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A decreased activity of the anterior pituitary gland can lead to growth hormone deficiency.
A decreased activity of the anterior pituitary gland can lead to growth hormone deficiency.
True
What are some clinical manifestations of growth hormone deficiency?
What are some clinical manifestations of growth hormone deficiency?
Below 3rd percentile, grows less than 2 inches a year, well nourished, retarded bone age, teeth eruption delayed, sexual development delayed, vocal qualities are not correct, osteoporosis, premature closure of epiphyseal growth plates, short stature, disturbed body image.
What is the treatment for growth hormone deficiency?
What is the treatment for growth hormone deficiency?
Growth hormone replacement therapy sub q injection 6-7 times a week at night to mimic body's natural growing pattern. Stop the treatment at bone age >14 in girls and >16 in boys, or when achievable height is reached, or growth velocity drops to less than 1 inch a year.
What is the difference between precocious puberty and congenital hypothyroidism?
What is the difference between precocious puberty and congenital hypothyroidism?
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Lethargy is a common sign of acquired hypothyroidism.
Lethargy is a common sign of acquired hypothyroidism.
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Which of the following are symptoms of hypothyroidism?
Which of the following are symptoms of hypothyroidism?
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What is the treatment for hypothyroidism?
What is the treatment for hypothyroidism?
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Hyperthyroidism is primarily a disease of adolescents.
Hyperthyroidism is primarily a disease of adolescents.
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Which of these are symptoms of hyperthyroidism?
Which of these are symptoms of hyperthyroidism?
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Propylthiouracil is a medication used to treat hyperthyroidism, but can cause leukopenia and liver issues.
Propylthiouracil is a medication used to treat hyperthyroidism, but can cause leukopenia and liver issues.
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The accumulation of phenylalanine in the blood is the cause for CNS damage in PKU.
The accumulation of phenylalanine in the blood is the cause for CNS damage in PKU.
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A musty odor to the body, musty urine, seizures, and irritability are symptoms associated with PKU.
A musty odor to the body, musty urine, seizures, and irritability are symptoms associated with PKU.
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Which of the following are high-protein foods that should be restricted in a PKU diet?
Which of the following are high-protein foods that should be restricted in a PKU diet?
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What is diabetes insipidus?
What is diabetes insipidus?
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What are some of the complications and nursing considerations related to diabetes insipidus?
What are some of the complications and nursing considerations related to diabetes insipidus?
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Type 1 diabetes is a congenital condition.
Type 1 diabetes is a congenital condition.
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What is the primary treatment for type 1 diabetes?
What is the primary treatment for type 1 diabetes?
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Type 2 diabetes is characterized by insulin resistance, where the body fails to utilize insulin properly.
Type 2 diabetes is characterized by insulin resistance, where the body fails to utilize insulin properly.
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Exercise is a key component in the management of both type 1 and type 2 diabetes.
Exercise is a key component in the management of both type 1 and type 2 diabetes.
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Stress, illness, or infection can lead to a need for more insulin in diabetic patients.
Stress, illness, or infection can lead to a need for more insulin in diabetic patients.
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What is the target A1C level for diabetic patients?
What is the target A1C level for diabetic patients?
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The body breaks down fat as an energy source when there is a shortage of carbohydrates, leading to the release of ketones in diabetic patients.
The body breaks down fat as an energy source when there is a shortage of carbohydrates, leading to the release of ketones in diabetic patients.
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Pheochromocytoma is a tumor of the adrenal gland that causes an excessive release of catecholamines, leading to hypertension.
Pheochromocytoma is a tumor of the adrenal gland that causes an excessive release of catecholamines, leading to hypertension.
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What are the common symptoms of pheochromocytoma?
What are the common symptoms of pheochromocytoma?
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What is the recommended treatment for pheochromocytoma?
What is the recommended treatment for pheochromocytoma?
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Congenital adrenal hyperplasia is a condition where the adrenal glands cannot produce sufficient levels of aldosterone and cortisol, due to a mutation in a specific chromosome.
Congenital adrenal hyperplasia is a condition where the adrenal glands cannot produce sufficient levels of aldosterone and cortisol, due to a mutation in a specific chromosome.
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Increased production of androgens can lead to the development of masculine secondary sexual characteristics.
Increased production of androgens can lead to the development of masculine secondary sexual characteristics.
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Salt-losing adrenal hyperplasia is characterized by a deficiency in aldosterone, leading to excessive loss of sodium in the urine.
