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Questions and Answers
What is a potential consequence of not starting therapy for nodular thyroid immediately in childhood?
What is a potential consequence of not starting therapy for nodular thyroid immediately in childhood?
- Reversal of any existing mental development delay
- Rapid uptake of radioactive iodine
- Increased risk of thyroid malignancy
- Prevention of further mental development delay (correct)
What is the purpose of administering radioactive iodine to children with nodular thyroid?
What is the purpose of administering radioactive iodine to children with nodular thyroid?
- To diagnose thyroid malignancy
- To stimulate growth in children with hypothyroidism
- To manage therapeutic dosage of synthetic thyroid hormone
- To determine if thyroid nodes are benign or malignant (correct)
Why is it essential to crush T4 tablets before administering them to children?
Why is it essential to crush T4 tablets before administering them to children?
- To ensure proper absorption of the medication
- To mix with food or formula for ease of administration (correct)
- To facilitate dosage measurement
- To prevent overdose
What is the treatment for acquired hypothyroidism in children?
What is the treatment for acquired hypothyroidism in children?
What is the consequence of inadequate thyroid hormone dosage in children?
What is the consequence of inadequate thyroid hormone dosage in children?
Why is it crucial to recognize acquired hypothyroidism early in childhood?
Why is it crucial to recognize acquired hypothyroidism early in childhood?
What is the benefit of periodic monitoring of T4 and T3 levels in children with hypothyroidism?
What is the benefit of periodic monitoring of T4 and T3 levels in children with hypothyroidism?
What is a potential consequence of excessive thyroid hormone dosage in children?
What is a potential consequence of excessive thyroid hormone dosage in children?
What is the primary goal of administering antithyroid drugs in a child with acute adrenocortical insufficiency?
What is the primary goal of administering antithyroid drugs in a child with acute adrenocortical insufficiency?
Why does it take around 2 weeks for antithyroid drugs to have an effect?
Why does it take around 2 weeks for antithyroid drugs to have an effect?
What is a common side effect of antithyroid drugs?
What is a common side effect of antithyroid drugs?
What is the consequence of a lack of aldosterone production?
What is the consequence of a lack of aldosterone production?
What is the typical outcome if acute adrenocortical insufficiency is left untreated?
What is the typical outcome if acute adrenocortical insufficiency is left untreated?
What is a sign of dehydration in a child with acute adrenocortical insufficiency?
What is a sign of dehydration in a child with acute adrenocortical insufficiency?
Why is it important to monitor the child's blood for leukopenia and thrombocytopenia?
Why is it important to monitor the child's blood for leukopenia and thrombocytopenia?
What is the medical classification of acute adrenocortical insufficiency?
What is the medical classification of acute adrenocortical insufficiency?
What is the consequence of not treating the condition in an adolescent girl?
What is the consequence of not treating the condition in an adolescent girl?
What is a characteristic appearance of a child with hyperthyroidism?
What is a characteristic appearance of a child with hyperthyroidism?
What is the cause of low or absent TSH levels in a child with hyperthyroidism?
What is the cause of low or absent TSH levels in a child with hyperthyroidism?
What is the primary goal of therapy in treating hyperthyroidism?
What is the primary goal of therapy in treating hyperthyroidism?
What can cause acute adrenocortical insufficiency?
What can cause acute adrenocortical insufficiency?
What is a characteristic of acute adrenocortical insufficiency?
What is a characteristic of acute adrenocortical insufficiency?
What is the result of abruptly stopping corticosteroid therapy?
What is the result of abruptly stopping corticosteroid therapy?
What is a characteristic of a child with acute adrenocortical insufficiency?
What is a characteristic of a child with acute adrenocortical insufficiency?
What is the primary treatment if a tumor is detected in the pituitary gland?
What is the primary treatment if a tumor is detected in the pituitary gland?
What is the result of a large loss of fluid in the body if the condition remains untreated?
What is the result of a large loss of fluid in the body if the condition remains untreated?
What is the purpose of administering vasopressin (Pitressin) to the child?
What is the purpose of administering vasopressin (Pitressin) to the child?
What may be affected when GH secretion is halted?
What may be affected when GH secretion is halted?
What is the symptom that parents may notice first in a toilet-trained child?
What is the symptom that parents may notice first in a toilet-trained child?
What is the condition that occurs when sodium becomes concentrated in the body?
What is the condition that occurs when sodium becomes concentrated in the body?
What is the more permanent therapy to halt GH production?
What is the more permanent therapy to halt GH production?
What is the purpose of MRI, CT scanning, or ultrasound study of the skull?
What is the purpose of MRI, CT scanning, or ultrasound study of the skull?
What is the primary cause of the thirst response in diabetes?
What is the primary cause of the thirst response in diabetes?
What is the result of large amounts of fat being metabolized in the body?
What is the result of large amounts of fat being metabolized in the body?
What is the difference between type 1 and type 2 diabetes?
What is the difference between type 1 and type 2 diabetes?
What is the acid end product of fat breakdown in the body?
What is the acid end product of fat breakdown in the body?
What is the approximate incidence of type 1 diabetes in children and adolescents in the United States?
What is the approximate incidence of type 1 diabetes in children and adolescents in the United States?
What is the result of potassium and phosphate passing from body cells into the bloodstream?
What is the result of potassium and phosphate passing from body cells into the bloodstream?
What are the three cardinal symptoms of diabetes?
What are the three cardinal symptoms of diabetes?
What happens to ketone bodies in the body when large amounts of fat are metabolized?
What happens to ketone bodies in the body when large amounts of fat are metabolized?
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Study Notes
Excess GH Secretion
- If left untreated, a child may reach a height of over 8 ft due to excess GH secretion
- Symptoms include irritability, weakness, lethargy, fever, headache, and seizures
- Polyuria is a common symptom, which may be noticed as bed-wetting in a toilet-trained child or weight loss
- If left untreated, the child may lose a large quantity of water, leading to dehydration and death
Therapeutic Management
- Laser surgery or cryosurgery may be used to remove a tumor or reduce GH production
- GH antagonists such as bromocriptine (Parlodel) or octreotide (Sandostatin) may be used to slow GH production
- Irradiation or radioactive implants of the pituitary gland may be used as a more permanent therapy
- Supplemental thyroid extract, cortisol, and gonadotropin hormones may be needed in later life
Hypothyroidism
- A nodular thyroid is usually benign, but an investigation into the possibility of thyroid malignancy must be considered
- Radioactive iodine uptake is rapid in benign nodes, but not in malignant nodes
- Treatment for acquired hypothyroidism involves administration of synthetic thyroid hormone (sodium levothyroxine)
- Adequate dosage is essential to stimulate growth before epiphyseal lines close at puberty
Acute Adrenocortical Insufficiency
- Insufficiency can occur in either an acute or chronic form
- Acute adrenocortical insufficiency can occur following a severe infection or when corticosteroid therapy is abruptly stopped
- Symptoms include low blood pressure, dehydration, and hypoglycemia
- Sodium and chloride levels fall, while potassium levels become elevated
- Seizures may occur, and without treatment, death can occur abruptly
Type 1 Diabetes Mellitus
- Type 1 diabetes mellitus is a disorder involving an absolute or relative deficiency of insulin
- Symptoms include polyuria, polydipsia, and hyperglycemia
- The body breaks down protein and fat for energy, leading to weight loss and ketosis
- Ketone bodies accumulate in the bloodstream, causing high serum cholesterol levels and ketoacidosis
- Potassium and phosphate levels increase in the bloodstream, attempting to serve as buffers
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