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Diseases of the human systems > Endocrine disease > Flashcards

Endocrine disease Flashcards

1
Q

What is endocrine disease

A

Dysfunction of hormone secreting glands

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2
Q

What are the 2 types of endocrine disease

A

Control failure and Gland failure

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3
Q

What type of failure is control failure

A

secondary

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4
Q

What type of failure is gland failure

A

primary

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5
Q

What is meant by multiple endocrine neoplasia

A

When there is tumours in at least two endocrine glands, because even they are different gland/organ some stem from the same embryonic tissues

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6
Q

What are the different types of multiple endocrine neoplasia

A

MEN 1, MEN 2, MEN2b

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7
Q

what falls under multiple endocrine neoplasia 1

A

Parathyroid, pancreatic islets, anterior pituitary

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8
Q

what falls under multiple endocrine neoplasia 2a

A

Parathyroid, medullary thyroid and phaeochromocytoma

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9
Q

what falls under multiple endocrine neoplasia 2b

A

Medullary thyroid, Phaeochromocytoma

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10
Q

What is important for dentists to be able to identify MEN 2b

A

mucosal neuromas

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11
Q

What is the role of the pituitary gland

A

It controls many gland activities and tells other glands to release hormones

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12
Q

What controls the pituitary gland

A

The hypothalamus

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13
Q

What are the 2 parts of the pituitary gland

A

Anterior and posterior

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14
Q

What is the anterior pituitary served by

A

The vascular plexus

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15
Q

What is the posterior pituitary gland served by

A

The vascular plexus and neurological control

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16
Q

What hormones does the anterior pituitary release

A

TSH, thyroid stimultaing hormone
ACTH, Adrenocorticotrphic hormone
GH, Growth hormone
Prolactin

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17
Q

What hormones does the posterior pituitary release

A

ADH, anti diuretic hormone

Oxytocin

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18
Q

What are the 2 types of pituitary adrenoma

A

Functional and non-funtional

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19
Q

What is a functional pituitary adrenoma

A

A tumour in the pituitary that still produces active hormones, although unrestricted

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20
Q

What is a non-functional pituitary adrenoma

A

A tumour in the pituitary that has no secretion ability, instead it compresses other glands

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21
Q

What would insufficent growth hormone lead to

A

Growth failure in children and metabolic changes in adults(increased fat and reduced vitality)

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22
Q

What would too much growth hormone lead to

A

Giantism and Acromegly

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23
Q

How would you measure growth hormone

A

By trying to measure the IGF-1 levels

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24
Q

What would be the dental aspects of someone who has acromegly

A

enlarged tounge, interdental spacing, ‘shrunk’ dentures, reverse overbite

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25
Q

What is thyrotoxicosis

A

The clinical manestfestation of excess thryoid hormone action

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26
Q

What is the most comon form of HyperTH

A

Graves disease (70-80%)

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27
Q

What are the causes of HyperTH

A

Graves disease
toxic multi-nodular goitre
toxic adenoma
pituitary tumour(rare)

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28
Q

What causes graves disease

A

auto antibodies stimulate the TSH receptor

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29
Q

What are the signs of HyperTH

A 
Warm moist skin
Tachycardia and atrial fibrillation
Increased BP and heart failure
Tremor and hyperflexia
Eyelid retraction
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30
Q

What are the symptoms of hyperTH

A 
Hot and excess sweating
weight loss
diarrhoea
palpitations
irritable, manic, anxious
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31
Q

What are the PRIMARY causes of HypoTH

A 
Autoimmune(Hashimotos) thyroiditis
Idiopathic atrophy
Radioiodine atrophy
radioiodine treatment
Iodine deficency
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32
Q

What drugs cause HypoTH

A

Lithium and carbimazole

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33
Q

What are the secondary causes of HypoTH

A

hypothalmic and pituitary disease

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34
Q

what are the signs of HypoTH

A 
Dry coarse skin
bradycardia, hyperlippidemia
Confusion
Goitre (Hashimotos)
Delayed reflexes
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35
Q

What are the symptoms of HypoTH

A 
Tired
Cold intolerance, weight gain, constipation
Hoarse voice
Angina
Hair loss
36
Q

What is the most common form of HypoTH

A

Hashimotos (90%)

37
Q

When investigating Thyroid disease what would want to look for in the blood

A

TSH, T3 and T4 levels

38
Q

What imaging investigations can be carried out for thyroid disease

A

ultrasound scan, radioisotope scans

39
Q

What would be the differences to identify whether its a HyperTH caused from pituitary cancer or graves/adrenoma

A

Cancer: RAISED TSH and RAISED T3 levels

Graves/adrenoma: LOW TSH and RAISED T3 levels

40
Q

What would be the differences to identify whether its a HypoTH caused from pituitary cancer or a gland failure

A

Cancer: LOW TSH and LOW T4 levels

gland failure: HIGH TSH and LOW T4 levels

41
Q

What treatment is there for Hyper TH

A

Carbimazole
B blockers
Radioiodine
surgery-partial Thyroidectomy

42
Q

What treatment is there for HypoTH

A

Give T4 tablets, increasing dose slowly

43
Q

What is goitre

A

Enlargement of the area around the thyroid

44
Q

Treatment of goitre?

A

Diffuse enlargment of the TH gland

45
Q

What often causes goitre

A

Iodine defficency

46
Q

What would identify thyroid cancer

A

‘Cold’ nodules on radioisotrope scans

47
Q

As a dentist would you treat patients getting treated for thyroid disease any different

A

NO

48
Q

What disease involves the destruction of the adrenal tissue

A

Addisons disease

49
Q

What disease results in excess adrenal function

A

cushings

50
Q

What are the 3 layers of the adrenal gland and what do they produce

A

Zona glomerulosa-Aldosterone
Zona fasicularis- Cortisol
Zona reticularis- Adrenal androgens

51
Q

What hormone stimulates the anterior pituitary

A

CRH- cortitrophic releasing hormone

52
Q

What releases CRH

A

Hypothalamus

53
Q

What hormone stimulates the adrenal cortex

A

ACTH- Adrenocorticotrophic hormone

54
Q

What does the adrenal cortex release

A

DHEA, Aldosterone, Cortisol

55
Q

What is used as negative feedback for adrenal cortex control

A

Cortisol

56
Q

What is the role of aldosterone

A

Salt and water regulation

57
Q

What inhibits the action of aldosterone

A

ACE inhibitors, AT2 blockers

58
Q

What is cortisol

A

A natural glucocorticoid

59
Q

What are the effects of cortisol

A 
Antagonist to insulin
lowerd immune reacivity
raises BP 
inhibits bone synthesis 
inhibits cortitrophic releasing hormone
60
Q

What causes the hyperfunction of glucocorticoids

A

cushings disease

61
Q

What causes the hyperfunction of aldosterone

A

Conns syndrome

62
Q

What are the symptoms of cushings disease

A 
Diabetes mellitus features
poor resistance to infection 
osteoporotic changes 
psychiatric disorders(depresssion) 
hirsuitism 
Skin and mucosal pigmentation
63
Q

What are the signs of cushings disease

A 
centripetal obesity-moon face, buffalo hump
hypertension
thin skin & purpura
muscle weakness
Osteoporotic changes & fractures
64
Q

Why does high ACTH levels result in hyperpigmentation

A

because similarities in sequence with MSH which means that HIGH ACTH will stimulate pigment cells

65
Q

What are the causes of addisons disease

A

Tb, autoimmune adrenalitis(90%)

66
Q

Does addisonds disease have a slow or fast onset

A

slow

67
Q

What are the signs of Addisons disease

A

postural hypotension
weight loss & lethargy
hyperpigmentation
vitiligo

68
Q

What are the symptoms of addisons disease

A

weakness
anorexia
loss of body hair (females)

69
Q

Is addisons disease the hyper or hypofunction of the adrenal gland

A

Hypo

70
Q

What investigations is there for cushings

A

high 24hr urinary cortisol excretion
abnormal dexamethasone suppression tests
CRH tests
-cushings disease show rise in ACTH with CRH

71
Q

What investigations is there for addisons

A

high ACTH level

negative synACTHen tests

72
Q

What is a negative synACTHen test

A

A test to identify addisons, in which if there is no plasma cortisol rise in response to a ACTH injection it means addisons

73
Q

when investigating adrenal disease and the cause is hyperfunction due to a [Pituitary adenoma or Ectopic ACTH production] what would the results be

A

HIGH ACTH

HIGH cortisol

74
Q

when investigating adrenal disease and the cause is hyperfunction due to a Gland adenoma, what would the results be

A

LOW ACTH

HIGH Cortisol

75
Q

Why does a pituitary adenoma result in High cortisol and ACTH levels in the adrenal gland hyperfunction

A

because the adenoma produces an excess amount of ACTH, which in turn stimulates the adrenal glands to make more cortisol

76
Q

Why does a gland adenoma result in Low ACTH and High cortisol levels in the adrenal gland hyperfunction

A

The adenoma is secreting cortisol without any regulation and this excess cortisol still through negative feedback tells the body to stop secreting ACTH

77
Q

In hyperfunction of the adrenal gland what are the PRIMARY(gland) failure and SECONDARY(control failure) failure

A

Primary- gland adenoma

Secondary- Pituitary adenoma or Ectopic ACTH production

78
Q

when investigating adrenal disease and the cause is hypofunction due to Pituitry failure, what would the results be

A

LOW ACTH

LOW cortisol

79
Q

when investigating adrenal disease and the cause is hypofunction due to Gland destruction, what would the results be

A

HIGH ACTH

LOW Cortisol

80
Q

Why does pituitary failure result in Low ACTH and Low cortisol levels in the adrenal gland hypofunction

A

Because with pituitary failure it aint producing ACTH which then results in low cortisol levels because the adrenal gland is not being activated

81
Q

Why does gland destruction result in High ACTH and Low cortisol levels in the adrenal gland hypofunction

A

Because the adrenal gland cant produce cortisol but the body is still producing ACTH to release cortisol

82
Q

In hypofunction of the adrenal gland what are the PRIMARY(gland) failure and SECONDARY(control) failure

A

Primary- Gland destruction

Secondary- Pituitary failure

83
Q

What would the synacthen test result be in Hypofunction due to pituitary failure

A

Positive

84
Q

What would the synacthen test result be in Hypofunction due to gland destruction

A

Negative

85
Q

What dental infection could be a possible sign of cushings

A

candidiasis

Diseases of the human systems (3 decks)

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