Salt-losing adrenal hyperplasia is characterized by a deficiency in aldosterone, leading to excessive loss of sodium in the urine.
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Non-salt-losing adrenal hyperplasia is characterized by a deficiency in aldosterone, but with adequate production of cortisol and an increase in ACTH and androgens.
Non-salt-losing adrenal hyperplasia is characterized by a deficiency in aldosterone, but with adequate production of cortisol and an increase in ACTH and androgens.
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Adrenal hyperplasia can lead to virilization, which refers to the development of masculine secondary sexual characteristics in females.
Adrenal hyperplasia can lead to virilization, which refers to the development of masculine secondary sexual characteristics in females.
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Males with adrenal hyperplasia typically have a larger penis and reach full penile growth by kindergarten age.
Males with adrenal hyperplasia typically have a larger penis and reach full penile growth by kindergarten age.
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Lifelong treatment with glucocorticoids is typically required in cases of adrenal hyperplasia.
Lifelong treatment with glucocorticoids is typically required in cases of adrenal hyperplasia.
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In cases of salt-losing adrenal hyperplasia, mineralocorticoids are provided to replace the missing hormone, and electrolyte and fluid balance is monitored.
In cases of salt-losing adrenal hyperplasia, mineralocorticoids are provided to replace the missing hormone, and electrolyte and fluid balance is monitored.
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What is the reason for premature sexual development, such as pubic and axillary hair growth, in children with adrenal hyperplasia?
What is the reason for premature sexual development, such as pubic and axillary hair growth, in children with adrenal hyperplasia?
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Females with adrenal hyperplasia may experience an adrenal crisis, characterized by symptoms like tachycardia, hypotension, fatigue, weight loss, nausea, vomiting, metabolic acidosis, encephalopathy, and even death.
Females with adrenal hyperplasia may experience an adrenal crisis, characterized by symptoms like tachycardia, hypotension, fatigue, weight loss, nausea, vomiting, metabolic acidosis, encephalopathy, and even death.
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Briefly explain what a UTI is and how it affects the urinary tract.
Briefly explain what a UTI is and how it affects the urinary tract.
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Uncircumcised males are more prone to UTIs in their first year of life.
Uncircumcised males are more prone to UTIs in their first year of life.
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Sexual activity in young females increases the risk of UTIs.
Sexual activity in young females increases the risk of UTIs.
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Symptoms of UTI are nonspecific and depend on the location of the infection and age of the child.
Symptoms of UTI are nonspecific and depend on the location of the infection and age of the child.
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Which of the following are symptoms of a UTI in a child?
Which of the following are symptoms of a UTI in a child?
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Classic symptoms of a lower UTI, like frequent urination, are not typically seen until preschool years.
Classic symptoms of a lower UTI, like frequent urination, are not typically seen until preschool years.
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Which of the following methods are used for diagnosing a UTI?
Which of the following methods are used for diagnosing a UTI?
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Early morning urine samples are ideal for detecting a UTI.
Early morning urine samples are ideal for detecting a UTI.
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What are the recommended treatments for a UTI in a child?
What are the recommended treatments for a UTI in a child?
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What is vesicoureteral reflux?
What is vesicoureteral reflux?
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Vesicoureteral reflux is classified by severity into five stages, with stage 1 being mild reflux and stage 5 involving severe dilation of the ureter and renal pelvis.
Vesicoureteral reflux is classified by severity into five stages, with stage 1 being mild reflux and stage 5 involving severe dilation of the ureter and renal pelvis.
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Vesicoureteral reflux can be caused by UTI obstruction, urine holding, or congenital urinary tract abnormalities.
Vesicoureteral reflux can be caused by UTI obstruction, urine holding, or congenital urinary tract abnormalities.
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Vesicoureteral reflux can lead to increased risk of UTIs due to incomplete emptying of the bladder.
Vesicoureteral reflux can lead to increased risk of UTIs due to incomplete emptying of the bladder.
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What are some of the methods used to diagnose VUR?
What are some of the methods used to diagnose VUR?
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What are the common treatments for VUR?
What are the common treatments for VUR?
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Enuresis is the repeated involuntary voiding by a child old enough that bladder control is expected.
Enuresis is the repeated involuntary voiding by a child old enough that bladder control is expected.
