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Endocrine Pathology Flashcards

(59 cards)

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1
Q

Where does the thyroid gland lie?

A

Anterior midline of neck
Below thyroid cartilage

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2
Q

What does the thyroid gland produce?

A

Thyroxine T4
Triiodothyronine T3 - regulates metabolic rate
Calcitonin - calcium homeostasis

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3
Q

What is hypothyroidism?

A

Under activity of thyroid gland
Due to primary thyroid disease
Secondary pituitary disease, reduced TSH

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4
Q

What is the hypothalamic pituitary thyroid feedback system?

A

T3 and T4 feed back on pituitary to reduce TRH and TSH

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5
Q

What are the primary causes of thyroid damage?

A

Congenital
Hormone synthesis defects - iodine
Autoimmune - hashimotos
Tumour
Infective

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6
Q

What is secondary causes of thyroid damage?

A

Hypopituitarism
Reduced TSH

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7
Q

What are the clinical features of hypothyroidism?

A

Slows everything down except menstruation
Mental
Weight gain
Cold intolerance
Bradycardia
Depression

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8
Q

What is the dental relevance of hypothyroidism?

A

Children have delayed dental development
Increased risk of decay, perio
Adults have enlarged tongue
Delayed tooth eruption, wound healing
Changed taste
Avoid sedation
Lower pain threshold

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9
Q

What is hyperthyroidism?

A

Overactivity of the thyroid

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10
Q

What are the causes of hyperthyroidism?

A

Graves
Plumbers
Toxic goitre
Acute thyroiditis

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11
Q

What are the clinical features of hyperthyroidism?

A

Everything increases
Goitre
Graves - more T3 and T4
Weight loss
Heat intolerance
Tachycardia

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12
Q

What are the 3 treatments or hyperthyroidism?

A

Anti thyroid drugs - carbimazole and beta blockers
Radioactive iodine
Surgery

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13
Q

What is the dental relevance of hyperthyroidism?

A

Accelerates perio
Sensitive to adrenaline
Drugs cause infections and poor wound healing

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14
Q

What is a goitre?

A

A visible thyroid swelling

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15
Q

What is the key feature of a thyroglossal cyst?

A

Elevates when protrude tongue

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16
Q

What is the key feature of a thyroid lump?

A

Elevate on swallowing
Anterior midline below thyroid cartilage

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17
Q

How can we tell if a goitre is benign or malignant?

A

Multinodular is benign
Single nodes higher malignant risk

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18
Q

What is the treatment for thyroid lumps?

A

Toxic remove surgically or radioiodine
Cysts aspirated

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19
Q

What is the dental relevance of thyroid nodules?

A

Swelling at base of tongue could be due to thyroid

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20
Q

What is hypoparathyroidism?

A

Hypocalcaemia causing neuromuscular instability

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21
Q

What is hypoparathyroidism caused by?

A

Post-thyroid surgery
Autoimmune cases
Genetic Di Georges
Low magnesium
Chrons, renal tubular

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22
Q

What are the signs of hypocalcaemia?

A

Increased excitability of nerves
Seizures
Spasms

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23
Q

What is the dental relevance of hypoparathyroidism?

A

Addisons disease
Oral candidiasis

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24
Q

What is hyperparathyroidism caused by?

