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60 Cards in this Set

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new-onset wt loss + polydipsia + polyphagia + polyuria

dx?
DM2
after x% of beta-cell fxn destroyed, clinical signficance
90%
when blood glucose > x, then osmotic diuresis occurs
180 mg/dl
DKA sx
1.hyperglycemia
2.metabolic acidosis
3.dehydration
4.lethargy
most common cause of DKA
inadequate insulin dosing
most severe complication of DKA
cerebral edema
most common endocrine disorder in childhood
DM1
DM1: main risk factor
+FH
hypoglycemia sx? caused by?
trembling, diaphoresis, flushing, tachycardia

catecholamine release
headache + n/v + abd pain + polyuria + polydipsia + fatigue

dx?
DKA
secondary diabetes: causes
1.excess glucocorticoids
2.hyperthyroidism
3.pheochromocytoma
4.GH excess
5.thiazide diuretics
diabetes dx: random plasma glucose > x
> 200 mg/dl
in diabetic, glucose that falls to quickly can lead to...
cerebral edema
insulin drip: dosage
0.1 U/kg/hr
diabetics develop microvascular disease after x yrs of disease
10 yrs
acanthosis nigricans
hyperpigmentation & thickening of skin folds

usually neck back & flexor areas
only oral hypoglycemic med used in children age > 10
metformin
inability to concentrate urine

dx?
diabetes insipidus

no ADH
diabetes insipidus: causes
1.head trauma
2.brain tumor
3.CNS infxn
4.craniophargioma removal SE
abrupt onset polydipsia + polyuria

dx?
tx?
diabetes insipidus

desmopressin (DDAVP)
short stature: usually due to...
genetics
constitutional delay
proportionate short stature: causes
1.GH deficiency
2.primary hypothyroidism
3.Cushing disease
4.chronic systemic dz
5.psychosocial deprivation
6.Turner
7.meds
disproportionate short stature: examples
1.achondroplasia
2.rickets
short stature: caused by what kind of meds?
1.steroids
2.dexedrine
3.methylphenidate (ritalin)
hyperthyroidism: most common cause (& other causes)
1.grave's disease
2."hot" nodule
3.acute suppurative thyroiditis
T/F: exophthalmos is common in hyperthyroid children
false
T/F: hyperthyroid childen display change in behavior & school performance
true
acute-onset tachycardia + hyperthermia + fever + diaphoresis + n/v

dx?
thyroid storm
infant that stares + jitters + hyperactive + increased appetite + poor wt gain

dx?
tx?
neonatal grave's

resolves over first several months
x% of children w/grave's have spontaneous remission
50%
hypothyroidism: most common cause
hashimoto's (chronic lymphocytic thyroiditis)
coarse puffy face + dry thin hair + dry skin + delayed DTRs + slow linear growth + delayed puberty

dx?
hypothyroid
hyperthyroid: tx

hypothyroid: tx
PTU - hyperthyroid

levothyroxine - hypothyroid
congenital adrenal hyperplasia: most common cause
21-hydroxylase deficiency

a.classic salt-wasting
b.virilizing
21-hydroxylase: needed to form...
1.cortisol
2.aldosterone
21-hydroxylase deficiency: inheritance pattern
autosomal recessive
21-hydroxylase deficiency: genital clinical presentation
females: ambiguous genitalia

males: nl
21-hydroxylase deficiency: dx via...
17-hydroxyprogesterone levels (elevated)
21-hydroxylase deficiency: sx
1.dehydration
2.salt-wasting
3.emesis
4.shock
5.hyperkalemia, hyponatremia
6.hypoglycemia
11-hydroxylase deficiency: sx
1.HTN
2.hypernatremia, hypokalemia
3.decreased renin, aldosterone
21-hydroxylase deficiency: tx
1.cortisol
2.mineralocorticoid
21-hydroxylase deficiency: undertreatment may lead to...
1.premature epiphyseal fusion
2.adult short stature
precocious puberty
secondary sex qualities age < 7.5 (female), < 9 (boys)
precocious puberty: causes
girls: idiopathic
boys: CNS pathology
premature adrenarche: cause
early maturation of adrenal androgen secretion
gonadotropin-dependent precocious puberty: examples
1.glioma
2.embryonic germ cell tumor
3.hamartomas
gonadotropin-independent precocious puberty: examples
1.mccune-albright
2.leydig cell tumors
3.ectopic hCG production by hepatic/pineal tumors
GDPP: tx
leuprolide (GnRH analogue)
pubertal delay
(-) 2ndary sex qualities before age 13 (females), age 14 (males)
pubertal delay: most common cause
constitutional delay
Cushing syndrome: most common cause in children age > 7
Cushing disease (bilateral adrenal hyperplasia)
Cushing syndrome: lab studies
1.serum cortisol
2.24-hr urine free cortisol
3.dexamethasone suppression test
prolonged dexamethasone suppression test: purpose
differentiate adrenal tumor vs. Cushing disease
adrenal tumor: Tx
surgery (removal)
addison disease
primary adrenal insufficiency
adrenal insufficiency: most common cause in older children & adolescence
autoimmune
ACTH deficiency: most common cause
chronic steroid tx
addisonian crisis: sx
1.fever
2.vomiting
3.dehydration
4.shock
addisonian crisis: tx
1.D5W
2.STRESS DOSE IV glucocorticoids
addisonian crisis: causes
1.illness
2.surgery
3.trauma