Fn2 test 4[1].txt

• author "me"
• fileName "Fn2 test 4"
• tags "Endo"
• description ""
• causes of pituitary problems
• Overrsecretion
• Undersectrion
• Receptor site failure

• Deficiency of one or more anterior pituitary hormones
• Deficiencies of ACTH and TSH and the most life threatening (result in corresponding dec in secretion of vital hormones from the adrenal and thyroid gland)
• Defic. Of gonadotropins (LH,FSH) change sexual function
• Def of growth hormone

• Normal at birth
• Growth patterns progressively deviate, often beginning in infancy
• Short stature
• Growth retardation: dwarfisim"
• Sexual development usually normal but delayed
• Appear younger than age and others frequently relate to them in childish ways

• Recombinant growth hormone
• Somatroping (genotropin, nutropin)
• Typically show immediate inc in growth and may inc 12 in or ore in ht over several years of treatment
• Ultimately, resistance develops to the PRO and growth tapers off
• SC or IM
• Given at bedtime to most closely approximate physiologic release of GH
• Should not be given to adolescents whose epiphyses have sealed

• Hormone oversecretion
• Hypothalmic dyffunction

• Primary cause is the presence of pituitary adenoma
• Causes: gigantism and acromegaly

Excessive amounts of releasing hormones are produced and then overstimulate the normal pituitary gland

• Onset occurs before puberty
• Rapid proportional growth in the length of this bones
• May have delayed closure of fontanels

• Continues past puberty
• Early diagnosis and treatment essential to prevent irreversible changes in soft tissue
• Skeletal changes permanent

• Changes in facial features
• Arthritic changes
• Vision changes
• Inc perspiration and oil secretion
• Organomegaly
• Htn
• Dysphagia
• Deepening of voice
• Hypersescretion of PRL
• Hypogonadism
• Galactorrhea
• Hypertrophy of skin
• In skeletal thickness
• Hyperglycemia

• Inc lip and nose size
• Inc head, hand and foot size
• Prominent supraorbital ridge
• Prognathism(lower jaw protrudes out
• Difficulty chewing

• Degeneration of joint cartilage
• Joint pain
• Dec mobility

• Surgical
• External ratiation
• Radioactive implants

• Early identification of excessive growth rates
• Emotional support

• Manifestations of sexual development before age 9 in boys and 8 in girls
• Monthly SC luteinizing hormone-releasing hormone(Lupron)
• --regulates pituitary secretions
• --slows prepubertal growth to normal rates
• --discontinued in time to allow normal pubertal changes to occur

Thyroid cant produce amount of hormones pituitary calls for

Thyroid isnt being stimulted by pituitary to produce hormones

• Apear normal at birth
• If not detected irreversible brain damage and physical signs of develop
• Neonatal screening mandatory
• Hormone replacement
• Bone age surveys so ensure optimum treatment
• Normal physical growth and intelligence if treatment started shortly after birth

• Early ID
• Be suspicious of:
• --unusally wuiet and good baby
• --prolonged jaundice
• --constipation
• --umbilical hernia
• Life long therapy
• Synthroid
• Breast feeding acceptable

• S.o.: rapid pulse
• --dyspnea
• --irritability
• --insomnia
• --fever
• --sweating
• --wt loss
• I,t,--fatigue
• --sleepiness
• --dec appetite
• --constipation

• Develops after neonatal period but before puberty
• Stunted growth (earliest sign)**
• Dry skin
• Puffiness around eyes
• Sparse hai
• Constipation
• Sleepiness
• Mental decline
• Tx:lthyroxine

• Autoimmune diorder
• Strong genetic predisposition
• Thyroid becomes invaded with antithyroid antibodies and lymphocytes, causing thyroid tissue destrcution (replaced with fibrous tissue)
• More freq after 6 years reaching peak in adolescence

• Painless goiter
• Tracheal compression*****
• --sense of fullenss
• --hoarseness
• --dysphagia
• Most children euthyroid, but may be hypo- or hyper-thyroid

• In many cases, goiter regresses spontaneously within a yr or two
• Thyroid hormone**
• --supresses TSHsecretion
• --surgery (subtotal thyroidectomy) if goiter does not respond to thyroid horone if it compresses other structures
• Reassure that condition is probably temporary

• May be mild and noticeable when inc demand TH(rapid growth)
• Can cause resp distress
• --if born with it, immediate precautions instituted for emergency vent
• --position neck hyperextended to breath
• Immediate surgery to remover part of glane may be life saving
• THreplacement tx the hypothyroidism and reverse the TSH effect on the gland