Study These Flashcards
A

Parathyroid adenoma
Parathyroid hyperplasia

25
What does hyperparathyroidism cause?
Hypercalcaemia Carcinoma Immobilisation Renal disease
26
What are the clinical features of hyperparathyroidism?
Bones - cysts Stones - renal Groans - weakness Abdominal moans - peptic ulceration
27
What is the dental relevance of hyperparathyroidism?
Brown tumours of mandible maxilla Loss of lamina dura around teeth Autoimmune diseases
28
What are the 3 types of pituitary tumours?
Excess hormone secretion Large - non-secreting prolactinomas Medium - acromegaly Small - Cushings, TSH secreting
29
What is cranial diabetes insipidus?
Lack of vasopressin Polyuria, nocturia, thirst Lots of urine leads to dehydration Diabetes as result of renal disease
30
What is acromegaly?
Due to pituitary tumour secreting growth hormone
31
What are the clinical features of acromegaly?
Hand and feet enlargement Coarse facial hair Hypertension Diabetes Overbite lower jaw Splaying teeth
32
what is the dental relevance of acromegaly?
Growth in facial structures Affecting dentures, bridges, orthodontics Difficult extractions
33
What is hypopituitarism?
Deficiency of: Hypothalamic releasing hormones - GH, FSH Pituitary tropic hormones - LH, TSH, ACTH
34
What is panhypopituitarism?
Deficiency of all anterior pituitary hormones Caused by pituitary tumours
35
Which 5 main hormones are affected in panhypopituitarism?
Gonadotropin - LH, FSH Prolactin - high Growth hormone TSH - hypothyroidsim ACTH - adrenal failure
36
What is the dental relevance of pituitary disease?
Extractions difficult - bony ankyloses Multiple endocrine problems Hypertension, cardiac, arthritis usually affected
37
What is the importance of the adrenal gland?
Produces catecholamines from medulla Steroid hormones from cortex - cortisol, aldersterone, androgens
38
What are the 3 classes of steroid hormone produced?
Glucocorticoids - affects metabolism, fluid balance, immune response - increase blood glucose Mineralocorticoids - affect sodium and potassium balance, salt and water - increase BP prevent addison Androgens
39
What is the dental relevance of adrenal disease?
Liable to infections, candidiasis Avoid NSAIDs - increase risk of peptic ulceration
40
What are the side effects of adrenal disease?
Osteoporosis increased risk of fractures Diabetes Cushings Hypertension
41
What is another name for Addisons disease?
Hypoadrenalism
42
What is Addison’s disease caused by?
Lack of corticosteroids Autoimmune disease Primary - destruction of adrenal cortex by antibodies TB, HIV
43
What are the clinical features of Addison’s disease?
Scar hyperpigmentation - excess ACTH Postural hypotension Addisonian crisis Dehydration
44
What is the treatment for Addison’s disease?
Long term glucocorticoid and mineralocorticoid replacement
45
What is another name for Cushing’s syndrome?
Hyperadrenalism
46
What is Cushings caused by?
Over-production of cortisol - glucocorticoid After taking exogenous steroids, adrenal tumour, pituitary tumour - lung cancer
47
What are the clinical features of cushings?
Moon face Frontal balding Acne Hump on back shoulders Thin skin, bruising Hypertension Osteoporosis
48
What are phaeochromocytomas?
Rare tumours of adrenal medulla Hypersecretion of catecholamines
49
What is the dental relevance of Addison’s disease?
Pigmentation of oral mucosa
50
What is diabetes mellitus?
High blood glucose levels - hyperglycaemia Deranged metabolism, lack of insulin
51
What are the 3 things that cause hyperglycaemia?
Glucagon Cortisol - promotes gluconeogenesis Catercholamines, GH - stress response
52
What are the 2 types of diabetes?
Type 1 - autoimmune, destruction of pacreatic beta cells, childhood Type 2 - impaired insulin function, older age, obesity, exercise, genetic
53
What are some other causes of diabetes?
Pregnancy Endocrinopathies Steroids, thiazides Pancreatic disease Genetic defects of beta cells or insulin
54
What is the aetiology of diabetes?
Insulin secreted by islets of langerhans in response to raised blood sugar Promotes glucose uptake, fatty acids, amino acids Stored in liver as glucagon Lack of insulin - triglycerides to fatty acids - ketones
55
What are the clinical features of diabetes?
Excess glucose in blood excreted kidneys Osmotic diuresis - polyuria Dehydration, thirst, weight loss
56
What are complications of diabetes?
Hypoglycaemia Autonomic Neurological Type 1 - ketoacidosis Type 2 - non-ketotic coma Atheroma formation
57
What is the dental relevance of diabetes?
Increased perio Increased infection risk - candidiasis Xerostomia Burning mouth Lichen planus Caries Ulcers
58
What is the treatment for diabetes?
Type 1 - insulin injections Type 2 - oral hypoglycaemic drugs stimulate insulin Metformin
59
What to do for a diabetes emergency?
Rapid ingestion of sugar, dextros IV glucose Schedule AM appointments Avoid sedation

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