Hormones
How can a patient develop Acquired Growth Hormone Deficiency?
Brain injury
Chemo/Cancer treatment
Surgeries
Define precocious puberty in girls (age)
Onset of pubertal signs prior to the age of 8
Signs of hypopituitarism in neonates
Hypoglycemia
Jaundice
Micropenis
Poor growth
Sleepiness
Signs of DI (name 2)
Excessive urine output (Polyuria)
Excessive thirst (polydipsia)
Dehydration
High sodium
Low specific gravity of urine
The kidneys cannot concentrate the urine-->has excessive water loss
What laboratory values might you expect to find in patients with hypothyroidism?
TSH elevated (to help raise the T3 and T4)
Low T3 and T4
Treatment of type 1 diabetes vs type 2 diabetes?
Insulin and diet (type 1)
Lifestyle changes and oral medications typically (type 2)
Butterfly rash is common
Lupus
What is ACTH?
Adrenocorticotropic Hormone
"Stress regulator"
Stimulates adrenal glands to release cortisol
Regulates BP, blood sugar and metabolism
Define precocious puberty in boys (age)
Onset of pubertal signs prior to the age of 9
Signs of hyperpituitarism in children
Delayed puberty
Accumulation of upper body fat
Excessive facial hair
Easy bruising
What causes DI
Deficiency of ADH (anti diuretic hormone)
What labs might you expect to see in HYPERthyroidism?
Low TSH
Elevated T3 and T4
Autoimmune destruction of insulin producing beta cells leading to insulin DEFICIENCY is found in which type of diabetes?
Type 1 diabetes
What is Juvenile Idiopathic Arthritis (JIA)
Autoimmune disorder in which the immune system mistakenly attacks the lining of the joints causing inflammation.
Most common rheumatic disease in children
How is a child diagnosed with Growth Hormone Deficiency?
Growth patterns
Xrays of hands and wrists
Blood tests for Growth Hormone Factor and GH simulation
Define delayed puberty in girls (age
No signs of puberty by the age of 13
How do we diagnose hypopituitarism and hyperpituitarism?
ACTH testing/cortisol testing
What causes Central DI? (name 2)
brain surgery
brain malformation
tumor
genetic disorders
head injury
encephalitis
meningitis
What is the most common type of hyperthyroidism?
Graves disease
antibodies stimulate the TSH receptor causing an overproduction
DKA is typically seen in Type 1 or Type 2 diabetes?
Type 1
Name the 5 components of the immune system
Thymus
Tonsils
Adenoids
Lymphatic system
Bone marrow
What is the most common form of hormone deficiency found in children?
Growth Hormone Deficiency
Define delay in puberty in boys (age)
Delay in puberty signs by the age of 14
Signs of hypopituitarism in children (name 2)
low GH (short stature)
low ACTH (hypoglycemia, hypotension)
low TSH (hypothyroid symptoms)
low LH/FSH (delayed puberty)
Low ADH (polyuria, polydipsia)
What is nephrogenic DI
Medications such as lithium, genetic disorder, kidney disease or hypercalcemia
Kidneys fail to respond to ADH appropriately
What are the 2 signs of hyperthyroidism AND 2 signs of hypothyroidism?
HYPER:
irritability, feeding issues,
hypertension, tachycardia, goiter,
microcephaly, sleep disturbances,
hyperactivity, heat intolerance,
weight loss, tremors, palpitations
HYPO: (low and slow)
hypotonic, jaundice, large tongue
dry skin, abdominal distention,
bradycardia, hypotension, anemia
Insulin resistance and impaired beta cell function is found in what type of diabetes?
Type 2 diabetes
What is methotrexate used for?
Disease modifying drug
Suppresses the overactive immune system and decreases inflammation
LUPUS, JIA
Dan also be used in ectopic pregnancies (stops the dividing pregnancy tissue from growing)
What does prolactin hormone do?
Breast milk production
How do we treat precocious puberty and delayed puberty?
Precocious: hormone blockers
Delayed: Testosterone and estrogen
This occurs if the pituitary gland secretes TOO much ACTH?
Cushings Disease
(Adrenal glands overproduce cortisol)
How do we treat DI?
Thiazide diuretics
A low-solute diet
Close monitoring of Intake and Output
DDAVP if it is central
What are the 4 types of hypothyroidism and the causes?
Acquired hypothyroidism (immune system attacks the thyroid)
Congenital (developmental issues in the thyroid)
Iatrogenic (thyroid glad is medically destroyed)
Central (lack of TSH secreted by the pituitary gland)
Symptoms: Increased thirst (Polydipsia), increased urination (Polyuria), increased hunger (polyphagia) and weight loss are signs of what?
Type 1 diabetes
What is the diagnostic criteria for Juvenile Idiopathic Arthritis? (JIA)
Arthritis begins before ate 16
Symptoms are present for at least 6 weeks
What is the Follicle Stimulating Hormone? (FSH)
Stimulates sperm production
Stimulates the ovaries to produce estrogen/produce eggs
What is the first sign of puberty in girls typically?
Breast buds
Name the 2 hormones stored in the posterior pituitary
Antidiuretic (ADH)
Oxytocin
What is the function of Antidiuretic Hormone?
Helps the body to regulate water (these patients will dump large amounts of very diluted urine)
In DI the patient cannot preserve water
Dump large amounts of diluted water
Treatment of hypothyroidism
Levothyroxine
VERY important for babies (must treat early to prevent brain damage-preferably prior to 2 weeks of age)
What are the signs of DKA?
Extremely high blood sugar
Metabolic acidosis
Ketosis
These cells are infected by HIV and or AIDs
CD4
These are a subset of T cells
What is the role of Oxytocin?
Helps labor progress by signaling the uterus to contract
What is the first sign of puberty in boys typically?
Testicular enlargement
Name 2 hormones that are secreted by the anterior portion of the pituitary gland
Adrenocorticotrophic Hormone (ACTH)
Follicle Stimulating Hormone (FSH)
Growth Hormone (GH)
Luteinizing Hormone (LH)
Prolactin
Thyroid Stimulating Hormone (TSH)
What are the 2 types of DI?
Central (neurogenic-ADH issue)
Nephrogenic (Kidneys do not respond to ADH)
Treatment of hyperthyroidism
Methimazole, may need radioactive
iodine, or surgery
Hyperglycemia hyperosmolar state is typically seen in which type of diabetes?
Type 2
What are common s/s of Juvenile Idiopathic Arthritis?
Joint pain
Swelling of one or more joints
Morning stiffness
Limping (especially in the mornings)
Warm joints (not always red)
Fatigue