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Human Disease Y3 > Endocrine Disorders > Flashcards

Endocrine Disorders Flashcards

1
Q

what are the types of endocrine disorders ?

A

diabetes mellitus,
adrenocortical disorders - hypo function, hyper function,
adrenal medulla,
thyroid disorders - hypothyroidism, hyperthyroidism,
parathyroid disorders,
acromegaly

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2
Q

what is diabetes mellitus ?

A

impaired glucose utilisation caused by insulin resistance or or deficiency

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3
Q

what are the clinical features of diabetes mellitus ?

A

central - polydypsia, polyphagia, lethargy, stupor
blurred vision,
weight loss,
smell of acetone on breath,
kassmual breathing (hyperventilation)
gastric - nausea, vomiting, abdominal pain
urinary - polyuria, glycosuria

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4
Q

how is diabetes mellitus diagnosed ?

A 
BM stix,
random blood glucose >11 mol/l 
fasting blood glucose > 7 mol/l
serum fructosamine,
glycosylated haemoglobin
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5
Q

what are the acute complications of diabetes mellitus ?

A

hyperglycaemia

hypoglycaemia

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6
Q

what are the chronic complications of diabetes mellitus ?

A 
atheroma - ischemic heart disease, CVA
infection s aureus and c albicans 
retinopathy and cataracts
renal disease - glomerulosclerosis and UTI 
neural - motor or sensory polyneuropathy
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7
Q

what causes hypoglycaemia ?

A

known diabetic, too much insulin, too little food, exercise, alcohol

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8
Q

what are the symptoms of hypoglycaemia ?

A

fatigue, hunger, sweating, anxiety/aggression, confusion, rapid unconsciousness

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9
Q

what is the treatment for hypoglycaemia ?

A

conscious - 25g glucose

unconscious - 50 ml 50% dextrose IV, 1mg glucagon IM

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10
Q

what causes hyperglycaemia ?

A

undiagnosed diabetes, too little insulin

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11
Q

what are the symptoms of hyperglycaemia ?

A

fatigue, thirst, polyuria, vomiting, hyperventilation, ketotic breath, slow loss of consciousness

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12
Q

what are the orofacial manifestations of diabetes mellitus ?

A

periodontal disease,
infections - bacterial sialadenitis, candidosis
dry mouth,
sialosis,
glossitis/burning mouth,
lichenoid drug reactions - metformin, chlorpropramide

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13
Q

what is the treatment for diabetes mellitus ?

A 
diet,
orla hypoglycaemia,
sulphonylureas (glibenclamide, chlorpropramide)
biguanides - metformin 
insulin
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14
Q

describe primary adrenocortical hypo function

A

autoimmune addison’s disease
infections - tuberculosis, histoplasmosis
bilateral adrenalectomy
suppression form long term steroids

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15
Q

describe secondary adrenocortical hypo function

A

hypoptuitarism - ACTH deficiency

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16
Q

what are the clinical features of adrenal hypo function ?

A

weight loss, weakness, hypotension, anorexia, nausea, vomiting, cutaneous and mucosal pigmentation

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17
Q

how is adrenal hypo function diagnosed ?

A

low BP, diurnal rhythm of plasma cortisol, synachthen test, autoimmune profile, urea and electrolytes - reduced Na and increased K, abdominal film +/- MRI

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18
Q

what are the dental manifestations of adrenal hypo function ?

A

oral pigmentation

19
Q

what does excess aldosterone cause ?

A

Conn’s syndrome

20
Q

what does excess cortisol cause ?

A

Cushing’s syndrome

21
Q

what can systemic steroids cause ?

A

Cushingoid features

22
Q

what causes ACTH induced cushing’s disease ?

A

pituitary tumour, ACTH therapy, ectopic secretion from tumours

23
Q

what causes autonomous cushing’s disease

A

adrenal carcinoma or adenoma

24
Q

what are the clinical features of Cushing’s disease ?

A 
emotional disturbance, 
enlarged selia turcica,
moon face,
osteoporosis,
cardiac hypertrophy,
obesity,
buffalo hump,
adrenal tumor or hyperplasia,
think wrinkled skin,
abdominal striae,
amenorrhoea,
muscle weakness,
purpura,
skin ulcers
25
Q

how is Cushing’s disease investigated ?

A

increaed BP,
diurnal variations on plasma cortisol,
urea and electrolytes - increased Na decreased K,
lateral skull x ray to see pituitary fossa,
abdominal imaging

26
Q

what is phaechromocytoma ?

A

benign tumour of the adrenal medulla,
overproduction of adrenaline/noradrenaline,
episodic hypertension

27
Q

what are the clinical symptoms of phaechromocytoma ?

A

anxiety, palpitations, sweating, pyrexia, headaches

28
Q

what is goitre ?

A

enlargement of the thyroid gland

29
Q

what causes hypothyroidism ?

A

autoimmune - Hashimoto’s thyroiditis,
iodide deficiency,
hypopituitarism,
treatment for hyperthyroidism

30
Q

what are the clinical features of hypothyroidism ?

A

intolerance to cold, receding hairline, facial and eyelid oedema, blank expression, thick tongue, anorexia, brittle nails and hair, menstrual disturbances, constipation, muscle aches and weakness, dry skin, lethargy, apathy

31
Q

what are the late clinical manifestations of hypothyroidism ?

A

subnormal temperature, bradycaridia, weight gain, thickened skin, cardiac complications

32
Q

what is the relevance of hypothyroidism to dentistry ?

A

avoid sedatives and opiates, GA—> coma, oral candidacies, presence of other autoimmune diseases

33
Q

what are the causes of hyperthyroidism ?

A

adenoma - toxic goitre, grave’s disease, inappropriate thyroxine therapy

34
Q

what are the clinical features of hyperthyroidism ?

A

fine hair, bulging eyes, flushing, enlarged thyroid, tachycardia, increased systolic BP, breast enlargement, weight loss, muscle wasting, menstrual changes, diarrhoea, tremors, finger clubbing

35
Q

what is the treatment for hyperthyroidism ?

A

partial thyroidectomty, antithyroid drugs e.g. carbimazole, radioactive iodine

36
Q

what is the relevance of hyperthyroidism to dentistry ?

A

anxiety, irritability, avoid general anaesthesia, LA with adrenaline, hyperpyrexia, tachycardia - heart failure

37
Q

what is the function of PTH?

A

regulate normal plasma calcium

38
Q

what are the symptoms of hypoparathyroidism ?

A

tetany, facial twitch, facial paraesthesia

39
Q

what are the symptoms of hyperparathyroidism ?

A

osteoporosis, focal bone resorption - brown tumour, metastatic calcification - renal stones

40
Q

what is acromegaly ?

A

hyperplasia/neoplasia of anterior pituitary, prolonged and excessive secretion of growth hormone, reactivation of bone growth in adults

41
Q

what are the clinical signs of acromegaly ?

A

visual field defects, prominent supraorbital ridge, large nose and jaw, teeth separated of lacking, spade shaped hands and feet, arthrosis, abnormal glucose tolerance test glycosuria/polyuria, peripheral neuropathy, sexual dysfunction, cardiomegaly hypertension, galacterhoea, hypertrophy of sweat and sebaceous glands, pituitary adenoma

42
Q

what are the effects of acromegaly on the skull ?

A

enlarged and thickened pituitary fossa (visual disturbances), prominent supraorbital ridges

43
Q

what is the effect of acromegaly on the jaws ?

A

prognathic (condylar growth centre)

44
Q

what is the effect of acromegaly of the soft tissues ?

A

thick and enlarged nose/lips

Human Disease Y3 (24 decks)

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