WILKES NSG 500 COMPREHENSIVE EXAM
QUESTIONS AND CORRECT ANSWERS
COMPLETE STUDY SHEET
●● Hormonal control is poorly regulated until ___________ months of
age
Answer: 12-18
●● manifestations of underdeveloped endocrine system in
newborns/infants
Answer: - poor hormone regulation
imbalances in:
- concentration of fluids
- electrolytes
- amino acids
- glucose
- trace substances
●● how are endocrine abnormalities detected in pediatrics?
Answer: - Accurate anthropometric measurement and growth plots
- Often manifest as failure-to-thrive and/or developmental delay
,●● growth hormone deficiency
Answer: Inadequate production or secretion of GH causing poor growth
& short stature
●● growth hormone deficiency incidence
Answer: 1/3480 children in the US
●● growth hormone deficiency etiology
Answer: - Hypopituitarism
- Brain tumor (pituitary gland)
- Cranial irradiation
●● growth hormone deficiency clinical manifestations
Answer: - Height less than 5th percentile
- Growth rate less than 2 SD from mean for age
- Immature face
- Delayed puberty
- Hypoglycemia
- Diminished muscle mass
- Deficiencies in other hormones
,●● growth hormone deficiency diagnostic studies
Answer: - Serial growth measurements using consistent equipment
- Bone age evaluation
- Complete metabolic laboratory analysis
- 2 positive GH levels that indicate deficiency
●● growth hormone deficiency therapeutic management
Answer: - Biosynthetic replacement GH
- SQ injection (usually specialty pen)
- Best administered at bedtime
●● percocious puberty
Answer: - Puberty before the age of 8 years in females & 9 years in
males HOWEVER...
- Workup justified in Caucasian girls under 7 and African-American girls
under 6
●● percocious puberty incidence/etiology
Answer: - More frequently in females
- Most are idiopathic etiology
- CNS lesions or trauma
- Adrenal, ovarian, testicular tumors
- Congenital adrenal hyperplasia (CAH)
, - Partial effects seen with some medications
●● percocious puberty clinical manifestations
Answer: - Demonstration of secondary sexual characteristics before the
ages of 7 or 8 depending on gender (also consider race)
- Rapid bone growth
- Early growth plate fusion
- Short stature
- Psychological effects
●● percocious puberty therapeutic management
Answer: Administration of GnRH agonist (Lupron) injection every 4-12
weeks
●● percocious puberty treatment goals
Answer: - Stop the development of secondary sexual characteristics
- Maximize adult height (may require GH)
●● percocious puberty psychosocial considerations
Answer: - Mental/Chronological age vs Age of appearance
- Dress, peer relationships education
●● congenital hypothyroidism etiology
QUESTIONS AND CORRECT ANSWERS
COMPLETE STUDY SHEET
●● Hormonal control is poorly regulated until ___________ months of
age
Answer: 12-18
●● manifestations of underdeveloped endocrine system in
newborns/infants
Answer: - poor hormone regulation
imbalances in:
- concentration of fluids
- electrolytes
- amino acids
- glucose
- trace substances
●● how are endocrine abnormalities detected in pediatrics?
Answer: - Accurate anthropometric measurement and growth plots
- Often manifest as failure-to-thrive and/or developmental delay
,●● growth hormone deficiency
Answer: Inadequate production or secretion of GH causing poor growth
& short stature
●● growth hormone deficiency incidence
Answer: 1/3480 children in the US
●● growth hormone deficiency etiology
Answer: - Hypopituitarism
- Brain tumor (pituitary gland)
- Cranial irradiation
●● growth hormone deficiency clinical manifestations
Answer: - Height less than 5th percentile
- Growth rate less than 2 SD from mean for age
- Immature face
- Delayed puberty
- Hypoglycemia
- Diminished muscle mass
- Deficiencies in other hormones
,●● growth hormone deficiency diagnostic studies
Answer: - Serial growth measurements using consistent equipment
- Bone age evaluation
- Complete metabolic laboratory analysis
- 2 positive GH levels that indicate deficiency
●● growth hormone deficiency therapeutic management
Answer: - Biosynthetic replacement GH
- SQ injection (usually specialty pen)
- Best administered at bedtime
●● percocious puberty
Answer: - Puberty before the age of 8 years in females & 9 years in
males HOWEVER...
- Workup justified in Caucasian girls under 7 and African-American girls
under 6
●● percocious puberty incidence/etiology
Answer: - More frequently in females
- Most are idiopathic etiology
- CNS lesions or trauma
- Adrenal, ovarian, testicular tumors
- Congenital adrenal hyperplasia (CAH)
, - Partial effects seen with some medications
●● percocious puberty clinical manifestations
Answer: - Demonstration of secondary sexual characteristics before the
ages of 7 or 8 depending on gender (also consider race)
- Rapid bone growth
- Early growth plate fusion
- Short stature
- Psychological effects
●● percocious puberty therapeutic management
Answer: Administration of GnRH agonist (Lupron) injection every 4-12
weeks
●● percocious puberty treatment goals
Answer: - Stop the development of secondary sexual characteristics
- Maximize adult height (may require GH)
●● percocious puberty psychosocial considerations
Answer: - Mental/Chronological age vs Age of appearance
- Dress, peer relationships education
●● congenital hypothyroidism etiology