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Primary enuresis refers to children who have never been reliably dry at night, while secondary enuresis occurs in children who have been reliably dry but experience bedwetting again.
Primary enuresis refers to children who have never been reliably dry at night, while secondary enuresis occurs in children who have been reliably dry but experience bedwetting again.
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Enuresis can be associated with a small functional bladder, stress, infection, or deep sleep disturbances.
Enuresis can be associated with a small functional bladder, stress, infection, or deep sleep disturbances.
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Hypospadias is a condition where the urethral opening is located on the ventral side of the penis, while epispadias is a condition where the urethral opening is located on the dorsal side of the penis.
Hypospadias is a condition where the urethral opening is located on the ventral side of the penis, while epispadias is a condition where the urethral opening is located on the dorsal side of the penis.
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Hypospadias and epispadias are generally repaired surgically in the first year of life, aiming to position the urethral meatus at the end of the penis.
Hypospadias and epispadias are generally repaired surgically in the first year of life, aiming to position the urethral meatus at the end of the penis.
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A stent or catheter is often used to maintain patency of the urethral opening post-surgery.
A stent or catheter is often used to maintain patency of the urethral opening post-surgery.
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Circumcision is typically performed before surgery in cases of hypospadias or epispadias, to ensure that the foreskin can be used for repair.
Circumcision is typically performed before surgery in cases of hypospadias or epispadias, to ensure that the foreskin can be used for repair.
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What is bladder exstrophy?
What is bladder exstrophy?
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The exposed bladder in bladder exstrophy is typically covered with a plastic wrap.
The exposed bladder in bladder exstrophy is typically covered with a plastic wrap.
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What are the primary goals of bladder exstrophy management?
What are the primary goals of bladder exstrophy management?
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Wilms tumor is a common abdominal tumor of childhood, typically characterized by a firm, lobulated mass.
Wilms tumor is a common abdominal tumor of childhood, typically characterized by a firm, lobulated mass.
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Wilms tumor is usually asymptomatic, but may present with noticeable mass, hypertension, abdominal pain, or hematuria.
Wilms tumor is usually asymptomatic, but may present with noticeable mass, hypertension, abdominal pain, or hematuria.
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Palpating a Wilms tumor is not recommended because this can release cancer cells into the abdomen.
Palpating a Wilms tumor is not recommended because this can release cancer cells into the abdomen.
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Glomerulonephritis is an inflammatory condition of the glomeruli in the kidneys, often triggered by an immune response.
Glomerulonephritis is an inflammatory condition of the glomeruli in the kidneys, often triggered by an immune response.
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Glomerulonephritis can lead to proteinuria and hematuria due to increased permeability of the glomeruli, allowing proteins and red blood cells to leak into the urine.
Glomerulonephritis can lead to proteinuria and hematuria due to increased permeability of the glomeruli, allowing proteins and red blood cells to leak into the urine.
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Glomerulonephritis is often treated symptomatically with antibiotics, and measures to maintain fluid and electrolyte balance.
Glomerulonephritis is often treated symptomatically with antibiotics, and measures to maintain fluid and electrolyte balance.
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Kayexalate is a medication used to decrease potassium retention in glomerulonephritis.
Kayexalate is a medication used to decrease potassium retention in glomerulonephritis.
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Nephrotic syndrome is characterized by increased glomerular basement membrane permeability to plasma protein, causing proteinuria and edema.
Nephrotic syndrome is characterized by increased glomerular basement membrane permeability to plasma protein, causing proteinuria and edema.
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Nephrotic syndrome is often secondary to minimal change disease, where damage to the glomeruli causes increased permeability.
Nephrotic syndrome is often secondary to minimal change disease, where damage to the glomeruli causes increased permeability.
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In nephrotic syndrome, the body's low serum protein levels lead to high levels of protein in the urine.
In nephrotic syndrome, the body's low serum protein levels lead to high levels of protein in the urine.
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Nephrotic syndrome is a diagnosis that is made based on clinical signs and symptoms, rather than a specific disease entity.
Nephrotic syndrome is a diagnosis that is made based on clinical signs and symptoms, rather than a specific disease entity.
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Periorbital edema, foamy frothy urine, proteinuria, hematuria, and hypoalbuminemia are characteristic symptoms of nephrotic syndrome.
Periorbital edema, foamy frothy urine, proteinuria, hematuria, and hypoalbuminemia are characteristic symptoms of nephrotic syndrome.
