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Flashcards in Endocrinology Deck (54)
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1

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

- excess hormone
- reduced hormone
- physical gland enlargement

2

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

- excess and reduced hormone level

3

what are the 3 thyroid diseases?

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

4

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

20-40 years old

5

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

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

6

what are the 3 possible causes for hyperthyroidism?

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

7

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

graves disease

8

give some symptoms of hyperthyroidism?

- sweating -irritability
- heat intolerance -anxiety
- palpitations -poor sleep
- breathlessness -excess appetite
- diarrhoea -weight loss

9

what are some of the signs of hyperthyroidism?

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

10

what is an addition symptoms of graves disease?

eye disease

11

which 2 ways can hyperthyroidism be diagnosed?

- clinical
- blood tests

12

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

1. thyroid function tests
2. auto-antibodies

13

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

- low TSH (thyroid stimulating hormone)
- high T4 (thyroxine)

14

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

1. anti-thyroid drugs
2. beta-blockers

15

why are beta blockers given to those with hyperthyroidism?

to help control symptoms

16

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

1. younger patients
2. pregnant/breast-feeding

17

what is the mean age of diagnosis of hypothyroidism?

60

18

is hypothyroidism more or less common in women than men?

more (2% compared to 0.2%)

19

what are the 4 possible causes of hypothyroidism?

- auto immune
- iatrogenic (surgery/radioiodine)
- iodine deficiency
- pituitary disease (rare)

20

what are the signs and symptoms of hypothyroidism?

- 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

21

what are the 2 acute signs of hypothyroidism?

- coma
- hypothermia

22

what are the 2 ways to test for hypothyroidism?

1. clinical
2. blood tests

23

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

- high TSH
- low T3, T4
- auto-antibodies

24

name 2 anti-thyroid drugs?

- 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)