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Flashcards in Endocrine Disorders Deck (19)

What is the comment type if endocrine disorder?

Diabetes mellitus


What is the adrenal gland made up of?

On the outside is the cortex which secretes cortisol, aldosterone and androgens.
On the inside is the medulla which secretes adrenaline.
They sit on top of the kidneys


What is adrenocortical hypofunction?

-autoimmune (Addison's disease)
-infections (tb, histoplasmosis)
-bilateral adrenalectomy
Suppression from long term steroids

-hypopituitarism (ACTH deficiency)


What is cushing's disease?

An endocrine disease that's:
-Due to high levels of cortisol
Weight gain, thinning skin that bruises easily, stretch marks, fat deposits esp face making it round (moon face), decreased interest in sex, buffalo hump


What's are the causes of cushing's disease?

-side effect of treatment with corticosteroids (used to reduce inflammation and treat autoimmune diseases) this is iatrogenic
-could be due to an adrenal adenoma or carcinoma
-could be ACTH induced due to a pituitary tumour (adenoma), ACTH therapy, ectopic secretion from tumours


Why is cushing's hard to diagnose?

Because it's similar to underactive thyroid gland and high bp. Urine test or blood test to be done to check cortisol levels.


What is phaeochromocytoma?

A rare usually benign tumour of the adrenal glands usually noticed early to mid adulthood. Causes overproduction of adrenaline/noradrenaline and episodic hypertension. Symptoms:
Anxiety, palpitations, sweating, pyrexia, headaches


What is goitre?

Enlargement of the thyroid gland. Causes: hyperthyroidism, hypothyroidism, pregnancy, lack of iodine in the diet.
Treatment depends on the underlying cause. If it's small and not causing any problems wait and see, otherwise thyroid hormone replacement, dietary supplements and surgery are options. Most are benign but could be a sign of thyroid cancer.


What's hypothyroidism? (Cretinism in children and sometimes know. As 'myxoedema'

Underactive thyroid gland. Causes:
Autoimmune (hashinoto's thyroiditis), iodide deficiency, hypopituitarism, from treating hyperthyroidism


What are general complications of diabetes?

Retinopathy, cataracts, diabetic foot ulcer, gangrene, perio, candidosis, dry mouth, sialosis, glossitis, depression, heart disease, kidney disease, erectile dysfunction, peripheral vascular disease


What are the dental aspects of hypothyroidism?

You should avoid sedatives and opiates. Giving a GA could lead to a coma. They could have oral candidosis and other autoimmune diseases.


What are the causes of hyperthyroidism? (Also known as thyrotoxicosis)

Adenoma (toxic goitre)
Graves' disease (ab's against TSH receptor)
Inappropriate thyroxine therapy


Signs of hyperthyroidism?

Finger clubbing and bulging eyes (plus ones I already know including tachycardia)


What's the treatment for hyperthyroidism?

Partial thyroidectomy
Anti-thyroid drugs eg. Carbinazole.
Radioactive iodine


What are the dental aspects of hyperthyroidism (thyrotoxicosis)?

Anxiety, irritability
Avoid GA and LA containing adrenaline
A thyrotoxic storm it crisis could occur which involves: hyper pyrexia, tachycardia (could lead to heart failure), confusion (could lead to coma)


What is hypoparathyroidism?
(PTH regulates plasma calcium levels)

Facial twitch (chvostek's sign)
Facial parasthesia


What is hyperparathyroidism?

Generalised osteoporosis
Focal bone resorption (brown tumour which can be seen on gum or on a dental xray))
Metastatic calcification (renal stones)


What is acromegaly?

Called gigantism in children. It's hyperplasia/neoplasia of the anterior pituitary gland causing excessive secretion of growth hormones which reactor ages bone growth in adults of the skull jaws hands and feet


What are the clinical signs symptoms of acromegaly?

High blood conc of growth hormone.
Pituitary adenoma could be seen on a CR scan or MRI scan.
Cardiomegaly, hypertension.
Sexual dysfunction.
Peripheral neuropathy.
Prominent forehead.
Large nose, lips and jaw, teeth are separated or lacking.
Abnormal glucose tolerance test.
Spade shaped hands or feet.