Overproduction of Thyroid Hormones in Children

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Questions and Answers

What is monitored in the blood of a child taking medication for hyperthyroidism?

Blood sugar levels

White blood cell and platelet count (correct)

Thyroid hormone levels

Insulin levels

What is the reason for discontinuing medication in a child with hyperthyroidism?

Development of infection

Occurrence of spontaneous bleeding

Decreased white blood cell or platelet count (correct)

All of the above

How long does it take for the medication to have an effect on hyperthyroidism?

2 weeks (correct)

1 month

3 months

1 week

What is the alternative therapy for a child with a toxic reaction to medical management?

Radioiodine ablative therapy or thyroid surgery Signup and view all the answers

Why is it important to regulate adolescent girls with hyperthyroidism before childbearing?

To prevent neonatal hyperthyroidism Signup and view all the answers

What is a common symptom of hyperthyroidism in children?

Loss of muscle strength Signup and view all the answers

What is the usual cause of acute adrenocortical insufficiency?

Severe overwhelming body infection Signup and view all the answers

What is a possible consequence of untreated hypothyroidism in children?

Severe and irreversible cognitive deterioration Signup and view all the answers

What is the effect of untreated hyperthyroidism on a child's bone growth?

It causes the epiphyseal lines of long bones to close prematurely Signup and view all the answers

What can occur when corticosteroid therapy is abruptly stopped?

Adrenal gland becomes nonproductive Signup and view all the answers

What may be necessary after radioiodine ablative therapy or thyroid surgery?

Supplemental thyroid hormone therapy Signup and view all the answers

What is the treatment for true hypothyroidism in children?

Oral administration of synthetic thyroid hormone Signup and view all the answers

What is the purpose of administering a β-adrenergic blocking agent in the treatment of hyperthyroidism?

To decrease the antibody response Signup and view all the answers

Why is supplemental vitamin D given to children with hypothyroidism?

To prevent rickets Signup and view all the answers

What is the effect of hyperthyroidism on a child's skin?

It feels moist and perspires freely Signup and view all the answers

What is the purpose of administering an antithyroid drug in the treatment of hyperthyroidism?

To suppress the formation of T4 Signup and view all the answers

What is a sign of hyperthyroidism in children?

Vomiting and diarrhea Signup and view all the answers

How often should the medication dosage of thyroid hormone be monitored in children with hypothyroidism?

Periodically Signup and view all the answers

What is a common laboratory finding in children with hyperthyroidism?

Elevated T4 and T3 levels Signup and view all the answers

What is a possible complication of untreated hyperthyroidism in children?

Not reaching usual adult height Signup and view all the answers

What happens if the dose of thyroid hormone is not adequate in children with hypothyroidism?

The T4 level will remain low Signup and view all the answers

What is the appearance of the thyroid gland in children with hyperthyroidism?

It appears as a swelling on the anterior neck Signup and view all the answers

Why is it important to crush T4 tablets and add them to a small amount of food or formula?

To ensure proper administration Signup and view all the answers

What is the benefit of early treatment of hypothyroidism in children?

Prevention of further cognitive deterioration Signup and view all the answers

Study Notes

Hyperthyroidism in Children

Overproduction of T3 and T4 hormones leads to nervousness, tremors, loss of muscle strength, and fatigue in children.
Symptoms include increased basal metabolic rate, blood pressure, and pulse, as well as moist skin and excessive sweating.
Children may experience increased hunger but fail to gain weight due to increased metabolic rate.
Bone age appears advanced on X-ray, and epiphyseal lines may close prematurely, preventing full height attainment.
The thyroid gland becomes prominent, and exophthalmia may occur in some cases.
Laboratory tests reveal elevated T4 and T3 levels, increased radioactive iodine uptake, and low or absent TSH.

Therapeutic Management

Therapy involves β-adrenergic blocking agents (e.g., propranolol) to decrease antibody response, followed by antithyroid drugs (e.g., propylthiouracil or methimazole) to suppress T4 formation.
Monitoring is necessary for leukopenia and thrombocytopenia, which are side effects of these drugs.
Radioiodine ablative therapy or thyroid surgery may be necessary in cases of toxic reaction or noncompliance.
Supplemental thyroid hormone therapy may be required indefinitely after radioiodine ablative therapy or thyroidectomy.

Acute Adrenocortical Insufficiency

Insufficiency can occur in acute or chronic forms, leading to nonproductive adrenal gland function.
Causes include severe infections (e.g., meningococcemia) or abrupt cessation of long-term corticosteroid therapy.
Untreated, the condition can result in severe, irreversible cognitive deterioration or delay.
Treatment involves synthetic cortisol replacement therapy, with dosage adjustments based on the child's response.

Hypothyroidism

Transient hypothyroidism typically resolves within 3 months.
True hypothyroidism requires oral administration of synthetic thyroid hormone (sodium levothyroxine), which must be continued indefinitely.
Supplemental vitamin D may be necessary to prevent rickets during rapid bone growth.
Early treatment can prevent further cognitive challenges, but existing impairment cannot be reversed.

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Description

This quiz assesses understanding of symptoms and effects of excessive thyroid hormone production in children, including physical and behavioral changes. It covers the impact on metabolism, growth, and overall health.