Endocrine Diseases Flashcards
Which gland releases cortisol and aldosterone?
Adrenal glands
Which gland instructs the pituitary gland to release hormones?
Hypothalamus
Which cells release insulin and glucagon?
Islet cells of the pancreas
Which gland releases eggs and produces sex hormones?
Ovaries
Which gland controls blood calcium levels?
Parathyroid gland
Which gland secretes melatonin?
Pineal gland
Which gland controls other glands in the endocrine system?
Pituitary gland
Which gland produces sperm and sex hormones?
Testes
Which gland helps develop the immune system?
Thymus
Which gland controls metabolism?
Thyroid gland
What are three causes of endocrine system disorders?
- Hormone levels too high
- Hormone levels too low
- Body not responding to hormones properly
What can cause endocrine diseases?
- Hormonal imbalance (too much or too little hormone)
- Development of lesions (e.g., tumors)
What is the function of the endocrine feedback system?
It controls hormone levels in the bloodstream and signals glands to correct imbalances.
What happens if the feedback system malfunctions?
It leads to hormone imbalances.
Where is the pituitary gland located?
At the base of the brain, below the hypothalamus.
Name hormones produced by the anterior pituitary.
- TSH (Thyroid-Stimulating Hormone)
- GH (Growth Hormone)
- ACTH (Adrenocorticotropic Hormone)
- LH, FSH, Prolactin
Name two hormones released by the posterior pituitary.
ADH (Anti-Diuretic Hormone) and Oxytocin
What type of pituitary tumor is more common in people under 40?
Functional adenomas (e.g., producing Prolactin or ACTH)
What is a symptom of a pituitary tumor pressing on the optic nerve?
Vision problems or visual field defects
What condition results from excess growth hormone in adults?
Acromegaly
What condition results from growth hormone deficiency in children?
Growth failure
Which hormones are produced by the thyroid gland?
T3 and T4
What is the primary function of thyroid hormones?
Regulate metabolism
What is the most common cause of hyperthyroidism?
Graves’ disease (autoimmune condition)
Name signs of hyperthyroidism.
- Warm moist skin
- Tachycardia, Atrial Fibrillation
- Increased Blood Pressure
- Tremor & hyperreflexia
- Eyelid retraction & lid lag
Name symptoms of hyperthyroidism.
- Hot & excessive sweating
- Weight loss
- Diarrhoea
- Heart Palpations
- Muscle weakness
- Irritable, manic, Anxious
What is the most common cause of primary hypothyroidism?
Hashimoto’s thyroiditis (autoimmune disease)
Name signs of hypothyroidism.
- Dry Course Skin
- Bradycardia
- Hyperlipideamia
- Confusion
- Goitre (Hashimoto’s)
- Delayed reflexes
Name symptoms of hypothyroidism.
- Tiredness
- Cold intolerance
- Weight gain
- Constipation
- Hoarse voice
- Puffed face & Extremities
- Angina
- Slow/ poor memory
- Hair loss
What blood test is used to investigate thyroid function?
TSH, T3, and T4 levels
What imaging is commonly used for thyroid evaluation?
- Ultrasound scan (cysts)
- Radioisotope scan (gland uptake)
What medication is commonly used to treat hyperthyroidism?
Carbimazole or beta-blockers (e.g., propranolol)
What is the standard treatment for hypothyroidism?
T4 tablets (Thyroxine)
What is the most common type of thyroid cancer?
Papillary thyroid cancer
What is a key indicator of thyroid cancer on a radioisotope scan?
Cold nodules
What oral change is associated with acromegaly?
- Enlarged tongue
- Interdental spacing
- Shrunk’ dentures
- Reverse overbite
What is a dental concern for patients with untreated hyperthyroidism?
Increased anxiety and risk during dental procedures
What oral symptom might patients with hypothyroidism experience?
Burning mouth sensation
What hormones are released by the adrenal medulla?
- Adrenaline (epinephrine)
- Noradrenaline (norepinephrine)
What hormones are produced by the adrenal cortex?
- Glucocorticoids (e.g., cortisol)
- Mineralocorticoids (e.g., aldosterone)
- Adrenal androgens
What hormone is secreted by the zona glomerulosa, and what is its function?
Aldosterone: Regulates salt and water balance, affecting blood pressure and pH
Which drugs inhibit aldosterone action?
- ACE inhibitors (side effects: cough, angioedema, oral lichenoid reactions)
- AT2 blockers
What hormone is secreted by the zona fasciculata, and what is its function?
Cortisol: Manages stress response, metabolism, immune suppression, and blood pressure
How is cortisol secretion regulated?
By the hypothalamus-pituitary-adrenal (HPA) axis through ACTH
What are the effects of cortisol on the body?
Increases blood glucose (via gluconeogenesis), suppresses the immune system, raises blood pressure, and reduces bone formation
What is secreted by the zona reticularis?
Adrenal androgens (converted to testosterone and oestrogen)
What are therapeutic steroids, and what are they used for?
Man-made versions of adrenal hormones used to treat inflammatory diseases like asthma, lupus, and arthritis
How can long-term use of therapeutic steroids cause adrenal insufficiency?
By suppressing the HPA axis, leading to adrenal gland atrophy
What are the dental implications of adrenal insufficiency?
Increased risk of infection, delayed healing, and the need for steroid cover during major dental procedures
What are the primary and secondary causes of adrenal insufficiency?