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In nephrotic syndrome, periorbital edema typically shifts from the face to the abdomen and lower extremities over time.
In nephrotic syndrome, periorbital edema typically shifts from the face to the abdomen and lower extremities over time.
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Study Notes
Growth Hormone Deficiency
- Decreased activity of the anterior pituitary gland
- Delayed bone maturation
- Delayed linear growth
Growth Hormone Deficiency Clinical Manifestations
- Growth less than 2 inches per year
- Well-nourished but with a delayed bone age
- Normal skeletal proportions
- Delayed teeth eruption
- Delayed sexual development
- Incorrect vocal qualities
- Osteoporosis, premature closure of epiphyseal plates
- Short stature
- Distorted body image
GH Deficiency Diagnosis and Treatment
- Growth charting
- Growth hormone replacement therapy (subcutaneous injections 6-7x/week at night to mimic natural growth patterns)
- Treatment stops when bone age is >14 in girls and >16 in boys, a maximal height is reached or growth velocity drops to less than one inch per year.
Precocious Puberty
- Secondary sexual characteristics before age 8 in girls and 9 in boys
- Increased breast/genital development in females
- Increased body hair in males
- Possible causes: birth control pills, hormones in products, tumors (in males, typically idiopathic)
Precocious Puberty Symptoms and Diagnosis
- Early breast development
- Sexual hair
- Testicular growth
- Taller than peers
- Increased risk of early pregnancy
- Early closure of growth plates
- Males: CT/MRI to rule out tumors
Congenital Hypothyroidism
- Present at birth
- Few clinical signs in first few weeks
- Lethargy is the most common sign
Acquired Hypothyroidism
- Acquired usually during the teen years
Hypothyroidism Symptoms, Diagnosis and Treatment
- Symptoms: cold intolerance, bradycardia, hypotension, decreased height, delayed bone growth, weight gain, muscle hypertrophy, constipation, enlarged tongue, hypotonia
- Diagnosis: tested at birth, thyroid levels drawn
- Treatment: Synthroid/Levothyroxine (do not give with soy-based formulas); improper dosage can lead to hyperthyroidism
Hyperthyroidism
- Increased thyroid hormone levels (T3 and T4)
- Results in excessive thyroid hormone
- Mostly in adolescents (11–15 years old)
- Almost always caused by Graves' disease
Hyperthyroidism Symptoms and Treatment
- Symptoms: palpitations, tachycardia, fatigue, irritability, muscle weakness, restlessness, itching, tremors, sweating, heat intolerance, increased appetite but weight loss, frequent bowel movements, difficulty sleeping
- Treatment: propylthiouracil (PTU) or methimazole (often used due to fewer side effects), but PTU is associated with more side effects than methimazole
Phenylketonuria (PKU)
- Inherited disorder
- Body cannot break down phenylalanine
- Very high levels of phenylalanine in the blood
- Causes damage to the central nervous system
- Routine newborn screening (24 hours after birth)
- Restrict foods containing high amounts of protein (meat and dairy)
PKU Complications
- CNS damage from very high levels of phenylalanine in the blood
- Very high phenylalanine metabolites in the blood
- Inability to metabolize proteins
Diabetes Insipidus
- Disorder of vasopressin (ADH)
- Hormone regulates water balance in the body
- Insufficient hormone production
- Body cannot secrete the hormone
- Symptoms: buildup of sodium, seizures, or death
- Treatment: vasopressin infusion
Type 1 Diabetes
- Congenital insulin deficiency
- Pancreatic beta cells are disrupted (cannot produce insulin)
- Body becomes insulin dependent.
Type 2 Diabetes
- Insulin resistance
- Reduced sensitivity of insulin receptor sites that signal insulin's presence in cells
Diabetes Management
- Exercise
- Nutritional control with carb counting
- Insulin (for type 1 diabetes)
Diabetes Treatment Considerations
- In both Type 1 and Type 2 Diabetes, stress, illness, or infection can increase insulin needs.
Diabetes Patient Education
- Insulin regimens must be followed.
