Peds Exam 4: Thyroid/PKU

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Last updated 6:24 PM on 8/28/26
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9 Terms

1
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congenital hypothyroidism s/s? (7)

  1. short, thick neck

  2. hypotonia w/ ⬇reflexes

  3. jaundice

  4. enlarged tongue (macroglossia)

  5. sleep alot

  6. poor sucking

  7. abd distention/constriction


  • baby born w/ low TH levels


<ol><li><p><span style="color: rgb(240, 102, 102);"><strong>short, thick neck</strong></span></p></li><li><p><span style="color: rgb(124, 79, 219);"><strong>hypotonia </strong></span>w/ <span data-name="arrow_down" data-type="emoji">⬇</span>reflexes</p></li><li><p><span style="color: rgb(173, 186, 50);"><strong>jaundice</strong></span></p></li><li><p><span style="color: rgb(203, 31, 215);"><strong>enlarged tongue</strong></span> (macroglossia)</p></li><li><p><span style="color: rgb(28, 150, 129);"><strong>sleep alot</strong></span></p></li><li><p><span style="color: rgb(142, 123, 29);"><strong>poor sucking</strong></span></p></li><li><p><span style="color: rgb(22, 110, 197);"><strong>abd distention/constriction</strong></span></p></li></ol><p></p><ul><li><p>baby born w/ low TH levels</p></li></ul><p></p>
2
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nurse care for congenital hypothyroidism: (4)

  1. give synthetic TH (levothyrxine)

  2. give vitamin D

  3. monitor TH levels (T3,T4, TSH), weight, resp status

  4. monitor feeding


3
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what does it mean for mom if she tests positive for PKU?

  • what happens if she doesnt follow?


  1. strict diet from 3 months b4 conception throughout pregnancy

  2. if dont follow→ baby retardation

  • microcephaly

  • cognitive impairment

  • heart defects


4
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PKU signs: (5)

  1. musty odor pee

  2. microcephaly

  3. blue eyes & very fair skin w/ light blonde hair

  4. FTT

  5. heart defects


<ol><li><p><span style="color: rgb(159, 124, 44);"><strong>musty od</strong>or pee</span></p></li><li><p><span style="color: rgb(31, 176, 81);"><strong>microcephaly</strong></span></p></li><li><p><span style="color: rgb(39, 150, 161);"><strong>blue eyes &amp; very fair skin w/ light blonde hair</strong></span></p></li><li><p><span style="color: rgb(167, 91, 241);"><strong>FTT</strong></span></p></li><li><p><span style="color: rgb(178, 40, 40);"><strong>heart defects</strong></span></p></li></ol><p></p>
5
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PKU screening requirements: (3)

  1. phenylalanine 0.5-1 mg/dL

  2. repeat screen @ 1-2 weeks

  3. newborn metabolic screen w/in 2 days of birth


6
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PKU dietary restrictions: (5)

  1. NO high PKU foods: eggs, meat, milk/yogurt, soy products, beans (no high protein)

  2. EAT fruits/veggies, low protein grains (bread, pasta, rice)

  3. initiate regimen ASAP or w/in 7-10 days of birth

  4. formula low in PKU

  5. can breastfeed in moderation

  • contains protein


7
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whats the intake of PKU/ kg of body weight/day:

  • and what should the PKU level be normally?


20-30 mg PKU/kg of body weight/day

  • PKU level for PKU pts: < 8mg/dL ideal


8
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Whats growth hormone deficiency?

Hypopituitarism

  • low secretion of pituitary hormone


9
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signs of Hypopituitarism: (4)

  1. short stature but proportional

  • child is shorter than expected for their age, but their body proportions are normal

  1. delayed epiphyseal closure

  • growth plates at the ends of long bones stay “open” longer than usual

  1. ⬆insulin sensitivity

  • body responds more strongly to insulin, meaning blood sugar is used efficiently

  1. delayed dentition, jaw, sexual development

  • Teeth come in later than normal

  • Jaw growth may be slower