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Diseases of the human systems > Endocrine disease > Flashcards

Endocrine disease Flashcards

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1
Q

What is endocrine disease

A

Dysfunction of hormone secreting glands

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2
Q

What are the 2 types of endocrine disease

A

Control failure and Gland failure

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3
Q

What type of failure is control failure

A

secondary

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4
Q

What type of failure is gland failure

A

primary

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5
Q

What is meant by multiple endocrine neoplasia

A

When there is tumours in at least two endocrine glands, because even they are different gland/organ some stem from the same embryonic tissues

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6
Q

What are the different types of multiple endocrine neoplasia

A

MEN 1, MEN 2, MEN2b

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7
Q

what falls under multiple endocrine neoplasia 1

A

Parathyroid, pancreatic islets, anterior pituitary

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8
Q

what falls under multiple endocrine neoplasia 2a

A

Parathyroid, medullary thyroid and phaeochromocytoma

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9
Q

what falls under multiple endocrine neoplasia 2b

A

Medullary thyroid, Phaeochromocytoma

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10
Q

What is important for dentists to be able to identify MEN 2b

A

mucosal neuromas

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11
Q

What is the role of the pituitary gland

A

It controls many gland activities and tells other glands to release hormones

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12
Q

What controls the pituitary gland

A

The hypothalamus

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13
Q

What are the 2 parts of the pituitary gland

A

Anterior and posterior

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14
Q

What is the anterior pituitary served by

A

The vascular plexus

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15
Q

What is the posterior pituitary gland served by

A

The vascular plexus and neurological control

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16
Q

What hormones does the anterior pituitary release

A

TSH, thyroid stimultaing hormone
ACTH, Adrenocorticotrphic hormone
GH, Growth hormone
Prolactin

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17
Q

What hormones does the posterior pituitary release

A

ADH, anti diuretic hormone

Oxytocin

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18
Q

What are the 2 types of pituitary adrenoma

A

Functional and non-funtional

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19
Q

What is a functional pituitary adrenoma

A

A tumour in the pituitary that still produces active hormones, although unrestricted

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20
Q

What is a non-functional pituitary adrenoma

A

A tumour in the pituitary that has no secretion ability, instead it compresses other glands

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21
Q

What would insufficent growth hormone lead to

A

Growth failure in children and metabolic changes in adults(increased fat and reduced vitality)

