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REGIS NU665 WEEK 15 FINAL EXAM NEWEST 2024 / 2025 ALL 50 COMPLETE ACTUAL QUESTIONS AND CORRECT VERIFIED ANSWERS (REVISED EXAM) A NEW UPDATED VERSION|GUARANTEED PASS A+ (BRAND NEW!!)$17.99
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REGIS NU665 WEEK 15 FINAL EXAM NEWEST 2024 / 2025 ALL 50 COMPLETE ACTUAL QUESTIONS AND CORRECT VERIFIED ANSWERS (REVISED EXAM) A NEW UPDATED VERSION|GUARANTEED PASS A+ (BRAND NEW!!)
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REGIS NU665 WEEK 15 FINAL EXAM NEWEST 2024 / 2025 ALL 50 COMPLETE ACTUAL QUESTIONS AND CORRECT VERIFIED ANSWERS (REVISED EXAM) A NEW UPDATED VERSION|GUARANTEED PASS A+ (BRAND NEW!!)
REGIS NU665 WEEK 15 FINAL EXAM NEWEST 2024 /
2025 ALL 50 COMPLETE ACTUAL QUESTIONS AND
CORRECT VERIFIED ANSWERS (REVISED EXAM) A NEW
UPDATED VERSION|GUARANTEED PASS A+ (BRAND
NEW!!)
Predicting height for male and female - ANSWER: -Deviation can be the first sign of
an endocrine disorder
-Need to assess pattern of growth and current growth velocity
-Growth potential is based in large part on genetic potential and may change with
altered nutritional status and illness patterns
-Target height for boys - (mothers height plus 5 inches) + (fathers height)/2
-Target height for girls - (father's height - 5 inches) + (mother's height)/2
CGD vs. GHD - ANSWER: 1. Growth hormone deficiency (failure of the hypothalamic-
pituitary-gonadal axis)
-Congenital or acquired
-Cause - idiopathic (most common); pituitary or hypothalamic disease, trauma,
minor organic hypothalamic lesion, infection, radiation
-Presents with - slow growth rate with normal birth weight, signs and symptoms of
increased ICP, microphallus, proportional short stature, delayed bone age
-Diagnosis - get a glucose, CBC, ESR, urinalysis, chemistries, screen for GI illness,
thyroid studies, growth factors, bone age of x-ray of left wrist and hand, rule out
turner syndrome in girls, measurement of GH production using stimulation agents
(levodopa, clonidine)
-Management - pediatric endocrinologist if hypothyroidism, IGF-3 or other hormone
deficiency is confirmed or for unexplained slow growth; Genotropine based on
weight - 0.16-0.24 mg/kg/week
2. Constitutional growth delay (endocrine diseases associated with delayed bone
age; hypothyroidism
-Onset - first years of life with impaired growth; normal length and weight at birth
-Cause - variation of normal growth; normal height velocity; not a disease
-Presents with - growth velocity is normal after 3 years of age, slowed linear growth
between 1-3 years of age; delayed puberty with pubertal growth spurt, delayed
bone age, positive family history
-No endocrine or metabolic disturbance - final height is appropriate for parent's
height
-Delayed bone age with growth velocity normal for bone age
-Diagnosis - Same screening for GHD, bone x-ray; this child will have a bone age
consistent with his or her height; the child with short stature will have a bone age
consistent with the chronological age
-Management - reassurance, support; endocrine to differentiate between GHD vs.
