ATI RN
Endocrine System Pediatric Questions
Question 1 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 2 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 3 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.
Question 4 of 5
A 15-year-old boy is brought to clinic by his parents because of delayed puberty. His growth chart reveals a height just below but parallel to the 5th centile. Examination is unremarkable. Bone age is consistent with a 12 year chronological age. Lab investigations including hormonal study are normal. Of the following, the MOST likely diagnosis is
Correct Answer: D
Rationale: Constitutional growth delay involves delayed puberty and growth with normal labs and a delayed bone age, matching this case. Hypothyroidism (A), Klinefelter (B), hypogonadism (C), and craniopharyngioma (D) typically show abnormal labs or physical findings.
Question 5 of 5
An adolescent female develops fever, palpitation and disorientation. Examination shows exophthalmos, goiter, tachycardia and elevated blood pressure. Lab tests reveal elevated T4 and T3 with low TSH. Of the following, the BEST initial treatment is
Correct Answer: A
Rationale: Thyroid storm requires immediate symptom control; beta blockers (e.g., propranolol) rapidly manage tachycardia and palpitations, making them the best initial treatment before antithyroid drugs (B, C), radioiodine (D), or surgery (E).