40 Questions
What is a potential consequence of not starting therapy for nodular thyroid immediately in childhood?
Prevention of further mental development delay
What is the purpose of administering radioactive iodine to children with nodular thyroid?
To determine if thyroid nodes are benign or malignant
Why is it essential to crush T4 tablets before administering them to children?
To mix with food or formula for ease of administration
What is the treatment for acquired hypothyroidism in children?
Synthetic thyroid hormone administration
What is the consequence of inadequate thyroid hormone dosage in children?
T4 levels will remain low with few signs of clinical improvement
Why is it crucial to recognize acquired hypothyroidism early in childhood?
To stimulate growth before epiphyseal lines close
What is the benefit of periodic monitoring of T4 and T3 levels in children with hypothyroidism?
To ensure appropriate medication dosage
What is a potential consequence of excessive thyroid hormone dosage in children?
T4 levels will rise
What is the primary goal of administering antithyroid drugs in a child with acute adrenocortical insufficiency?
To suppress the formation of T4
Why does it take around 2 weeks for antithyroid drugs to have an effect?
Because the thyroid stores considerable thyroid hormone that must be used up first
What is a common side effect of antithyroid drugs?
Leukopenia
What is the consequence of a lack of aldosterone production?
Elevated potassium levels
What is the typical outcome if acute adrenocortical insufficiency is left untreated?
Abrupt death
What is a sign of dehydration in a child with acute adrenocortical insufficiency?
Musty odor of urine
Why is it important to monitor the child's blood for leukopenia and thrombocytopenia?
To monitor the effects of antithyroid drugs
What is the medical classification of acute adrenocortical insufficiency?
Medical emergency
What is the consequence of not treating the condition in an adolescent girl?
She will not reach usual adult height
What is a characteristic appearance of a child with hyperthyroidism?
A wide-eyed, staring appearance
What is the cause of low or absent TSH levels in a child with hyperthyroidism?
Antibodies stimulating the thyroid gland
What is the primary goal of therapy in treating hyperthyroidism?
Decreasing the antibody response
What can cause acute adrenocortical insufficiency?
Meningococcemia
What is a characteristic of acute adrenocortical insufficiency?
The gland becomes nonproductive
What is the result of abruptly stopping corticosteroid therapy?
The gland becomes nonproductive
What is a characteristic of a child with acute adrenocortical insufficiency?
Low blood pressure
What is the primary treatment if a tumor is detected in the pituitary gland?
Laser surgery or cryosurgery to remove the tumor
What is the result of a large loss of fluid in the body if the condition remains untreated?
Dehydration and death
What is the purpose of administering vasopressin (Pitressin) to the child?
To rule out kidney disease
What may be affected when GH secretion is halted?
Thyroid extract, cortisol, and gonadotropin hormones
What is the symptom that parents may notice first in a toilet-trained child?
Bed-wetting
What is the condition that occurs when sodium becomes concentrated in the body?
Hypernatremia
What is the more permanent therapy to halt GH production?
Irradiation or radioactive implants of the pituitary gland
What is the purpose of MRI, CT scanning, or ultrasound study of the skull?
To determine the presence of a tumor or lesion in the pituitary gland
What is the primary cause of the thirst response in diabetes?
Excess fluid loss
What is the result of large amounts of fat being metabolized in the body?
Weight loss
What is the difference between type 1 and type 2 diabetes?
Type 1 involves an absolute deficiency of insulin, while type 2 involves a relative deficiency
What is the acid end product of fat breakdown in the body?
Ketone bodies
What is the approximate incidence of type 1 diabetes in children and adolescents in the United States?
1 in every 500
What is the result of potassium and phosphate passing from body cells into the bloodstream?
Buffering action
What are the three cardinal symptoms of diabetes?
Polyuria, polydipsia, and hyperglycemia
What happens to ketone bodies in the body when large amounts of fat are metabolized?
They accumulate in the bloodstream and spill into the urine
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
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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