Endocrine Disorders Flashcards
Name 4 endocrine disorders?
Diabetes mellitus
Adrenocortical disorders
Adrenal medlla disorders
Thyroid disorders
What is diabetes mellitus?
Commonest endocrine disorder - 4% population
Impaired glucose utilisation (resistance or deficiency)
Consistently hyperglycaemic
Juvenille onset = IDDM, Adult onset = NIDDM
How do you diagnose diabetes mellitus?
random blood glucose (>11mmol/L) fasting blood glucose (>7mmol/L) glycosylated haemoglobin (HbA1c)
How can we treat diabetes mellitus?
diet, insulin, oral hypoglycaemics, sulphonylureas, biguanides
How does diabetes present oro-facially?
perio disease infections xerostaemia sialosis glossitis lichenoid drug reactions
What are the complication associated with diabetes mellitus?
GENERAL : retinopathy, cataracts, foot ulcers, gangrene ACUTE : hypoglycaemia, hyperglycaemia (diabetic ketoacidosis) CHRONIC : atheroma - ischaemic heart disease, CVA infections - S. aureus and C. albicans renal disease - UTI, neural - motor / sensory polyneuropathy
Describe hypoglycaemia and what are the symptoms and treatment?
Known diabetic Too much insulin Too little food Exercise Alcohol SYMPTOMS - fatigue, hunger, sweating, anxiety, aggression, confusion, rapid unconsciousness TREATMENT : conscious = 25g glucose unconscious = 50% dextrose IV or 1mg glucagon IM
Describe hyperglycaemia and what are the symptoms?
Undiagnosed diabetic Too little insulin SYMPTOMS - fatigue, thirst, polyuria, vomiting, hyperventilation, ketotic breath, slow unconsciousness TREATMENT: hospital fluids, electrolytes and insulin
What are adrenocortical disorders?
Adrenocortical hypofunction or adrenocortical hyperfunction
What is the normal process of adrenal gland?
pituitary gland - ACTH - kidneys - adrenal gland :
Cortex - cortisol, aldosterone, androgens
medulla - adrenaline
What is adrenocortical hypofunction?
A condition where there is an under expression of products of the adrenal cortex
Can be primary or secondary
PRIMARY - autoimmune (Addisons disease)
SECONDARY - hypopituitarism - ACTH deficiency
What causes primary adrenocortical hypofunction?
Infections - TB
Bilateral adrenalectomy
Suppression from long term steroid use
What are the clinical signs of adrenocortical hypofunction?
weight loss, weakness, hypotension, anorexia, nausea, vomiting, cutaneous and mucosal pigmentation
How do we diagnose adrenocortical hypofunction?
low BP diurnal rhythm of plasma control synacthen test (ACTH) autoimmine profile urea and electrolytes (low Na and high K)
How does adrenocortical hypofunction affect dentally?
oral pigmentation physiological stress as undiagnosed infections anaesthesia surgery systemis steroids in undiagnosed