face

44
Q

Diagnostic (thyroid specific) lab work in HYPOthyroidism?

A

o elevated TSH
o decreased T4
o decreased free T4

“T3 has no role in hypothyroidism”

45
Q

Other lab values in HYPOthyroid?

A 
o  increased serum cholesterol
o  increased liver enzymes
o  hyponatremia
o  hypoglycemia
o  anemia
46
Q

Failure to grow more than how many cm per year is a red flag?

A

4 cm per year

47
Q

How is a bone age test used to determine if growth hormone therapy is appropriate?

A

If bone age is consistent with height age then the child should NOT be given growth hormone.

48
Q

What happens if growth hormone is given when not clinically appropriately?

A

It speeds the closure of the epiphyseal growth plate, actually thwarting growth

49
Q

Major side effect of growth hormone

A

severe headache

50
Q

Four endocrine diseases that can result in proportional short stature?

A

o growth hormone deficiency
o hypothyroid
o hypopituitary
o diabetes

51
Q

What are two conditions that can result in DISproportionate short stature?

A

o dwarfism

o rickets

52
Q

With what effect on puberty is constitutional growth delay associated?

A

delayed onset of puberty

patient and family should be educated

NP (76 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions