endocrine diseases Flashcards
where is the pituitary gland located?
sella turcica
what does the hypothalamus secrete
- corticotrophin rh
- gonadotrophin rh
- prolactin rh
- growth hormone rh
- thyrotrophin rh
what does the posterior and anterior pituitary gland secrete
posterior
- ADH (vasopressin)
- oxytocin
anterior
- adrenocorticotropic h
- follicle stimulating
-luteinizing
- thyroid stimulating
- growth
- prolactin
- melanocyte stimulating
significance of the optic chiasm
located next to the pituitary gland, where the visual field crosses
if there is swelling or tumour, might have vision problems
what hormones do the renal glands ie kidneys secrete
o renin
o erythropoietin
o activate vitamin D
is pancreas an endocrie gland
yes 2%
- insulin
- glucagon
- somatostatin
MEN2b
- multiple endocrine neoplasia
- 2b is relevant for dentistry
- mucosal neuromas = swelling seen in mouth
how to remove pituitary tumours
trans sphenoidal surgery
functional vs non functional adenomas
functional = excess hormones created like cuhsings or acromegaly
non function = no production of pituitary hormones, hormone deficiencies
what causes acromegaly
- excess growth hormone in adults
how to test for acromegaly cause
- measure IGF-1 to assess GH
- if IGF-1 is high after puberty, suggests acromegaly
what does IGF-1 do
IGF-1 promotes cell growth and division, especially in bones and muscles during growth phases. It stimulates the growth of muscle tissue, cartilage, and bone.
what dental problems do you see in patients with acromegaly
o reverse overbite
o increased interdenal spacing
o enlarged tongue
what are some physical changes you see in patients with acromegaly?
large hands and feet
enlarged supraorbital ridges
vision defects
thickened lips and soft tissues
diabetes type 2
CVS problems
acromegalic cardiomyopathy
why do people with acromegaly have type 2 diabetes?
insulin resistance from GH
GH promotes more gluconeogenesis and raises blood glucose
increases basal insulin levels
cause of primary hyperthyroidism
Graves dieases autoimmune
toxic adenoma
toxic multi-nodular goitre
causes of secondary hyperthyroidism
pituitary tumour
causes of primary hypothyroidism
hashimoto’s thyroiditis
iodine deficiency
radioiodine tx for hyper causes a change hyper-> hypo
drugs like
- carbimazole
- amiodarone
- lithium
is primary thyoid problems or secondary more rare
secondary rarer
primary causes like Graves and hashimotos’ more common
causes of secondary hypothyroidism
thyroid disease
signs and symptoms for hyperthyroidism
Warm moist skin
Tachycardia
Increased BP
Increased metabolism
Tremor
Eyelid retraction and lid lag
Bulging eyes
Goitre
weight loss
muscle weakness
manic
anxious
signs and symptoms for hyporthyroidism
Bradycardia
Confusion
Goitre (Hashimoto’s)
- inflammation of thyroid gland from antibody attack
Tired
Cold
Weight gain
Puffed face
Hair loss
Graves disease what it is and who tends to have it
autoimmune disease that causes excess production of thyroid hormone T3
people with family history of autoimmune diseases
common autoimmune disease
o vitiligo
o pernicious anaemia
o diabetes mellitus type 1
o coeliac
o myasthenia gravis
o Addison’s disease
o Graves disease
o Hashimoto’s thyroiditis
diffused goitre, proptosis and ophthalmopathy could represent what
graves disease
proptosis = eyelids pushed forward in socket due to fat tissue in the orbit
Investigation for thyroid disease
1 blood (tsh t3 t4)
2 imaging cysts
3 tissue biopsy
low TSH, high T3
pri hyper thyroid
high TSH. high T3
sec hyperthyroid