Endocrine Disorders: Uncontrolled Growth
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Questions and Answers

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?

  • 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?

  • 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?

    <p>Synthetic thyroid hormone administration</p> Signup and view all the answers

    What is the consequence of inadequate thyroid hormone dosage in children?

    <p>T4 levels will remain low with few signs of clinical improvement</p> Signup and view all the answers

    Why is it crucial to recognize acquired hypothyroidism early in childhood?

    <p>To stimulate growth before epiphyseal lines close</p> Signup and view all the answers

    What is the benefit of periodic monitoring of T4 and T3 levels in children with hypothyroidism?

    <p>To ensure appropriate medication dosage</p> Signup and view all the answers

    What is a potential consequence of excessive thyroid hormone dosage in children?

    <p>T4 levels will rise</p> Signup and view all the answers

    What is the primary goal of administering antithyroid drugs in a child with acute adrenocortical insufficiency?

    <p>To suppress the formation of T4</p> Signup and view all the answers

    Why does it take around 2 weeks for antithyroid drugs to have an effect?

    <p>Because the thyroid stores considerable thyroid hormone that must be used up first</p> Signup and view all the answers

    What is a common side effect of antithyroid drugs?

    <p>Leukopenia</p> Signup and view all the answers

    What is the consequence of a lack of aldosterone production?

    <p>Elevated potassium levels</p> Signup and view all the answers

    What is the typical outcome if acute adrenocortical insufficiency is left untreated?

    <p>Abrupt death</p> Signup and view all the answers

    What is a sign of dehydration in a child with acute adrenocortical insufficiency?

    <p>Musty odor of urine</p> Signup and view all the answers

    Why is it important to monitor the child's blood for leukopenia and thrombocytopenia?

    <p>To monitor the effects of antithyroid drugs</p> Signup and view all the answers

    What is the medical classification of acute adrenocortical insufficiency?

    <p>Medical emergency</p> Signup and view all the answers

    What is the consequence of not treating the condition in an adolescent girl?

    <p>She will not reach usual adult height</p> Signup and view all the answers

    What is a characteristic appearance of a child with hyperthyroidism?

    <p>A wide-eyed, staring appearance</p> Signup and view all the answers

    What is the cause of low or absent TSH levels in a child with hyperthyroidism?

    <p>Antibodies stimulating the thyroid gland</p> Signup and view all the answers

    What is the primary goal of therapy in treating hyperthyroidism?

    <p>Decreasing the antibody response</p> Signup and view all the answers

    What can cause acute adrenocortical insufficiency?

    <p>Meningococcemia</p> Signup and view all the answers

    What is a characteristic of acute adrenocortical insufficiency?

    <p>The gland becomes nonproductive</p> Signup and view all the answers

    What is the result of abruptly stopping corticosteroid therapy?

    <p>The gland becomes nonproductive</p> Signup and view all the answers

    What is a characteristic of a child with acute adrenocortical insufficiency?

    <p>Low blood pressure</p> Signup and view all the answers

    What is the primary treatment if a tumor is detected in the pituitary gland?

    <p>Laser surgery or cryosurgery to remove the tumor</p> Signup and view all the answers

    What is the result of a large loss of fluid in the body if the condition remains untreated?

    <p>Dehydration and death</p> Signup and view all the answers

    What is the purpose of administering vasopressin (Pitressin) to the child?

    <p>To rule out kidney disease</p> Signup and view all the answers

    What may be affected when GH secretion is halted?

    <p>Thyroid extract, cortisol, and gonadotropin hormones</p> Signup and view all the answers

    What is the symptom that parents may notice first in a toilet-trained child?

    <p>Bed-wetting</p> Signup and view all the answers

    What is the condition that occurs when sodium becomes concentrated in the body?

    <p>Hypernatremia</p> Signup and view all the answers

    What is the more permanent therapy to halt GH production?

    <p>Irradiation or radioactive implants of the pituitary gland</p> Signup and view all the answers

    What is the purpose of MRI, CT scanning, or ultrasound study of the skull?

    <p>To determine the presence of a tumor or lesion in the pituitary gland</p> Signup and view all the answers

    What is the primary cause of the thirst response in diabetes?

    <p>Excess fluid loss</p> Signup and view all the answers

    What is the result of large amounts of fat being metabolized in the body?

    <p>Weight loss</p> Signup and view all the answers

    What is the difference between type 1 and type 2 diabetes?

    <p>Type 1 involves an absolute deficiency of insulin, while type 2 involves a relative deficiency</p> Signup and view all the answers

    What is the acid end product of fat breakdown in the body?

    <p>Ketone bodies</p> Signup and view all the answers

    What is the approximate incidence of type 1 diabetes in children and adolescents in the United States?

    <p>1 in every 500</p> Signup and view all the answers

    What is the result of potassium and phosphate passing from body cells into the bloodstream?

    <p>Buffering action</p> Signup and view all the answers

    What are the three cardinal symptoms of diabetes?

    <p>Polyuria, polydipsia, and hyperglycemia</p> Signup and view all the answers

    What happens to ketone bodies in the body when large amounts of fat are metabolized?

    <p>They accumulate in the bloodstream and spill into the urine</p> Signup and view all the answers

    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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    Description

    This quiz covers the consequences of an untreated condition that leads to excessive growth and other symptoms such as irritability and seizures. It also touches on the therapeutic management and diagnosis of the condition.

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