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Dental Meds > Module 6 Exam 3 > Flashcards

Module 6 Exam 3 Flashcards

1
Q

Where are the adrenal glands located

A

bilaterally at the superior pole of each kidney

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2
Q

What kind of glands are adrenal glands

A

endocrine, secretes directly into blood

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3
Q

What does the adrenal medulla stimulate

A

sympathetic nervous system

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4
Q

What does the adrenal medulla secrete

A

catecholamines

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5
Q

what are the 2 catecholamines that are secreted

A

-norepi

epi

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6
Q

What does the adrenal cortex secrete and produce

A

steroid hormones

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7
Q

what are 3 examples of steroid hormones

A

-glucocorticoids
mineralcorticoids
gonadocorticoids

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8
Q

What is an example of a glucocorticoid

A

hydrocortisone (cortisol)

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9
Q

What does hydrocortisone physiologically generate the metabolism of

A

carbs, fats, protients

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10
Q

What do glucocorticoids do?

A
  • inhibits inflammation
  • increases blood sugar levels (glucose
  • *maintenance of homeostasis during period of stress
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11
Q

What is the average 24 hour secretion of Cortisol

A

20 mg

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12
Q

What causes an increase in cortisol secretion

A 
surgery
stress
trauma
burns
emotional upsets
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13
Q

What can an increased release of cortisol be reduced by

A

-morphine
benzodiazepines (valium
local anethetic
nitrous

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14
Q

What are long term use glucocortioids used for

A

immunosuppressive therapy

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15
Q

What is the dental use of glucocorticoids

A

-pain reduction
edema
trismus
endo procedures

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16
Q

What is an example of a mineralocorticoid

A

aldosterone

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17
Q

What is the primary mineralcorticoid secreted by the adrenal cortex

A

aldosterone

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18
Q

What is aldosterone essential for

A

sodium and potassium balance

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19
Q

What is aldosterone responsible for

A

fluid/water maintenance in blood

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20
Q

What is addisons disease

A

chronic adrenal insufficiency, decreased gluco and mineralo corticoids

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21
Q

Addisons disease is a ____ adrenal insufficency

A

Primary

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22
Q

what is the cause of addisons disease

A
  • infectious diseases or malignancy

- autoimmune

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23
Q

What happens where there is a lack of cortisol

A
  • decrease glucose, fat, protein metabolism

- inability to tolerate stress

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24
Q

What physical characteristics do we see in Addisons disease

A

weakness
fatigue
abnormal pigmentation *

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25
Q

What may precipitate an adrenal crisis

A

stress

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26
Q

What happens when there is a decrease in aldosterone production

A
  • inability to conserve sodium and eliminate potassium

- hypotension due to decreased blood volume

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27
Q

Is primary or secondary adrenalcortical insufficency more common

A

secondary

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28
Q

What does secondary adrenocortical insufficency result from

A

administration of exogenous corticosteriods

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29
Q

What is the biggest cause of adrenal gland insufficiency

A

when and MD prescribes excess cortisol for autoimmune

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30
Q

What is the most common disease of hyperadrenalism

A

cushings syndrome

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31
Q

what is hyperadrenalism

A

glucocorticoid excess

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32
Q

what are some symptoms of cushings syndrome

A
  • moon shaped face
  • weight gain
  • buffalo hump
  • bone fractures
  • mental depression
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33
Q

do dental pts who are currently taking corticosteriods require additional supplementation for routine dental procedures? what about for dental surgery?

A

No

Yes, should double the amt on day of procedure, do a consult

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34
Q

In pts with hyperadrenalism what is there an increased possibility of

A

hypertension (increased aldosterone)

osteoporosis (increased corticosteroids)

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35
Q

What should tx plans address in pts with hyperadrenalism

A

perio bone loss
implants
avoid extensive neck manipulation

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36
Q

What is diabetes mellitus

A

-disorder of pancrease/cells, lack of insulin, metabolic and vascular components

37
Q

What is diabetes characterized by

A

hyperglycemia

38
Q

what are some complications of the microvascular disease portion of diabetes

A
  • causes increase in vascular thickness/loss of elasticity
  • neuropathy
  • retinopathy
39
Q

What are characteristics of type 1 diabetes

A
  • autoimmune
  • antibodies beta cells in pancreas
  • insulin deficency
  • onset before age 25
40
Q

Which type of diabetes is idiopathic

A

type 1

41
Q

What are some characteristics of Type 2 diabetes

A 
-adults
obesity
insulin prod. doesnt meet needs
resistance to insulin
gradual onset
middle age
42
Q

What can type 2 diabetes be controlled by

A

diet, exercise, oral hypoglycemics

43
Q

what are some examples of oral hypoglycemics

A

diabinese, orinase, tolinase

44
Q

What is gestational diabetes

A

temporary disorder of glucose metabolism

45
Q

What blocks the action of insulin in gestational diabetes

A

estradiol and progesterone

46
Q

What is the most important stimulus for insulin secretin

A

glucose

47
Q

what is hyperglycemia

A

lack of insulin or insulin action

glucose accumulates in the tissue fluids and blood

48
Q

What happens in hyperglycemia-ketoacidosis

A

-increased blood glucose, excreted in urine, fluid loss which leads to dehydration, cellular starvation begins, increased food intake with weightloss, if glucose cant be used it shifts to fat metabolism which forms ketone bodies

