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Clinical manifestations of GH - ANSWER✔✔ Short height for child's age
Increased amount of fat around waist and in face
Emotional feelings about height or weight
Younger appearance than children of same age
Decreased muscle mass
Delayed skeletal maturation Delayed onset of puberty Delayed tooth development
Hypoglycemia
GH Diagnostics - ANSWER✔✔ Thyroid panel
Evaluate renal and liver function
Insulin like growth factors (will be low)
Growth Hormone Stimulant test
Bone density scan
Brain CT or MRI
Karotyping
Growth Hormone Deficiency - ANSWER✔✔ Absence or deficiency of growth
hormone produced by the pituitary gland to stimulate the body to grow
Etiology of GH deficiency - ANSWER✔✔ Infections, trauma, brain tumors
,Etiology of Precocious Puberty - ANSWER✔✔ Hormone-secreting tumors
Brain injury caused by head trauma
Infection
Thyroid dysfunction
Ovarian dysfunction
Idiopathic (most cases)
Male: Testicular/Penile enlargement, axillary and chest hair, deepening voice, acne
Diagnostic evaluation of precocious puberty - ANSWER✔✔ Computed
tomographic scan or magnetic resonance imaging
Bone density scan
Pelvic and adrenal ultrasound
Gonadotropin-releasing hormone stimulation test
Blood work: Testosterone, estrogen, LH, FSH
Treatment involves the suppression of puberty
congenital hypothyroidism - ANSWER✔✔ Condition present at birth that results
in lack of thyroid hormones; results in poor physical and mental development;
formerly called cretinism
Clinical manifestations of hypothyroidism - ANSWER✔✔ Lethargy
Weakness
,Dry skin
Cold intolerance
Weight gain
Constipation
Coarse hair
GH Treatment - ANSWER✔✔ Most children receive subcutaneous injections
Injections can be daily or three to four times per week and have increased growth
velocity at bedtime GH must be refrigerated
Close monitoring of growth with endocrinology visits every 3 to 6 months
Treatment stops when growth plates fuse
Precocious puberty - ANSWER✔✔ The very early onset and rapid progression of
puberty
Before age 8 in girls
Before age 9 in boys
Diagnostic evaluation for hypothyroidism - ANSWER✔✔ State-required
screening: TSH and T4
Low T4, elevated TSH, or both indicate hypothyroidism
Positive test results may be followed by scan for bone age
, Blood tests before 48 hours after birth may be falsely interpreted because of the
rise in TSH immediately after birth
Treatment of hyperthyroidism - ANSWER✔✔ PTU or methimazole to control the
gland
Radioactive iodine to ablate the gland
Propranolol to treat sympathetic sxs such as tremors/palpitations, etc.
Thyroidectomy
congenital adrenal hyperplasia - ANSWER✔✔ Genetic disease in which the
adrenal gland is overdeveloped, resulting in a deficiency of certain hormones and
an overproduction of others
Clinical manifestations of CAH - ANSWER✔✔ Males-precocious genital
development
Females-may be born with varying degrees of ambiguous genitalia
-Enlarged clitoris appears as a small phallus
-Fused labia produce sac-like structure without testes
-Internal female sex organs are intact
Diagnostic evaluation CAH - ANSWER✔✔ Hormonal studies
Serum electrolyte
US to visualize pelvic organs