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Endocrinology Flashcards

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1
Q

what are the 3 main problems that can occur in the endocrine system?

A
  • excess hormone
  • reduced hormone
  • physical gland enlargement
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2
Q

which of these 3 problems that can occur in the endocrine system can give widespread effects?

A
  • excess and reduced hormone level
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3
Q

what are the 3 thyroid diseases?

A
  1. hyperthyroidism (excess thyroxine)
  2. hypothyroidism (lack of thyroxine)
  3. thyroid mass (goitre)
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4
Q

what is the common age range to get diagnosed with hyperthyroidism?

A

20-40 years old

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5
Q

is hyperthyroidism more or less common in women that in men?

A

more common in women (2.3% compared to 0.2%)

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6
Q

what are the 3 possible causes for hyperthyroidism?

A
  1. auto-immune
  2. goitre or toxic adenoma (benign tumour)
  3. pituitary driven
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7
Q

if hyperthyroidism is auto-immune then what is it called?

A

graves disease

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8
Q

give some symptoms of hyperthyroidism?

A
  • sweating -irritability
  • heat intolerance -anxiety
  • palpitations -poor sleep
  • breathlessness -excess appetite
  • diarrhoea -weight loss
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9
Q

what are some of the signs of hyperthyroidism?

A
  • warm moist skin
  • high blood pressure
  • tachycardia
  • heart failure
  • fine tremor
  • goitre
  • pre-tibial myoedema
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10
Q

what is an addition symptoms of graves disease?

A

eye disease

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11
Q

which 2 ways can hyperthyroidism be diagnosed?

A
  • clinical

- blood tests

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12
Q

which two sets of blood tests would you request for hyperthyroidism?

A
  1. thyroid function tests

2. auto-antibodies

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13
Q

what are the two main things to look for in a thyroid function test?

A
  • low TSH (thyroid stimulating hormone)

- high T4 (thyroxine)

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14
Q

what are the 2 groups of drugs given to manage hyperthyroidism?

A
  1. anti-thyroid drugs

2. beta-blockers

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15
Q

why are beta blockers given to those with hyperthyroidism?

A

to help control symptoms

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16
Q

in which 2 patient categories should you be cautious about using radioactive iodine as treatment of hyperthyroidism?

A
  1. younger patients

2. pregnant/breast-feeding

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17
Q

what is the mean age of diagnosis of hypothyroidism?

A

60

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18
Q

is hypothyroidism more or less common in women than men?

A

more (2% compared to 0.2%)

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19
Q

what are the 4 possible causes of hypothyroidism?

A
  • auto immune
  • iatrogenic (surgery/radioiodine)
  • iodine deficiency
  • pituitary disease (rare)
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20
Q

what are the signs and symptoms of hypothyroidism?

A
  • reduced metabolism (weight gain)
  • cold intolerance
  • mental slowness
  • poor memory
  • hoarse voice
  • thin, dry hair (or hair loss)
  • large tongue
  • goitre
  • constipation
  • puffed face and extremities
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21
Q

what are the 2 acute signs of hypothyroidism?

A
  • coma

- hypothermia

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22
Q

what are the 2 ways to test for hypothyroidism?

Study These Flashcards
A
  1. clinical

2. blood tests

23
Q

what are you looking for in the blood tests for hypothyroidism?

Study These Flashcards
A
  • high TSH
  • low T3, T4
  • auto-antibodies
24
Q

name 2 anti-thyroid drugs?

Study These Flashcards
A
  • carbimazole

- propylthiouracil

25
what are the dentally relevant points about anti-thyroid drugs?
they can cause - taste disturbances - neutropenia and agranulocytosis ( both increasing infection risk)
26
what are the drugs given to patients who have hypothyroidism?
- thyroxine (T4) | - levothyroxine
27
what are the 3 subgroups from thyroid masses?
1. no association with intrinsic thyroid disease 2. associated with intrinsic thyroid disease 3. malignancy
28
what are the 2 causes of thyroid masses not associated with intrinsic thyroid disease?
1. simple cysts (adenoma) | 2. iodine deficiency
29
what are the 2 causes of goitre that is associated with intrinsic thyroid disease?
- autoimmune (graves) | - toxic multi-nodular goitre (adenoma)
30
how common is goitre malignant?
rare
31
what are the dentally relevant points about goitres?
rarely have retro-sternal extension (compression) which will cause 1. dyspahgia 2. breathing difficulties - can have lymphadenopathy (ominous sign)
32
what are the 3 ways to investigate goitre?
1. blood tests 2. fine needle aspiration 3. radiology (ultrasound/ radioisotope scan)
33
what are the 2 treatment options for goitre?
- address underlying cause | - surgery to remove
34
the adrenal gland produces what?
corticosteroids
35
what is the disease that can occur due to a deficiency in the production of corticosteroids?
addisons disease
36
cushings syndome is...
when there is an excess in corticosteroid production
37
what are some of the causes of cushings syndrome?
- excess ACTH | - excess corticosteroids
38
where is ACTH produced? what affect does it have?
the anterior pituitary gland brings about cortisol production in the adrenal gland during stressful situations
39
what may cause an excess in ACTH?
1. pituitary adenoma (benign tumour) | 2. ectopic production by cancers ie lung
40
what may cause an increase in corticosteroids?
adrenal carcinoma or adenoma
41
what are the normal uses of cortisol?
- maintain BP - inhibit Bone formation - anti-Inflammatory - decreases Immune function - increases gluceogenesis
42
in cushings syndrome where there is a prolonged period of high cortisol levels what are 3 negative consequences?
- diabetes - hypertension - prone to infection
43
what are some of the signs and symptoms of cushings syndome?
- moon face - purple striae - easy bruising - impaired wound healing - hair thinning - acne - weight gain - increased body/facial hair - red cheeks - thin skin - buffalo hump - bronze skin
44
what are the 2 ways to manage cushings syndrome by addressing underlying cause?
1. iatrogenic? - ie taking to many corticosteroids tx = reduce dose 2. non-iatrogenic - surgery best option
45
what is the definition of addisons disease?
where steroid hormones are failed to be produced by the adrenal cortex
46
what are some of the causes of addisons disease?
1. auto immune adrenal destruction 2. iatrogenic (withdrawal from long term steroid use) 3. hypopituitary due to - cancer - infection - vascular issues - trauma
47
name two groups of steroid hormones and example from each
glucocorticoids - cortisol | mineralocorticoids - aldosterone
48
what is the symptoms of chronic addisons disease?
general malaise
49
what are the symptoms of acute addisons disease?
shock hypoglycaemia vomiting abdominal pain
50
what are some of the causes of ACUTE addisons disease
usually in response to stress - infection - trauma - surgery
51
what are some of the signs of addisons disease?
hyperpigmentation - scars - buccal mucosa - pressure points - skin creases
52
how can addisons disease be managed?
replacement therapy 1. hydrocortisone - glucocorticoid (20mg am & 10mg pm) 2. fludrocortisone - mineralocorticoid
53
an acute addisonian crisis needs what?
- urgent medical attention! - fluid replacement - glucose - hydrocortisone injection - tx of infection
54
what 2 ways can the dental professional recognise undiagnosed adrenal diseases?
1. hyperpigmentation of the buccal mucosa (addisons) | 2. oral infections (cushings)

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