Module 6 Exam 3 Flashcards
(88 cards)
1
Q
Where are the adrenal glands located
A
bilaterally at the superior pole of each kidney
2
Q
What kind of glands are adrenal glands
A
endocrine, secretes directly into blood
3
Q
What does the adrenal medulla stimulate
A
sympathetic nervous system
4
Q
What does the adrenal medulla secrete
A
catecholamines
5
Q
what are the 2 catecholamines that are secreted
A
-norepi
epi
6
Q
What does the adrenal cortex secrete and produce
A
steroid hormones
7
Q
what are 3 examples of steroid hormones
A
-glucocorticoids
mineralcorticoids
gonadocorticoids
8
Q
What is an example of a glucocorticoid
A
hydrocortisone (cortisol)
9
Q
What does hydrocortisone physiologically generate the metabolism of
A
carbs, fats, protients
10
Q
What do glucocorticoids do?
A
- inhibits inflammation
- increases blood sugar levels (glucose
- *maintenance of homeostasis during period of stress
11
Q
What is the average 24 hour secretion of Cortisol
A
20 mg
12
Q
What causes an increase in cortisol secretion
A
surgery stress trauma burns emotional upsets
13
Q
What can an increased release of cortisol be reduced by
A
-morphine
benzodiazepines (valium
local anethetic
nitrous
14
Q
What are long term use glucocortioids used for
A
immunosuppressive therapy
15
Q
What is the dental use of glucocorticoids
A
-pain reduction
edema
trismus
endo procedures
16
Q
What is an example of a mineralocorticoid
A
aldosterone
17
Q
What is the primary mineralcorticoid secreted by the adrenal cortex
A
aldosterone
18
Q
What is aldosterone essential for
A
sodium and potassium balance
19
Q
What is aldosterone responsible for
A
fluid/water maintenance in blood
20
Q
What is addisons disease
A
chronic adrenal insufficiency, decreased gluco and mineralo corticoids
21
Q
Addisons disease is a ____ adrenal insufficency
A
Primary
22
Q
what is the cause of addisons disease
A
- infectious diseases or malignancy
- autoimmune
23
Q
What happens where there is a lack of cortisol
A
- decrease glucose, fat, protein metabolism
- inability to tolerate stress
24
Q
What physical characteristics do we see in Addisons disease
A
weakness
fatigue
abnormal pigmentation *
25
What may precipitate an adrenal crisis
stress
26
What happens when there is a decrease in aldosterone production
- inability to conserve sodium and eliminate potassium
| - hypotension due to decreased blood volume
27
Is primary or secondary adrenalcortical insufficency more common
secondary
28
What does secondary adrenocortical insufficency result from
administration of exogenous corticosteriods
29
What is the biggest cause of adrenal gland insufficiency
when and MD prescribes excess cortisol for autoimmune
30
What is the most common disease of hyperadrenalism
cushings syndrome
31
what is hyperadrenalism
glucocorticoid excess
32
what are some symptoms of cushings syndrome
- moon shaped face
- weight gain
- buffalo hump
- bone fractures
- mental depression
33
do dental pts who are currently taking corticosteriods require additional supplementation for routine dental procedures? what about for dental surgery?