CGD; boys older than 11 and girls older than 10 - prime with sex steroids prior to GH
testing to
,Intrauterine growth retardation - ANSWER: -Resolved - 2 years
Turner syndrome - ANSWER: -Chromosomal anomaly resulting from multiple
karyotypes and a structurally abnormal X, leading to developmental, cardiac,
reproductive, genetic, and psychosocial issues
-The female must have features of TS with the complete or partial absence of the
second X sex chromosome with or without mosaicism of the cell line
-Growth concerns - short stature, short neck with webbing and low posterior hair
line, short legs, delayed puberty and infertility; female with unexplained growth
failure or pubertal delay
-Monitor growth using syndrome specific growth chart
-Present in 1/2500 live born females; many affected embryos do not survive to term
-Short stature
Growth excess - ANSWER: -Marfan - autosomal recessive inherited disorder of
connective tissue; affects the skeletal, CV, and ocular system; neurodevelopmental
cues WNL
-Tall for age, eye issues, long, narrow, face, slim; elongated limbs, fingers and toes,
loose flexible joints; pectus excavatum or pectus carinatum
-Klinefelter - most common sex chromosome disorder in males; the extra X can come
from either parent; linked to AMA, men with mosaicism are less affected and tend to
go undiagnosed; delayed expressive language, shy, withdrawn, immature for age,
ADHD
-Tall with long arm span, dental decay, delayed puberty, small penis, gynecomastia,
autoimmune disorders, skin striae, scoliosis, increased risk of malignancies
-Check arm span
Early puberty - ANSWER: 1. Males
-Premature adrenarche - hair before 10 years old - increased risk for PCOS
2. Females
-Premature thelarche - isolated breast development without any other features of
puberty, occurs in infant and toddler girls, sometimes at birth; *resolves and rarely
progresses; it is important to make sure growth acceleration is not present, bone age
is consistent with chronologic age, and there are no other signs of puberty
-Premature adrenarche - pubic hair or axillary hair in females prior to 8 years old
-More at risk for PCOS and metabolic syndrome*
-May be caused by an adrenal tumor, CAH, topical testosterone
-Normal variants of puberty
Precocious puberty - ANSWER: -The onset of multiple features of puberty earlier
than the normal range
, -Defined as thelarche or pubarche before 8 years old in girls and before 9 years old in
boys, except for Hispanic AA and Mexican American girls
-Features - accelerated linear growth, breast development, testicular or penile
enlargement, pubic hair development; bone age may be advanced
-Diagnosis for premature thelarche - nothing unless continued increase in breast or
other pubertal symptoms
-Diagnosis for premature adrenarche - serum 17-OHP to exclude CAH; 24 hour urine
or adrenal imaging to exclude an adrenal tumor
-Isolated menarche - thyroid tests and pelvic ultrasound
-Diagnostic tests for true precocious puberty - bone age x-ray of left wrist or hand,
LH, FSH, estradiol or testosterone; if FSH and LH are high - MRI to exclude CNS
tumor; if low - GnRH stimulation test to distinguish central from peripheral puberty;
if peripheral - pelvic U/S for girls, testicular U/S for boys, 17 OHP to rule out CAH
-Management - depends on cause; guide of a pediatric endocrinologist; CNS tumors -
radiation, surgery, or chemo; GnRH agonist to bring serum sex steroids to
prepubertal levels
-Treat to get to final adult height
-Central - gonadotropin dependent - idiopathic; CNS tumors, post CNS radiation, CNS
infection or trauma, congenital adrenal hyperplasia
-Peripheral - gonadotropin independent - girls (ovarian cyst or tumor, estrogen
secreting tumor, Mccune-albright syndrome); boys (testicular tumor, testotoxicosis);
both (HCG secreting tumor, hypothyroidism)
Delayed puberty - ANSWER: -When a boy 14 years old or older or a girl 13 years old
or older has no clinical features of puberty on physical examination or if puberty has
not progressed within a timely basis; normal is 11.5 years old in males and 10.5 years
old in females
-Girls should progress to menarche within 5 years of breast budding; boys should
attain sexual maturity rating stage 5 pubertal development within 4.5 years of
initiation of puberty
-The child should be referred to an endocrinologist for evaluation of hypogonadism;
treat with growth hormone if they have hypogonadism
-Most common cause is CGD
-Youth with CGD require reassurance that puberty will occur spontaneously later
compared to some peers
-Children with delayed puberty and elevated FSH and/or LH levels should be worked
up for Turner syndrome in girls and Klinefelter syndrome in boys
PCOS - ANSWER: -Presentation - hyperandrogenism, anovulation, and polycystic
ovaries greater than 10 cm on sonogram
-Insulin resistance is thought to be the major factor that is linked to this syndrome
-Irregular menstrual period (missed or fewer), hirsutism, acne, thinning hair or hair
loss on scalp, male pattern baldness, obesity or unexpected weight gain or difficulty
losing weight, darkening of skin, skin tags
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