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BDS 2 Diseases of Human Systems > Endocrine > Flashcards

Endocrine Flashcards

1
Q

endocrine disease

A

dysfunction of hormone secreting glands. negative feedback
control failure - secondary
gland failure - primary

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2
Q

multiple endocrine neoplasia

A

rare disorders, tumour develop, affect collection of glands not just one

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3
Q

MEN1

A

parathyroud, pituitary, pancreatic islets

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4
Q

MEN2a

A

parathyroid, medullary thyroid, phaeochromocytoma

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5
Q

MEN2b

A

dental concern
medullary thyroud, phaeochromocytoma
mucosal nueromas [swelling on nerves in tissue]

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6
Q

where it pituitary gland located

A

small depression in middle of skull, sella turcica

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7
Q

pituitary gland functions

A

gland controlling, releases hormones
directly act on tissues to cause effect

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8
Q

what hormnes does the anterior pituitary release

A

TSH - thyroid stimulating hormone
ACTH - adrenocorticotropic hormone
GH - growth hormone
LH, FSH, prolactin

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9
Q

what hormones does the posterior pituitary secrete

A

ADH - antidiuretic hormone
oxytocin

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10
Q

functional adenoma pituitary tumour

A

active homone, unrestricted
, still secrete hormones

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11
Q

non functional adenoma pituitary tumour

A

space occupying, no secreting ability, lack of other hormones, visual field defects

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12
Q

consequences of pituitary tumour

A

expands upwards causing mass effect on optic chiasma
optic nerve fibres cross each other, compression from tumour, narrowed visual field

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13
Q

pituitary tumour surgery

A

trans-sphenoidal
through sphenoid bone, up nose

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14
Q

growth hormone

A

from pituitary, necessary for growth in chlildren
GH releasing H occurs at night

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15
Q

excess GH

A

continued growth of tissues
child - giantism
adult - acromegaly

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16
Q

insufficient GH

A

growth failure

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17
Q

acromegaly

A

excess GH as adult
MEN1, onset 30-50
coarse features, broad nose, enlarged hands, CV disease as heart less efficient, thicken lips

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18
Q

acromegaly dental aspects

A

enlarged tongue, interdental spacing, shrunk dentures, reverse overbite

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19
Q

investigations for GH

A

IGF-1

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20
Q

thyroid disease 2 types

A

hyperthyroidsim, hypothyroidism

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21
Q

what hormone is released by thyroid

A

TSH - thyroid stimulating hormone
tells thyroid how much thyroid hormone is needed

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22
Q

hyperthyroidism

A

excess TSH

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23
Q

hyperthyroidism aetiology

A

Graves disease - common, autoimmune, thinks TSH already bonded, excess TSH, organ specific
toxic multi-nodular goitre - toxic adenoma tumour, thyroid hormones unregulated, too much
pituitary tumour - rare, excess TSH

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24
Q

signs + symptoms of hyperthyroidism

A

sign = warm moist skin, tachycardia, increased BP, tachycardia, heart failure, increased metabolic rate
sympt - hot, excess sweating, weight loss, diarrhoea, palpitations

25
Q

graves disease

A

hyperthyroidism
organ specific, familyh of autoimmune
thinks already bonded, unregulated excess release
symptoms - swelling of thyroid gland, propotosis [eyeballs pushed farward], swelling around eyes

26
Q

hypothyroidism

A

deficiency in TSH

27
Q

hypothyroidism aetiology

A

primary - gland problem, autoimmune Hashimotos, idiopathic atrophy, drugs, iodine deficiency, congenital
secondary - hypothalamic/pituitary disease

28
Q

hashimotos thyroiditis

A

autoimmune issue, 90% of hypothyroidism
women, goitre, familyH of AI disease, Down’s syndrome, addisons

29
Q

idiopathic atrophy

A

10x in females, primary hypothyroidism
normal thyroid tissue replaced with fat tissue
autoimmune cause, lymphocyte

30
Q

investigations for thyroid disease

A

blood - TSH, T4, T4
imaging - ultrasound, changes in gland, radioisotope
tissue - biopsy

31
Q

hyperthyroid graves or adenoma findings

A

low TSH, raised T3
common

32
Q

hyperthyroid pituitary cause findings

A

raised TSH + T3
rare

33
Q

hypothyroid gland failure hashimotos findings

A

high TSH, low T4

34
Q

hypothyroid pituitary cause findings

A

low TSH + T4

35
Q

treatment for hyperthyroidism

A

carbizamole [block T4], beta blockers [reduce side effects], partial thyroidectomy
optich chiamsa - not much to be done

