Chapter 9 Flashcards by Shaelynn Hicks

Endocrine disorders

Hyperpituitarism
Hyperthyroidism 
Hypothyroidism 
Hyperparathyroidism
Diabetes mellitus 
Addison disease

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What does the endocrine system consist of?

A group of integrated glands and cells that secrete hormones

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Endocrine disorders can result from what?

Too much or too little hormone production
Gland dysfunction
A problem with hormone control and production

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What is hyperpituitarism?

Excess hormone production by the anterior pituitary gland

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What is hyperpituitarism caused by?

A benign tumor called a pituitary adenoma, that produces growth hormone

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What results when hyperpituitarism occurs before the closure of long bones?

Gigantism

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What results when hypersecretion occurs during adult life?

Acromegaly

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Who does hyperpituitarism affect?

Men and women in their 40’s

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What are the clinics features and oral manifestations of hyperpituitarism?

Poor vision
Enlarged hands and feet
Increased rib size
Enlargement of maxilla and mandible 
Enlargement of nasal bones 
Voice deepening bc of enlarged sinus 
May have thick lips and macroglossia

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What disease is hyperthyroidism associated with?

Graves disease

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What is hyperthyroidism?

Excess production of thyroid hormone

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An autoimmune disorder that most commonly causes hyperthyroidism

Graves disease

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Who is hyperthyroidism more common in?

Women in their 30s and 40s

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A significant clinical characteristic often seen in patients with Graves’ disease

Exopthalmos (protrusion of eyeballs)

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Oral manifestations of hyperthyroidism

Premature exfoliation of deciduous teeth and premature eruption of permanent teeth
Osteoporosis may affect alveolar bone
Caries and perio develops more rapidly
Burning tongue

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What is hypothyroidism?

A decreased output of thyroid hormone

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Infancy and childhood hypothyroidism

Cretinism

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Hypothyroidism I’m older children and adults

Myxedema

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Hypothyroidism oral manifestations in infants

Thickened lips
Enlarged tongue
Delayed eruption of teeth

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Oral manifestation of hypothyroidism in adults

Enlarged tongue

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Most commonly prescribed hormone replacement therapy for hypothyroidism

Levothyoxine

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A chronic disorder of carbohydrate metabolism characterized by abnormally high blood glucose levels

Diabetes mellitus

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High blood glucose levels

Hyperglycemia

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What does diabetes mellitus result from?

A lack of insulin, defective insulin that does not work to lower blood glucose levels, or increased insulin resistance caused by obesity

What system is the most severely affected by diabetes?

Vascular

Clinical features of NIDDM

``` Decreased resistance to infection Skin infections: furuncles UTI’s Tuberculosis Blindness Can affect nervous system Atherosclerosis ```

A thickening of the blood vessel wall from fibrofatty plaques, can easily to impaired circulation, causing impaired oxygenation and nutrition in tissue

Atherosclerosis

Uncontrolled diabetes =

Uncontrolled periodontal conditions

What is Addison disease?

Insufficient production of adrenal steroids

What are the causes of adrenal gland destruction?

``` Malignant tumor TB deep fungal infections HIV Autoimmune disease Unknown ```

What are the clinical manifestations of Addison disease?

Stimulation of melanocytes | Bronze skin and macular on oral mucosa

Treatment of Addison disease

Steroid replacement therapy

Clinical features of Addison disease do not appear until how much of the adrenal gland has been destroyed?

90%

What is hypercortisolism known as?

Cushing syndrome

What is Cushing syndrome caused by?

Sustained increase in glucocorticosteroid levels

What is the most significant and obvious clinical feature of Cushing syndrome?

Weight gain

Do the signs for Cushing syndrome develop fast or slow?

Slow

What are blood disorders?

Disorders of red blood cells and hemoglobin Disorders of white blood cells Bleeding disorders

A reduction in the oxygen carrying capacity of blood that is most often related to a decrease in the number of circulating red blood cells

Anemia

Clinical signs of anemia

Pallor of skin and oral mucosa Angular cheilitis Erythema and atrophy of oral mucosa Loss of filiform and fungiform papillae on dorsum of tongue

An insufficient amount of iron is supplied to bone marrow for RBC development

Iron deficiency anemia

Possible causes for iron deficiency anemia

Deficient iron intake Blood loss from menstrual bleeding or chronic GI bleeding Poor iron absorption Pregnancy or infancy

Caused by a deficiency in intrinsic factor

Pernicious anemia

Which anemia is probably an autoimmune disorder?

Pernicious anemia

What vitamin is needed for DNA synthesis?

B12

What is folic acid and vitamin B12 deficiency anemia associated with?

Malnutrition Dietary deficiencies Increased metabolic requirements may be found with alcoholism or pregnancy

An inherited blood disorder predominantly in black individuals or those of Mediterranean or Asian origin. More common in women before age 30. RBCs in a sickle shape

Sickle cell anemia

What can oral cancer be treated with?

Surgery Radiation therapy Chemotherapy Or a combo

When does mucositis begin?

About the second week of radiation therapy and subsides a few weeks after its completion

Mucositis features

Painful Erythematous and ulcerated mucosa Pts may have difficulty eating, pain on swallowing, and loss of taste

Destruction of major salivary glands (may result in xerostomia) Pts are prone to rampant caries and oral candidiasis and osteoradionecrosis

Radiation therapy

Drugs for this cancer therapy affect nasal cells of the epithelium Mucositis and oral ulceration are common complications A decrease in all blood cells may occur

Chemotherapy

Lowered RBC count can lead to

Anemia

Lowered WBC count can lead to

Infections

Lowered platelet counts can lead to

Bleeding problems

Suppresses the immune system and can lead to candidiasis and oral infections

Prednisone

Which drugs can cause gingival enlargement?

Phenytoin (Dilantin) Nifedipine (Procardia) Cyclosporine

What is a complication associated with bisphosphonate therapy?

Osteonecrosis

Medication related osteonecrosis of the jaw may be considered if

Current or previous treatment with antiresorptive or antiangiogenic agent Exposed bone or bone that can be proved through a fistula in maxillofacial region that has persisted at least 8 weeks No history of radiation therapy to jaws