49
Q

what happens if there is a continual metabolism of of fat in ketoacidosis

A

metabolic acidosis

50
Q

What can severe acidosis lead to

A

coma and death

51
Q

What happens in ketoacidosis when the body can no longer maintain the pH

A

respiratory and renal regulation begins to fail

52
Q

What is diabetic acidosis

A
  • inhibits migration of cells to injured areas and decreases phagocytic activity
  • increases susceptibility to infection
53
Q

what are complications of diabetic acidosis

A 
diabetic retinopathy
cataracts
diabetic renal failure
antherosclerosis
ulceration and gangrene
54
Q

what are complications of diabetic acidosis

A 
diarrhea
muscle weakness
numbness
tingling
burning
55
Q

What are symptoms of diabetic acidosis

A 
-polydypsia
polyuria
polyphagia
weight loss
loss of strength
56
Q

What should you do in dental management of a Type 1 diabetes pt

A
  • usually procedures can be preformed
  • morning appt
  • usual insulin dosage and meds
  • have glucose available
57
Q

what should you do in dental management of type 2 diabetes pt

A
  • all dental procedures can be preformed

- no special precautions

58
Q

what are oral complications of diabetes

A 
-xerostomia
infection
poor healing
increased incidence and severity of caries
gingivits and perio disease
59
Q

What is the location of the thyroid

A

anterior portion of neck, inferior thyroid cartilage

60
Q

what is the function of the thyroid

A

influences growth and maturation of tissues, cell respiration and total energy expenditure

61
Q

What does the thyroid secrete

A

T4

62
Q

What is T4 converted to

A

the active form T3

63
Q

What do thyroid hormones affect

A

metabolic processes throughout the body BMR

increases the rate at which carbs are burned

64
Q

What are thyroid hormones important for

A

tissue growth and development

65
Q

What are causes of thyroid disorders

A 
drugs
illnesses
thyroid disease
pituitary disorders
age
66
Q

What is calcitonin involved with

A

-parathyroid hormone and vit D in regulating calcium and phosphate levels and skeletal remodeling

67
Q

What are some facts about a simple goiter

A
  • 75% of all swellings

- most are non functional nad do not cause hyperthyroidism

68
Q

What is graves disease

A

most common cause of hyperthyroidism in children and adolescents, autoimmune, overactive thyroid

69
Q

What does graves disease inhibit TSH from doing

A

binding to receptor

70
Q

What is exopthalmous in graves disease

A

-eye muscles swell, pressure pushes anterior, surgically corrected

71
Q

What does it mean when exopthalmous may be cyclic

A

-burn its self our or remain active

72
Q

what is hyperthyroidism

A
  • overactive thyroid

- cause of thyrotoxicosis (incr. thyroid hormone in blood)

73
Q

What should we do with uncontrolled hyperthyroidism and dental tx

A

requires medical consult before tx

74
Q

what should we do with controlled hyperthyroidism and dental tx

A

tx plan unaffected, conservative amt of epi, no epi, retraction cord

75
Q

just remember in hyperthyroidism everything goes up and hypo everything goes down

A

..

76
Q

What is hypothyroidism

A

-condition of decreased activity of the thyroid gland

77
Q

In hypothyroidism what fails to secrete

A

thyroxine(T4)

Triiodothyronine (T3)

78
Q

What are causes of primary hypothyroidism

A

hashimotos disease

79
Q

what is hashimotos disease

A

autoimmune disease
atrophy of thyroid gland
hypothyroidism symptoms

80
Q

what is the most common cause of goitrous hypothyroididsm

A

hashimotos disease

81
Q

what are causes of secondary hypothyroidism

A

failure of the pituitary gland to secrete TSH to stimulate the thyroid gland

82
Q

what are some other causes of hypothyroidism

A

-congentital
surgical removal of thyroid gland
irradiation of gland
inflammatory conditions

83
Q

What is neonatal cretinism characterized by

A

-dwarfism, overweight, broad nose, wide set eyes, thick lips, delayed eruption of teeth, poor muscle tone and cerebral dev, malocclusion

84
Q

WHat can be avoided if it is treated and detected early

A

neonatal cretinism

85
Q

What is the condition myxedema of hypothyroidism?*

A

accumulation of intracellular and extracellular fluid

86
Q

what are some characteristics of myxedema

A

-body retains water
-high B/P
-bradycardia
low body tem
weakness
weight gain

87
Q

How should we manage mild symptoms of hypothyroidism

A

do not present a danger when receiving dental tx

88
Q

what should be avoided in pt with hypothyroidism

A

avoid CNS drugs, sedatives, narcotics

Dental Meds (12 decks)

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