Edocrine peds

characterized by poor growth and short stature

increased fat in trunk area

childlike face with large prominent forehead

high pitched voice

hypoglycemia

micropenis with small testes

delayed sexual maturation

Administration of growth hormone

subcutaneous injection

measure accurately

measured q 6 mo

calculate drug doses as child gains weight

Bone scan

breast development before the age of 7 in whites and 6 in black girls

in boys less than 9 years of age

accelerated growth rate (taller, developed musculature)

advanced bone age

Evidence of secondary sex characteristics

Acne

Adult body odor

Behavioral changes

When to measure head circumference

If untreated child with precocius puberty is potentially

DI has nothing to do with

Disorder of water regulation

Complication following head trauma

Can be transient or perminent

Other causes of DI

Common sx of older child with DI

nocturnal enuresis

Urine specific gravity < 1.005

Hypernatremia common clinical manifestation in

Treatment of DI is not necessare to

TX of DI

Drug of choice in DI

Goals of DI therapy

Slow metabolism

Decreased BP

Low pulse

Cold intollerance

Pulse Increase

Disorder present at birth

Cuased by low concentration of T3 T4

Creti9nism

early detection and treatment of Hypothyroidism can prevent

TSH < .4

TSH > 5

Occurs during childhood and more frequently in females

may presetn with a goiter

thinning course hair

fragile skin

fatigue

puffy eyes

decreased reflexes

delatyed puberty and tooth eruption

hypermetabolic state

Opthalmic changes with

dowward displacement of the eyeball

primary concern in hyperthyroidism

temp 104

increased BP and pulse

seizures

Exopthalmos

common and usually benign

can have toxic goiter

Toxic diffuse goiter

Will die if untx

GI symtptoms of diarrhea

progresses to confusion, psychosis, seizures

mortality rate is high/death can occur within 48 hours without treatment

ambiguous genitalia

Most often occurs in childhood and adolescnese, second most common chronic disease of childhood in US

hyperglycemia

can be auto immune or idiopathic

gentic predisposition

Environmental facgtors

manifests when 90% of beta cells destoryed

3 P's of Type I Diabetes

Losing weight but eating more food

Electrolyte disturbance causes osmotic diuresis

mailaise and fatigue is common

blurred vision

must have exogenous source of insulin to live

Diabetic Ketoacidosis is associated with which diabetes?

Metabolic acidosis in diabetes

can result in coma and death if left untreated

person at risk of DKA

Results from severe dehydration and acidosis

treat DKA or dehydreation NOT

Foley important in DKA why

BS greater than 250

PH less than 7.35 diabetic condition

bicarb less than 15

increased potassioum

jincreased rate of respiratory rate and depth, longer insipration

Fluid of choice for DKA

Initial bolus of 1 liter of what with DKA

How to prevent luid overload

Which insulin given IV?

IV bolus of regular insulin...amount

what to achieve a steady decrease in serum glucose of

how often to monitor serum glucose when on insulin

What IV solution once glucose decreased to 250?

Foold while on insulin infusion

clear before cloudy

insulin can be given continuous subcutaneous

insulin no approved for pregnancy

insulin shock

normal range for fasting glucose

rapid acting or ultra short actin insulin

more rapid onset, less than 15 min

peak 30 - 60 min

duration 3-4 hours

administer 15 minutes before meals

Humalog

administer 30 - 60 before meals

short actin insulin

clear, given iv

24 hour long actin human insulin subcutaneous at bedtime

used to treat type I and II

constant effect, no peak time

can be used in combination

vial of insulin can be kept at room temp for

doe not reuqire mixing

most rapid site of absorption

15 grams of rapid acting shugar