- Patients should be able to give insulin by 8 years of age
Pheochromocytoma
- Tumor of the adrenal glands
- Excessive release of catecholamines
- Leads to hypertension
Congenital Adrenal Hyperplasia
- Gene mutation that prevents the adrenal glands from producing cortisol and aldosterone
- Increased androgen production in males
- Masculine secondary sexual characteristics
Salt-Losing Adrenal Hyperplasia
- Deficiency in aldosterone production
- Loss of sodium in the urine
- Can appear in the first days to weeks after birth
Non-Salt-Losing Adrenal Hyperplasia
- Deficiency in cortisol production
- Elevated adrenocorticotropic hormone (ACTH)
- Excess androgens
Adrenal Hyperplasia Symptoms, Diagnosis, and Treatment
- Symptoms: vary based on the specific type
- Diagnosis: hormone tests, imaging
- Treatment: depends on cause and type, can involve hormone replacement or surgery
Vesicoureteral Reflux(VUR)
- Retrograde flow of urine from the bladder to the ureters
- Possible causes: urinary tract infection (UTI) obstruction or congenital issues
- Can lead to kidney damage/high-frequency UTIs
Vesicoureteral Reflux Diagnosis and Treatment
- Diagnosis: VCUG, DMSA scan (only definitive testing)
- Treatment: surgery, prophylactic antibiotics
Enuresis
- Repeated involuntary urination beyond the expected age of bladder control or after 6 months of successful dry nights
Hypospadias and Epispadias
- Hypospadias: abnormal opening/position of urethra below the tip of the penis.
- Epispadias: opening/position of urethra above the tip/end of penis.
- Surgical treatment (usually in <1 year)
Cleft Lip and Cleft Palate
- Cleft Lip: Abnormal closure of the lip.
- Cleft Palate: Abnormal and incomplete closure of the palate.
Urogenital Tract Infections (UTIs)
- Infection of the urinary tract (Urinary stasis, poor hygiene, uncircumcised males in the first year of life, sexual activity in young females).
UTI Symptoms and Diagnosis
- Symptoms: nonspecific symptoms (fever, hypothermia, failure to thrive, poor feeding, vomiting, diarrhea, strong smelling urine)
UTI Management
- Antibiotics
- Antipyretics
- Increased fluid intake
- Proper hygiene
Nephrotic Syndrome
- Disorder that causes protein loss and swelling.
- Protein leakage into urine from the kidney.
Nephrotic Syndrome Symptoms and Diagnosis
- Symptoms: edema, proteinuria, foamy urine, anorexia, lethargy and low-grade fever
- Diagnosis: Urine, blood tests, kidney biopsy
Nephrotic syndrome Treatment
- Symptoms: depends on disease causing it
- Treatment: varies based on specific condition, often includes corticosteroids, other immunosuppressants, and dietary management.
- Corticosteroid use for up to 14 weeks, then tapered off
Hemolytic Uremic Syndrome (HUS)
- Damage to red blood cells, platelets, and kidneys.
- Mostly related to E. coli bacterial infection.
HUS Clinical Manifestations and Treatment
- Symptoms: hypertension, edema, pallor, bruising, oliguria
- Treatment: supportive care, dialysis for severe cases requiring it.
Intussusception
- Part of the intestine folds into another part, causing an obstruction.
Intussusception Treatment
- Barium enema, hydrostatic reduction
- Surgery if needed
Pyloric Stenosis
- Thickening of the pylorus muscle, leading to a narrowed opening between the stomach and the small intestine.
- Causes persistent vomiting.
Pyloric Stenosis Treatment
- Surgical correction
Volvulus
- Twisting of the intestine on itself, causing an obstruction.
- Surgical correction
Biliary Atresia
- Absence of some or all of major biliary ducts, resulting in bile flow obstruction.
Appendicitis
- Infection/Inflammation of the appendix.
- Can lead to rupture, peritonitis.
Psoas Sign and Obturator Sign
- Abdominal examination tests to potentially assess for appendicitis.
Pediatric Gastrointestinal Disorders
- Gastroschisis: intestines outside abdominal wall, not in sac
- Omphalocele: herniated bowel in sac
- Cleft Lip and Cleft Palate: facial defects
Hirschsprung's Disease
- Congenital absence of ganglion cells or parasympathetic nerve elements throughout parts of the small or large intestine.
- This lack of bowel relaxation results in an obstruction/blockage within the bowel.
Hirschsprung's Disease Treatment
- Surgery to remove the affected section of bowel
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Description
Explore the key concepts of Growth Hormone Deficiency, including its clinical manifestations, diagnosis, and treatment options. This quiz will challenge your knowledge about delayed growth and developmental issues related to GH deficiency. Perfect for students and professionals in the fields of endocrinology and pediatrics.
