ATI RN
Endocrine System Pediatric Questions
Question 1 of 5
A 6-year-old female presents with breast enlargement and pubic hair development. Otherwise, she is asymptomatic. Her serum LH level is elevated. The most likely diagnosis is
Correct Answer: D
Rationale: Elevated LH with puberty signs at age 6 indicates central precocious puberty (gonadotropin-dependent).
Question 2 of 5
A 6-year-old has a chronic rash involving all of the nails of the fingers and toes. Last year she had a seizure and was noted to have a low serum ionized calcium. Currently she has weakness and hypotension, and she presents with a hypoglycemic seizure. The most likely diagnosis causing this seizure is
Correct Answer: D
Rationale: Addison disease causes hypoglycemia, hypotension, and weakness due to adrenal insufficiency, fitting this presentation.
Question 3 of 5
Hyperkalemia in severe diabetic ketoacidosis is due to
Correct Answer: D
Rationale: Acidosis in DKA shifts potassium extracellularly, causing hyperkalemia despite total body depletion.
Question 4 of 5
In DKA, electrolyte abnormalities occurs secondary to hyperglycemia and acidosis. Which of the following electrolytes is artificially measured low in DKA?
Correct Answer: B
Rationale: Sodium is artificially low in DKA due to hyperglycemia causing osmotic shifts of water into the extracellular space, diluting serum sodium. Potassium (A) may appear high or normal despite total body depletion, while phosphorus (C), calcium (D), and bicarbonate (E) are not typically artifactual.
Question 5 of 5
Hypoglycemia may be a manifestation of child abuse or Munchausen syndrome by proxy induced by exogenous administration of insulin (i.e., factitious hyperinsulinemia). Of the following, the MOST reliable test that confirms the diagnosis of factitious hyperinsulinemia is
Correct Answer: A
Rationale: Factitious hyperinsulinemia from exogenous insulin shows high insulin levels with low C-peptide (produced by endogenous insulin), distinguishing it from endogenous causes. Low glucose (B) and ketones (C, D) are nonspecific, and high insulin (E) alone is insufficient.