- Primary: Addison’s disease (autoimmune destruction, infections like TB)
- Secondary: Pituitary failure (lack of ACTH)
What is Cushing’s syndrome, and what causes it?
A condition caused by excess cortisol, from adrenal or pituitary tumors, or prolonged steroid use
List three signs of Cushing’s syndrome.
Moon face, buffalo hump, thin skin with easy bruising
What is Addison’s disease, and what are its symptoms?
Primary adrenal insufficiency.
Symptoms include fatigue, weight loss, hyperpigmentation, and postural hypotension
How is Addison’s disease managed?
Hormone replacement: Hydrocortisone (glucocorticoid) and fludrocortisone (mineralocorticoid)
What is an Addisonian crisis, and how is it managed?
Life threatening condition when adrenal hormone levels fall significantly.
Managed with urgent corticosteroid administration and fluid replacement.
When is steroid cover recommended for dental procedures?
For patients with Addison’s disease, secondary adrenal insufficiency, or those on ≥5mg prednisolone (or equivalent) for over 4 weeks.
What is the main difference between Type 1 and Type 2 Diabetes?
Type 1 is caused by autoimmune destruction of pancreatic beta cells, leading to insulin deficiency, while Type 2 is characterized by insulin resistance and relative insulin deficiency.
What percentage of diabetes cases are Type 1, Type 2, or other types?
Type 1: 8%, Type 2: 90%, Other (Monogenic Diabetes): 2%.
What are the key autoimmune markers for Type 1 Diabetes?
GAD (Glutamic Acid Decarboxylase), ICA (Islet Cell Antibodies), IAA (Insulin Autoantibodies).
What is Latent Autoimmune Diabetes in Adults (LADA)?
A form of autoimmune diabetes diagnosed in adults (>30 years) with slower beta cell destruction and initially managed like Type 2.
What are the main risk factors for developing Type 2 Diabetes?
Obesity, sedentary lifestyle, family history, ethnicity (Asian, Afro-Caribbean, Middle Eastern), gestational diabetes, hypertension.
What is insulin resistance?
A condition where body cells fail to respond effectively to insulin, leading to high blood sugar and increased insulin production.
What is the most commonly used test for long-term glucose control in diabetes?
HbA1c (Glycated Hemoglobin) test.
What are the diagnostic criteria for diabetes using HbA1c?
HbA1c ≥ 48 mmol/mol (6.5%) indicates diabetes.
What is a Random Plasma Glucose (RPG) test?
A blood sugar test taken at any time of the day, regardless of when the person last ate.
What RPG level is diagnostic of diabetes?
11.1 mmol/L (200 mg/dL) or higher on two separate occasions.
What is the purpose of the Glucose Tolerance Test (GTT)?
To assess the body’s ability to metabolize glucose by measuring blood sugar levels before and after a glucose drink.
What are normal, impaired, and diabetic fasting plasma glucose (FPG) levels?
- Normal: ≤ 6.0 mmol/L
- Impaired Fasting Glucose: 6.1-6.9 mmol/L
- Diabetes: ≥ 7.0 mmol/L
What are normal, impaired, and diabetic 2-hour plasma glucose levels in the GTT?
- Normal: ≤ 7.7 mmol/L
- Impaired Glucose Tolerance (IGT): 7.8-11.0 mmol/L
- Diabetes: ≥ 11.1 mmol/L
What are the main management strategies for Type 1 Diabetes?
Insulin therapy, carbohydrate counting, regular glucose monitoring, and lifestyle adjustments.
What is the first-line medication for Type 2 Diabetes?
Metformin (Biguanide).
How do DPP-4 inhibitors (Gliptins) work?
They block the enzyme that degrades incretin, improving insulin response and reducing glucose production.
What are GLP-1 mimetics used for?
Increasing incretin levels to enhance insulin secretion and reduce glucose levels.
What is the role of bariatric surgery in Type 2 Diabetes?
It can lead to partial or complete diabetes remission, especially in obese individuals.
When is insulin required in Type 2 Diabetes?
When lifestyle changes and oral medications fail to maintain glycemic control.
What is diabetic ketoacidosis (DKA)?
A life-threatening complication of Type 1 Diabetes due to lack of insulin, leading to high ketone levels and acidosis.
What are early signs of DKA?
Thirst, frequent urination, nausea, abdominal pain, fruity breath, confusion.
What are macrovascular complications of diabetes?
Coronary artery disease, stroke, peripheral ischemia, hypertension.
What are microvascular complications of diabetes?
Nephropathy (kidney disease), retinopathy (eye disease), peripheral neuropathy.
What infections are diabetics at higher risk for?
UTIs, pneumonia, skin/soft tissue infections, fungal infections (candidiasis).
What is diabetic neuropathy?
Nerve damage causing loss of sensation, muscle weakness, and autonomic dysfunction.
What is the relationship between diabetes and periodontal disease?
Diabetes increases the risk of gum infections, poor wound healing, and tooth loss.
Why should dental appointments be scheduled in the morning for diabetic patients?
To avoid hypoglycemia by ensuring they have eaten before the appointment.
What are common oral manifestations of diabetes?
Dry mouth, fungal infections, burning mouth, periodontal disease, delayed healing, taste alterations.
How can stress impact a diabetic patient during a dental procedure?
Stress increases adrenaline, which interferes with insulin, potentially leading to hyperglycemia or hypoglycemia.
What precaution should a diabetic patient take before a dental visit?
Bring a sugary snack to prevent hypoglycemia if needed.
