Endocrine Disorders Flashcards
What is the adrenal gland made up of?
On the outside is the cortex which secretes cortisol, aldosterone and androgens.
On the inside is the medulla which secretes adrenaline.
They sit on top of the kidneys
What is the comment type if endocrine disorder?
Diabetes mellitus
What is adrenocortical hypofunction?
Primary: -autoimmune (Addison's disease) -infections (tb, histoplasmosis) -bilateral adrenalectomy Suppression from long term steroids
Secondary:
-hypopituitarism (ACTH deficiency)
What is cushing’s disease?
An endocrine disease that’s:
-Due to high levels of cortisol
Symptoms:
Weight gain, thinning skin that bruises easily, stretch marks, fat deposits esp face making it round (moon face), decreased interest in sex, buffalo hump
What’s are the causes of cushing’s disease?
- side effect of treatment with corticosteroids (used to reduce inflammation and treat autoimmune diseases) this is iatrogenic
- could be due to an adrenal adenoma or carcinoma
- could be ACTH induced due to a pituitary tumour (adenoma), ACTH therapy, ectopic secretion from tumours
Why is cushing’s hard to diagnose?
Because it’s similar to underactive thyroid gland and high bp. Urine test or blood test to be done to check cortisol levels.
What is phaeochromocytoma?
A rare usually benign tumour of the adrenal glands usually noticed early to mid adulthood. Causes overproduction of adrenaline/noradrenaline and episodic hypertension. Symptoms:
Anxiety, palpitations, sweating, pyrexia, headaches
What is goitre?
Enlargement of the thyroid gland. Causes: hyperthyroidism, hypothyroidism, pregnancy, lack of iodine in the diet.
Treatment depends on the underlying cause. If it’s small and not causing any problems wait and see, otherwise thyroid hormone replacement, dietary supplements and surgery are options. Most are benign but could be a sign of thyroid cancer.
What’s hypothyroidism? (Cretinism in children and sometimes know. As ‘myxoedema’
Underactive thyroid gland. Causes:
Autoimmune (hashinoto’s thyroiditis), iodide deficiency, hypopituitarism, from treating hyperthyroidism
What are general complications of diabetes?
Retinopathy, cataracts, diabetic foot ulcer, gangrene, perio, candidosis, dry mouth, sialosis, glossitis, depression, heart disease, kidney disease, erectile dysfunction, peripheral vascular disease
What are the dental aspects of hypothyroidism?
You should avoid sedatives and opiates. Giving a GA could lead to a coma. They could have oral candidosis and other autoimmune diseases.
What are the causes of hyperthyroidism? (Also known as thyrotoxicosis)
Adenoma (toxic goitre)
Graves’ disease (ab’s against TSH receptor)
Inappropriate thyroxine therapy
Signs of hyperthyroidism?
Finger clubbing and bulging eyes (plus ones I already know including tachycardia)
What’s the treatment for hyperthyroidism?
Partial thyroidectomy
Anti-thyroid drugs eg. Carbinazole.
Radioactive iodine
What are the dental aspects of hyperthyroidism (thyrotoxicosis)?
Anxiety, irritability
Avoid GA and LA containing adrenaline
A thyrotoxic storm it crisis could occur which involves: hyper pyrexia, tachycardia (could lead to heart failure), confusion (could lead to coma)