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22
Q

What would too much growth hormone lead to

A

Giantism and Acromegly

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23
Q

How would you measure growth hormone

A

By trying to measure the IGF-1 levels

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24
Q

What would be the dental aspects of someone who has acromegly

A

enlarged tounge, interdental spacing, ‘shrunk’ dentures, reverse overbite

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25
What is thyrotoxicosis
The clinical manestfestation of excess thryoid hormone action
26
What is the most comon form of HyperTH
Graves disease (70-80%)
27
What are the causes of HyperTH
Graves disease toxic multi-nodular goitre toxic adenoma pituitary tumour(rare)
28
What causes graves disease
auto antibodies stimulate the TSH receptor
29
What are the signs of HyperTH
``` Warm moist skin Tachycardia and atrial fibrillation Increased BP and heart failure Tremor and hyperflexia Eyelid retraction ```
30
What are the symptoms of hyperTH
``` Hot and excess sweating weight loss diarrhoea palpitations irritable, manic, anxious ```
31
What are the PRIMARY causes of HypoTH
``` Autoimmune(Hashimotos) thyroiditis Idiopathic atrophy Radioiodine atrophy radioiodine treatment Iodine deficency ```
32
What drugs cause HypoTH
Lithium and carbimazole
33
What are the secondary causes of HypoTH
hypothalmic and pituitary disease
34
what are the signs of HypoTH
``` Dry coarse skin bradycardia, hyperlippidemia Confusion Goitre (Hashimotos) Delayed reflexes ```
35
What are the symptoms of HypoTH
``` Tired Cold intolerance, weight gain, constipation Hoarse voice Angina Hair loss ```
36
What is the most common form of HypoTH
Hashimotos (90%)
37
When investigating Thyroid disease what would want to look for in the blood
TSH, T3 and T4 levels
38
What imaging investigations can be carried out for thyroid disease
ultrasound scan, radioisotope scans
39
What would be the differences to identify whether its a HyperTH caused from pituitary cancer or graves/adrenoma
Cancer: RAISED TSH and RAISED T3 levels Graves/adrenoma: LOW TSH and RAISED T3 levels
40
What would be the differences to identify whether its a HypoTH caused from pituitary cancer or a gland failure
Cancer: LOW TSH and LOW T4 levels gland failure: HIGH TSH and LOW T4 levels
41
What treatment is there for Hyper TH
Carbimazole B blockers Radioiodine surgery-partial Thyroidectomy
42
What treatment is there for HypoTH
Give T4 tablets, increasing dose slowly
43
What is goitre
Enlargement of the area around the thyroid
44
Treatment of goitre?
Diffuse enlargment of the TH gland
45
What often causes goitre
Iodine defficency
46
What would identify thyroid cancer
'Cold' nodules on radioisotrope scans
47
As a dentist would you treat patients getting treated for thyroid disease any different
NO
48
What disease involves the destruction of the adrenal tissue
Addisons disease
49
What disease results in excess adrenal function
cushings
50
What are the 3 layers of the adrenal gland and what do they produce
Zona glomerulosa-Aldosterone Zona fasicularis- Cortisol Zona reticularis- Adrenal androgens
51
What hormone stimulates the anterior pituitary
CRH- cortitrophic releasing hormone
52
What releases CRH
Hypothalamus
53
What hormone stimulates the adrenal cortex
ACTH- Adrenocorticotrophic hormone
54
What does the adrenal cortex release
DHEA, Aldosterone, Cortisol
55
What is used as negative feedback for adrenal cortex control
Cortisol
56
What is the role of aldosterone
Salt and water regulation
57
What inhibits the action of aldosterone
ACE inhibitors, AT2 blockers
58
What is cortisol
A natural glucocorticoid
59
What are the effects of cortisol
``` Antagonist to insulin lowerd immune reacivity raises BP inhibits bone synthesis inhibits cortitrophic releasing hormone ```
60
What causes the hyperfunction of glucocorticoids
cushings disease
61
What causes the hyperfunction of aldosterone
Conns syndrome
62
What are the symptoms of cushings disease
``` Diabetes mellitus features poor resistance to infection osteoporotic changes psychiatric disorders(depresssion) hirsuitism Skin and mucosal pigmentation ```
63
What are the signs of cushings disease
``` centripetal obesity-moon face, buffalo hump hypertension thin skin & purpura muscle weakness Osteoporotic changes & fractures ```
64
Why does high ACTH levels result in hyperpigmentation
because similarities in sequence with MSH which means that HIGH ACTH will stimulate pigment cells
65
What are the causes of addisons disease
Tb, autoimmune adrenalitis(90%)
66
Does addisonds disease have a slow or fast onset
slow
67
What are the signs of Addisons disease
postural hypotension weight loss & lethargy hyperpigmentation vitiligo
68
What are the symptoms of addisons disease
weakness anorexia loss of body hair (females)
69
Is addisons disease the hyper or hypofunction of the adrenal gland
Hypo
70
What investigations is there for cushings
high 24hr urinary cortisol excretion abnormal dexamethasone suppression tests CRH tests -cushings disease show rise in ACTH with CRH
71
What investigations is there for addisons
high ACTH level | negative synACTHen tests
72
What is a negative synACTHen test
A test to identify addisons, in which if there is no plasma cortisol rise in response to a ACTH injection it means addisons
73
when investigating adrenal disease and the cause is hyperfunction due to a [Pituitary adenoma or Ectopic ACTH production] what would the results be
HIGH ACTH | HIGH cortisol
74
when investigating adrenal disease and the cause is hyperfunction due to a Gland adenoma, what would the results be
LOW ACTH | HIGH Cortisol
75
Why does a pituitary adenoma result in High cortisol and ACTH levels in the adrenal gland hyperfunction
because the adenoma produces an excess amount of ACTH, which in turn stimulates the adrenal glands to make more cortisol
76
Why does a gland adenoma result in Low ACTH and High cortisol levels in the adrenal gland hyperfunction
The adenoma is secreting cortisol without any regulation and this excess cortisol still through negative feedback tells the body to stop secreting ACTH
77
In hyperfunction of the adrenal gland what are the PRIMARY(gland) failure and SECONDARY(control failure) failure
Primary- gland adenoma | Secondary- Pituitary adenoma or Ectopic ACTH production
78
when investigating adrenal disease and the cause is hypofunction due to Pituitry failure, what would the results be
LOW ACTH | LOW cortisol
79
when investigating adrenal disease and the cause is hypofunction due to Gland destruction, what would the results be
HIGH ACTH | LOW Cortisol
80
Why does pituitary failure result in Low ACTH and Low cortisol levels in the adrenal gland hypofunction
Because with pituitary failure it aint producing ACTH which then results in low cortisol levels because the adrenal gland is not being activated
81
Why does gland destruction result in High ACTH and Low cortisol levels in the adrenal gland hypofunction
Because the adrenal gland cant produce cortisol but the body is still producing ACTH to release cortisol
82
In hypofunction of the adrenal gland what are the PRIMARY(gland) failure and SECONDARY(control) failure
Primary- Gland destruction | Secondary- Pituitary failure
83
What would the synacthen test result be in Hypofunction due to pituitary failure
Positive
84
What would the synacthen test result be in Hypofunction due to gland destruction
Negative
85
What dental infection could be a possible sign of cushings
candidiasis

Diseases of the human systems (3 decks)

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