No
| Yes, should double the amt on day of procedure, do a consult
34
In pts with hyperadrenalism what is there an increased possibility of
hypertension (increased aldosterone)
| osteoporosis (increased corticosteroids)
35
What should tx plans address in pts with hyperadrenalism
perio bone loss
implants
avoid extensive neck manipulation
36
What is diabetes mellitus
-disorder of pancrease/cells, lack of insulin, metabolic and vascular components
37
What is diabetes characterized by
hyperglycemia
38
what are some complications of the microvascular disease portion of diabetes
- causes increase in vascular thickness/loss of elasticity
- neuropathy
- retinopathy
39
What are characteristics of type 1 diabetes
- autoimmune
- antibodies beta cells in pancreas
- insulin deficency
- onset before age 25
40
Which type of diabetes is idiopathic
type 1
41
What are some characteristics of Type 2 diabetes
```
-adults
obesity
insulin prod. doesnt meet needs
resistance to insulin
gradual onset
middle age
```
42
What can type 2 diabetes be controlled by
diet, exercise, oral hypoglycemics
43
what are some examples of oral hypoglycemics
diabinese, orinase, tolinase
44
What is gestational diabetes
temporary disorder of glucose metabolism
45
What blocks the action of insulin in gestational diabetes
estradiol and progesterone
46
What is the most important stimulus for insulin secretin
glucose
47
what is hyperglycemia
lack of insulin or insulin action
| glucose accumulates in the tissue fluids and blood
48
What happens in hyperglycemia-ketoacidosis
-increased blood glucose, excreted in urine, fluid loss which leads to dehydration, cellular starvation begins, increased food intake with weightloss, if glucose cant be used it shifts to fat metabolism which forms ketone bodies
49
what happens if there is a continual metabolism of of fat in ketoacidosis
metabolic acidosis
50
What can severe acidosis lead to
coma and death
51
What happens in ketoacidosis when the body can no longer maintain the pH
respiratory and renal regulation begins to fail
52
What is diabetic acidosis
- inhibits migration of cells to injured areas and decreases phagocytic activity
- increases susceptibility to infection
53
what are complications of diabetic acidosis
```
diabetic retinopathy
cataracts
diabetic renal failure
antherosclerosis
ulceration and gangrene
```
54
what are complications of diabetic acidosis
```
diarrhea
muscle weakness
numbness
tingling
burning
```
55
What are symptoms of diabetic acidosis
```
-polydypsia
polyuria
polyphagia
weight loss
loss of strength
```
56
What should you do in dental management of a Type 1 diabetes pt
- usually procedures can be preformed
- morning appt
- usual insulin dosage and meds
- have glucose available
57
what should you do in dental management of type 2 diabetes pt
- all dental procedures can be preformed
| - no special precautions
58
what are oral complications of diabetes
```
-xerostomia
infection
poor healing
increased incidence and severity of caries
gingivits and perio disease
```
59
What is the location of the thyroid
anterior portion of neck, inferior thyroid cartilage
60
what is the function of the thyroid
influences growth and maturation of tissues, cell respiration and total energy expenditure
61
What does the thyroid secrete
T4
62
What is T4 converted to
the active form T3
63
What do thyroid hormones affect
metabolic processes throughout the body BMR
| increases the rate at which carbs are burned
64
What are thyroid hormones important for
tissue growth and development
65
What are causes of thyroid disorders
```
drugs
illnesses
thyroid disease
pituitary disorders
age
```
66
What is calcitonin involved with
-parathyroid hormone and vit D in regulating calcium and phosphate levels and skeletal remodeling
67
What are some facts about a simple goiter
- 75% of all swellings
| - most are non functional nad do not cause hyperthyroidism
68
What is graves disease
most common cause of hyperthyroidism in children and adolescents, autoimmune, overactive thyroid
69
What does graves disease inhibit TSH from doing
binding to receptor
70
What is exopthalmous in graves disease
-eye muscles swell, pressure pushes anterior, surgically corrected
71
What does it mean when exopthalmous may be cyclic
-burn its self our or remain active
72
what is hyperthyroidism
- overactive thyroid
| - cause of thyrotoxicosis (incr. thyroid hormone in blood)
73
What should we do with uncontrolled hyperthyroidism and dental tx
requires medical consult before tx
74
what should we do with controlled hyperthyroidism and dental tx
tx plan unaffected, conservative amt of epi, no epi, retraction cord
75
just remember in hyperthyroidism everything goes up and hypo everything goes down
..
76
What is hypothyroidism
-condition of decreased activity of the thyroid gland
77
In hypothyroidism what fails to secrete
thyroxine(T4)
| Triiodothyronine (T3)
78
What are causes of primary hypothyroidism
hashimotos disease
79
what is hashimotos disease
autoimmune disease
atrophy of thyroid gland
hypothyroidism symptoms
80
what is the most common cause of goitrous hypothyroididsm
hashimotos disease
81
what are causes of secondary hypothyroidism
failure of the pituitary gland to secrete TSH to stimulate the thyroid gland
82
what are some other causes of hypothyroidism
-congentital
surgical removal of thyroid gland
irradiation of gland
inflammatory conditions
83
What is neonatal cretinism characterized by
-dwarfism, overweight, broad nose, wide set eyes, thick lips, delayed eruption of teeth, poor muscle tone and cerebral dev, malocclusion
84
WHat can be avoided if it is treated and detected early
neonatal cretinism
85
What is the condition myxedema of hypothyroidism?*
accumulation of intracellular and extracellular fluid
86
what are some characteristics of myxedema
-body retains water
-high B/P
-bradycardia
low body tem
weakness
weight gain
87
How should we manage mild symptoms of hypothyroidism
do not present a danger when receiving dental tx
88
what should be avoided in pt with hypothyroidism
avoid CNS drugs, sedatives, narcotics
