ATI RN
Endocrine System Pediatric Questions
Question 1 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 2 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).
Question 3 of 5
A 3-week-old neonate develops repeated vomiting and dehydration. Examination reveals ambiguous genitalia with fusion of the anterior portion of the labioscrotal folds. Ultrasonography reveals presence of uterus, ovaries, and fallopian tubes. Of the following, the MOST valuable test to establish the diagnosis is
Correct Answer: A
Rationale: Elevated 17-hydroxyprogesterone confirms congenital adrenal hyperplasia (e.g., 21-hydroxylase deficiency), common in 46,XX neonates with ambiguous genitalia and salt-wasting, as seen here. Other tests (B, C, D, E) are less diagnostic initially.
Question 4 of 5
Protein intake is typically restricted in which of the following populations?
Correct Answer: B
Rationale: Protein intake is typically not restricted in pediatric CKD (A) to support growth, but is restricted in adult CKD (B) to reduce uremic toxins. VUR (C) and ARPKD (D) do not typically require protein restriction.
Question 5 of 5
Any organ or system can be injured by toxic accumulation of any of the metabolites involved in inborn errors. Of the following, the metabolic disease causing hepatic failure is
Correct Answer: C
Rationale: Glycogen storage disease IV (Andersen) causes hepatic failure due to amylopectin-like polysaccharide accumulation leading to cirrhosis. GSD I (A) and III (B) affect liver function but rarely cause failure, while MPS I (D) and II (E) primarily affect other systems.