36
Q

treatment for hypothyroidism

A

thyroid/hormone replacement therapy
give T4 tablets, use TSH as a guide

37
Q

thyroid cancer

A

thyroid swelling, TSH senstitive, good prognosis in young

38
Q

dental aspects of thyroid disease

A

goitre detectible = feel neck
hyperthyroid - pain, anxiety, psychiatric problems, caution until controlled
hypothyroid avoid sedatives if severe, new drugs not metabolised well
treated px are normal - no extra considerations

39
Q

adrenal gland

A

sits on the kidneys, divided into outer cortex and inner medulla
secrete hormones

40
Q

adrenal gland areas

A

zona glomerulosa - aldosterone [renin, angiotensin]
cona fasicularis - cortisol [hypothalamus, pituitary]
zona reticularis - adrenal androngens

41
Q

adrenal regulation

A

controlled by hypothalamus and pituitary
hormones to regulate metabolism, immue system, BP, stress

42
Q

adrenla hormones

A

aldosterone, cortisol, progesterone, corticosterone

43
Q

aldosterone

A

MOA - salt and water regulation, retains fluid
inhibited by ACE inhibtors [cough, angiooedema], AT2 blockers
ABSENCE will cause px to have change in salt/water balance

44
Q

cortisol

A

MOA - psychological steroid, stress hormone, promotes gluconeogenesis
lowers immune reactivty, raised BP, inhibits bone synthesis

45
Q

therapeutic steroids

A

hydrocortisone, prednisolone, betamethasone [oral disease, mucosa inflammation]

46
Q

effects of therapeutic steroids

A

immunosuppression, reduced inflammatory response, enahnces salt/walter retention, hypertension, type2DM, osteoporosis, increased infection risk, thinning of skin, easy bruising, peptic ulceration, cataracts, increased cancer risk

47
Q

adrenal hyperfunction

A

excess glucocorticoids + aldosterone
causes - cushings, adrenal tumour [p], pituitary tumour [s]
aldosterone - conns syndrome, adrenal tumour

48
Q

adrenal hypofunction

A

addisons - primary
pituitary failure [s], compression from another adenoma, Sheehans syndrome
gland failure - autoimmune gland destructions

49
Q

cushings disease

A

adrenal hyperfunction, too much cortisol
aetiology - long term glucocorticoids use, pituitary/adrenal tumours

50
Q

cushing disease symptoms

A

weight gain, round face, purple stretch marks of abdomen, diabetes features
dental - oral fungal infection, reduced immune response, can’t resist infection

51
Q

high ACTH effects

A

adrenocorticotropic hormone, regulates cortisol
causes pigmenatation of cells - joints, mucosa, brown patchy
investigations - cortisol excretion test
diagnosis - pituitary adenoma [high ACTH, high cortisol], gland adenoma [low ACTH, high cortisol]

52
Q

addisons disease

A

adrenal hypofunction, too little cortisol
excess ACTH, pigmentation
aetiology - autoimmune attack response, DM, thyroid, TB

53
Q

addisons disease symptoms

A

weakness, anorexia, loss of body hair
hypotension, salt/water depletion, weight loss, lethargy, hyperpigmentation

54
Q

addisons investigations + diagnosis

A

investigations - high ACTH level, synaCTH test
diagnosis - pituitary failure [low ACTH, lowcort, positivr synacten
gland destruction [high ACTH, lowcort, negative synacthen

55
Q

adrenal hyperfunction treatment

A

detect cause - adenoma
surgery - pituitary, adrenal

56
Q

addisonian crisis

A

autoimmune destruction of adrenal gland
hypotension, vomiting, coma
basence of mineralcorticoid and glucocorticoid effects
takes time to develop

57
Q

addisons management

A

hormone replacement - cortisol, flurdrocortisone

58
Q

steroid prophylaxis

A

px aware of situations where needed
increased when - infection [abscess], surgery, psychological stress
if not enough, addisonian crisis, steroids needed to stop this

59
Q

dental aspects of steroids

A

precautions may be needed, liase for infections/illness with physician
candidiasis in cushings, can cause thrush
oral pigmentation in addisons, cushings

BDS 2 Diseases of Human Systems (9 decks)

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