N212: Health Differences Across the Life Span 2

Health Differences Across the Lifespan 2 Study Guide Assessment: normal weight and length at birth; below third percentile on growth chart by 1 year of age; child usually grows at rate less than 5cm or 2 inches per year • Infants: hypoglycemia; seizures; hyponatremia; neonatal jaundice; pale optic discs; micropenis and undescended testes (in males) • Children: youthful facial features; high pitched voice; delayed dentition; “ripply” abdominal fat; decreased muscle mass and skeletal maturation; delayed sexual maturation; possible associated slipped femoral epiphysis It is usually diagnosed at low levels of IGF-1 (insulin like growth factor) on a screening test. Radiographic studies are used to determine bone age (skeletal maturation) or to rule out other disorders. Treatment: treat underlying disorders if present; GH therapy by subcutaneous injection daily or every other day until acceptable height is reached or growth velocity drops to less than 2cm (1 inch) per year Hypothyroidism Hypothyroidism is a failure to secrete a satisfactory quantity of thyroid hormone, resulting in an overall decrease in metabolism. Hypothyroidism causes Hashimoto’s Disease, which is an autoimmune disorder. Primary hypothyroidism accounts for 99% of all cases and 50% of cases are caused by cell mediated and antibody mediated destruction of the thyroid gland. Other causes of thyroiditis include subacute postpartum, external irradiation of gland, iatrogenic (30-40%), infections, iodine deficiency, and congenital and idiopathic infections. Secondary hypothyroidism, also called central hypothyroidism, is caused by insufficient secretions of TSH from the pituitary gland or is related to disease of the hypothalamus. The thyroid gland gradually enlarges, forming a goiter (thickening of gland) in an attempt to secrete more thyroid hormone. Signs and symptoms include fatigue, cold intolerance, constipation (monitor bowel elimination), weight gain, dry, flaky skin, brittle nails, and hypersensitivity to narcotics, barbiturates, and anesthetics (1/2 –1/3 dose of sedative is adequate). Complications of hypothyroidism include a myxedema coma. This is a state of decompensated hypothyroidism, where the patient may have lab values identical to a "normal" hypothyroid state, but a stressful event (infections, MI, CVA, drugs, etc.) precipitates the myxedema coma state. Primary symptoms of myxedema coma are altered mental status and hypothermia. Hypoglycemia, hypotension, hyponatremia, bradycardia, and hypoventilation may also occur. Myxedema, although included in the name, is not necessarily seen in myxedema coma. This is a life-threatening emergency. Symptoms include non-pitting edema in connective tissue throughout the body, puffy face and tongue, hypoventilation, hypothermia, respiratory acidosis, syncope, bradycardia, hypotension, seizures and cerebral hypoxia. Low levels of T3 and T4, and an accumulation of mucopolysacchaides under the skin and in the intestinal tissue is also seen. Low metabolic rate, increased fatigue, low temperature, cold intolerance, low heart rate, stiff joints, weight gain and hair loss are also signs. ©2017 Achieve Test Prep Page 76 of 140