Children with scoliosis, a sideways curve of the spine, are monitored during somatropin therapy because rapid growth can make the curve worse.
Missing Word
scoliosis
Scoliosis can progress during periods of rapid growth, and somatropin speeds growth, so the spine of a child with this condition is checked during treatment. Somatropin has not been shown to cause new scoliosis.
Category: Growth Hormone Replacement
Question 2
Taking a systemic glucocorticoid such as prednisone together with an NSAID raises the risk of a peptic ulcer, so the client reports stomach pain or black, tarry stools.
Missing Word
ulcer
A peptic ulcer is an open sore in the lining of the stomach or duodenum. Glucocorticoids and NSAIDs both weaken the protection of that lining, so using them together adds to the risk of ulcers and gastrointestinal bleeding, which can show up as dark, tarry stools.
Category: Glucocorticoid Therapy
Question 3
Fludrocortisone makes the kidneys retain sodium and water, so the nurse weighs the client daily and checks the ankles and legs for edema, swelling from excess fluid in the tissues.
Missing Word
edema
Edema is swelling caused by fluid collecting in the tissues. As a mineralocorticoid, fludrocortisone acts like aldosterone and holds sodium and water in the body, so rapid weight gain, swelling and crackles in the lungs are reported to the provider.
Category: Adrenal Insufficiency
Question 4
The hypothalamic hormone that inhibits release of growth hormone and TSH from the anterior pituitary is somatostatin.
Missing Word
somatostatin
Somatostatin is an inhibiting hormone. Drugs that mimic it, such as octreotide and lanreotide, are used to suppress growth hormone in acromegaly.
Category: Endocrine Physiology
Question 5
Lanreotide can cause either high or low blood glucose because it suppresses the release of both insulin and glucagon.
Missing Word
glucagon
Glucagon raises blood glucose and insulin lowers it. Because somatostatin analogs suppress both, blood glucose can move in either direction, so it is monitored, especially in diabetes.
Category: Growth Hormone Suppressants
Question 6
The injectable growth hormone suppressant that is also approved to control the watery diarrhea of VIP-secreting tumors is octreotide.
Missing Word
octreotide
Octreotide is a somatostatin analog that suppresses growth hormone and many gut hormones. It treats acromegaly, carcinoid tumors and VIP-secreting tumors.
Category: Growth Hormone Suppressants
Question 7
The growth hormone receptor antagonist injected for acromegaly when surgery or radiation has not worked is pegvisomant.
Missing Word
pegvisomant
Pegvisomant blocks growth hormone receptors rather than lowering hormone release. Its effect is followed with insulin-like growth factor 1 levels and liver tests.
Category: Growth Hormone Suppressants
Question 8
The synthetic analog of antidiuretic hormone that is used for diabetes insipidus, bed-wetting and mild hemophilia A is desmopressin.
Missing Word
desmopressin
Desmopressin increases water reabsorption in the kidney and releases stored clotting factor VIII. Its major risk is hyponatremia from water retention.
Category: ADH Drugs
Question 9
Excessive thirst with heavy fluid intake, called polydipsia, accompanies the large urine output of diabetes insipidus.
Missing Word
polydipsia
Polydipsia is the body's response to losing large volumes of dilute urine. It improves when antidiuretic hormone replacement takes effect.
Category: ADH Drugs
Question 10
The oral antidiuretic hormone receptor antagonist used to raise serum sodium in hyponatremia from heart failure or SIADH is tolvaptan.
Missing Word
tolvaptan
Tolvaptan blocks the kidney's response to antidiuretic hormone so free water is excreted. It is started in a hospital where sodium can be checked often.
Category: ADH Antagonists
Question 11
The tetracycline antibiotic sometimes used for SIADH because it makes the kidneys less responsive to antidiuretic hormone is demeclocycline.
Missing Word
demeclocycline
Demeclocycline interferes with antidiuretic hormone's action in the kidney, increasing urine output and lowering body water. It is rarely used today as an antibiotic.
Category: ADH Antagonists
Question 12
Bromocriptine can stop galactorrhea, a milky discharge from the nipple that is unrelated to breastfeeding, by lowering a high prolactin level.
Missing Word
galactorrhea
Galactorrhea is inappropriate milk production caused by excess prolactin. As a dopamine agonist, bromocriptine suppresses prolactin release, which stops the discharge.
Category: Growth Hormone Suppressants
Question 13
Systemic glucocorticoids and potassium-wasting diuretics such as furosemide both promote potassium loss, so a client taking the two together is monitored for hypokalemia.
Missing Word
hypokalemia
Hypokalemia is a low serum potassium level. Glucocorticoids increase potassium excretion by the kidneys, and loop and thiazide diuretics do the same, so the combination adds up; muscle weakness, cramps and an irregular heartbeat are reported, and the risk matters even more in a client who also takes digoxin.
Category: Glucocorticoid Therapy
Question 14
Hydrocortisone used for replacement therapy is chemically identical to cortisol, the principal glucocorticoid made by the adrenal cortex.
Missing Word
cortisol
Cortisol regulates glucose metabolism, immune function and the stress response. Hydrocortisone replaces it in adrenal insufficiency.
Category: Adrenal Insufficiency
Question 15
The long-acting glucocorticoid given in a suppression test to help diagnose Cushing syndrome is dexamethasone.
Missing Word
dexamethasone
Dexamethasone normally suppresses ACTH and cortisol production. Failure of cortisol to fall after a dose suggests Cushing syndrome.
Category: Glucocorticoid Therapy