endocrinopathy

Question 1

endocrine root

Answer 1

1) endo - within
2) crine - secrete

Question 2

glands with the following characteristics

Answer 2

1) produce hormones
2) secrete direct into the bloodstream

Question 3

exocrine glands

Answer 3

1) exo - outside
2) crine - to separate
3) adeno - gland
4) sialo - saliva

Question 4

endocrine system includes

Answer 4

1) pancreas
2) adrenal glands
- cortex
- medulla
3) etc

Question 5

basic principle

Answer 5

1) two distinct clinical diseases
- hyperfunction
- hypofunction

Question 6

hyperfunction

Answer 6

1) proliferation of the endocrine tissue
- hyperplasia
- neoplasia (functional
2) loss of negative feedback signal

Question 7

hypofunction

Answer 7

1) destruction of endocrine tissue
- immune
- etc
2) loss of positive signal

Question 8

signs and symptoms tend to be

Answer 8

1) generalized or multifocal rather than presenting as localized

Question 9

pancreas

Answer 9

1) endocrine portion - the islets of langerhans
2) 5 cell types each producing a specific hormones
- alpha - glucagon
- beta cells - insulin

Question 10

insulin and glucagon

Answer 10

1) beta hyperfunction / inadequate
2) hypoglycemia
- fast heartbeat
- shaking
- sweating
3) beta hypofunction / inadequate or resistance
- hyperglycemia
-diabetes mellitus
- carb metabolism disorder, more resistance

Question 11

diabetes mellitus roots

Answer 11

1) dia - through, betes - siphon
2) mellitus - sweet

Question 12

juvenile type I

Answer 12

1) immune mediated disorder
- WBC think beta cells are foreign

Question 13

if there is more sugar in the blood why would you urinate more

Answer 13

1) more solute in the solvent that draws water into blood vessels, meaning more pee

Question 14

adult type II

Answer 14

1) non insulin dependent
2) constant supply of glucose causes insulin receptors to stop working well

Question 15

clinical signs of diabetes

Answer 15

1) excess sugar in blood
2) sugar in urine
3) increased thirst and water intake

Question 16

diabetes systemic pathology

Answer 16

1 )diabetic coma
- breaks down fat and muscles
- releases ketones which can cause ketoacidosis
2) impaired wound healing
3) dry mouth
4) predisposition to bacterial and fungal infection
- neutrophils have poor chemotaxis

Question 17

diabetic coma

Answer 17

1 )hyperglycemia
- can be exacerbated by dental treatment

Question 18

insulin shock

Answer 18

1) hypoglycemia - carbs are not consumed after insulin and can go into shock

Question 19

oral manifestation of diabetes

Answer 19

1 )delayed healing
2) bacterial and fungal infections
3) increased incidence of severity of gingivitis and periodontal disease
4) secondary burning mouth symptoms
5 )dry mouth

Question 20

mucomycoses

Answer 20

1) diabetic patients with glucose in blood
- fungal organisms invade around blood vessels

Question 21

adrenal gland

Answer 21

1) cortex
2) medulla

Question 22

HPA axis

Answer 22

1) hypothalamus
2) anterior pituitary
3) adrenal cortex

Question 23

hypoadrenocorticism

Answer 23

1) addisons disease
- usually immune destroys adrenal gland
2) secondary
- pituitary non functional

Question 24

addisons disease

Answer 24

1 )autoimmune destruction of adrenal cortex
2) clinical
- hyperpigmentation of skin
- hypotension
- macular pigmented lesions of oral mucosa
3) dental
- Addisonian crisis
- WANT to make cortisol because stress, but they cant, so they go into shock

Question 25

hyperadtenocorticism

Answer 25

1) cushing syndrome - most commonly due to corticosteroid therapy - adrenal atrophy due to increase in cortisol from meds - weight gain! 2) or adrenal hyperplasia 3) lung tumor may make ATCH (rare)

Question 26

adrenal medulla

Answer 26

1) hyperfunction - pheochromocytoma

Question 27

thyroid gland

Answer 27

1) controls metabolism through T4 and T3 (active form) - required iodine 2) monitored by TSH

Question 28

hyperthyroidism

Answer 28

1) grave's disease - increases thyroid hormone production 2) eight loss, tachycardia, excessive perspiration, warm smooth skin 3) thyroid storm - complication of dental treatment

Question 29

hypothyroidism

Answer 29

1) hashimoto thyroiditis 2) dry rough skin, bradycardia, hypothermia, weight gain

Question 30

other thyroid hormones

Answer 30

1) calcitonin - balances PTH from parathyroid

Question 31

parathyroid glands

Answer 31

1) 4-6 glands - [Ca] and [PTH]

Question 32

primary hyperparathyroidism

Answer 32

1) primary - parathyroid adenoma (1 grow) - 80-90% of the cases 2) secondary - chronic renal disease - if the kidney is not helping make vitamin D which helps intestine absorb [Ca] - all 4 will grow

Question 33

hyperparathyroidism clinical manifestations

Answer 33

1) stones, bones, and abdominal groans

Question 34

hyperparathyroidism treatment

Answer 34

1) primary form - remove tumor *surgically* 2) secondary - *address the cause* - restrict dietary phosphate - use phosphate binding agents - pharmacologic treatment with an active *vitamin D* metabolite (calcitriol can bind to VDR)

Question 35

hypoparathyroidism

Answer 35

1) stop produced PTH, less Ca2+ in blood 2) treatment - give more vitamin D

Question 36

hypoparathyroidism and dental

Answer 36

1) partial anodontia 2) malformed or hypoplastic teeth 3) failure of tooth eruption

Question 37

gigantism

Answer 37

1 )clinical findings - true macrodontia - mandibular pronapism 2) pre pubertal onset

Question 38

post pubertal onset gigantism

Answer 38

1) after closure of epiphyseal plates 2) similar manifestations - mandibular prognathism - diastemas - macroglossia

Question 39

pituitary dwarfism

Answer 39

1) short stature - normal proportions roughly maintained - not enough GF 2) still some crowding

Question 40

achondroplasia

Answer 40

1) normal head size 2) short stature 3) body proportions not maintained 4) nonendocrine - genetic autosomal dominant

Question 41

anti-diuretic hormone

Answer 41

1) hyperfunction - small cell CA of lung - SIADHs - syndrome of inappropriate ADH secretion - neuroendocrine tumor of the lung 2) hypofunction - diabetes insipidus *ADH promote resorption of water