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Human Disease > Endocrine Disorders > Flashcards

Endocrine Disorders Flashcards

1
Q

Name 4 endocrine disorders?

A

Diabetes mellitus
Adrenocortical disorders
Adrenal medlla disorders
Thyroid disorders

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2
Q

What is diabetes mellitus?

A

Commonest endocrine disorder - 4% population
Impaired glucose utilisation (resistance or deficiency)
Consistently hyperglycaemic
Juvenille onset = IDDM, Adult onset = NIDDM

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3
Q

How do you diagnose diabetes mellitus?

A 
random blood glucose (>11mmol/L)
fasting blood glucose (>7mmol/L)
glycosylated haemoglobin (HbA1c)
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4
Q

How can we treat diabetes mellitus?

A

diet, insulin, oral hypoglycaemics, sulphonylureas, biguanides

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5
Q

How does diabetes present oro-facially?

A 
perio disease
infections
xerostaemia
sialosis
glossitis
lichenoid drug reactions
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6
Q

What are the complication associated with diabetes mellitus?

A 
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
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7
Q

Describe hypoglycaemia and what are the symptoms and treatment?

A 
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
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8
Q

Describe hyperglycaemia and what are the symptoms?

A 
Undiagnosed diabetic
Too little insulin
SYMPTOMS - fatigue, thirst, polyuria, vomiting, hyperventilation, ketotic breath, slow unconsciousness
TREATMENT:
hospital
fluids, electrolytes and insulin
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9
Q

What are adrenocortical disorders?

A

Adrenocortical hypofunction or adrenocortical hyperfunction

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10
Q

What is the normal process of adrenal gland?

A

pituitary gland - ACTH - kidneys - adrenal gland :
Cortex - cortisol, aldosterone, androgens
medulla - adrenaline

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11
Q

What is adrenocortical hypofunction?

A

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

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12
Q

What causes primary adrenocortical hypofunction?

A

Infections - TB
Bilateral adrenalectomy
Suppression from long term steroid use

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13
Q

What are the clinical signs of adrenocortical hypofunction?

A

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

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14
Q

How do we diagnose adrenocortical hypofunction?

A 
low BP
diurnal rhythm of plasma control
synacthen test (ACTH)
autoimmine profile
urea and electrolytes (low Na and high K)
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15
Q

How does adrenocortical hypofunction affect dentally?

A 
oral pigmentation
physiological stress as undiagnosed
infections
anaesthesia
surgery
systemis steroids in undiagnosed
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16
Q

What is adrenocortical hyperfunction?

A

A condition where there is an overexpression of products of the adrenal cortex:
High aldosterone - Conns syndrome
High cortisol - Cushings syndrome
Systemic steroids - Cushingoid features

17
Q

What causes Cushings syndrome?

A

ACTH induced = pituitary tumour
autonomous = adrenal adenoma / carcinoma
High dose steroids = immunosuppression

18
Q

How would adrenocortical hyperfunction be diagnosed?

A 
high BP
diurnal rhythm of plasma control
urea and electrolytes (high Na and low K)
lateral skull to see pituitary fossa
abdominal imaging
19
Q

What are disorders of the adrenal medulla?

A

Overexpression of products of the adrenal medulla

20
Q

What causes adrenal medulla disorders?

A

benign tumour - overexpression of adrenaline / noradenaline, episodic hypertension

21
Q

What are the clinical symptoms of adrenal medulla disorders?

A 
anxiety
palpitations
sweating
pyrexia
headaches
goitre - enlargment of the thyroid gland
22
Q

what is the normal process for pituitary to make T4 and T5?

A

hypothalamus - pituitary - via TSH - thyroid - T4, T5

23
Q

What are thyroid disorders?

A

The thyroid gland in the neck makes hormones to help regulate the body’s metabolism and a person’s growth. Problems with the thyroid include hyperthyroidism and hypothyroidism.

24
Q

What causes hypothyroidism?

A

autoimmune - Hashimotos thyroiditis
Iodide deficiency
Hypopituitarism
Treatment for hyperthyroidism

25
Q

How does hypothyroidism affect dental?

A

Avoid sedative and opiates, oral candidosis, presence of other autoimmune disorders

26
Q

What causes hyperthyroidism?

A

Adenoma - toxic goitre
Graves disease - anitbodies against TSH receptor
Innapropriate thyroxine therapy

27
Q

What is the treatment for hyperthyroidism?

A

Partial thyroidectomy
anti thyroid drugs (carbimazole)
radioactive iodine
post treatment hypothyroidism

28
Q

How does hyperthyroid affect dental?

A

anxiety, irratibility, avoid GA, (LA contains adrenaline)

29
Q

What are the parathyroids?

A

Produce PTH which regulates normal plasma calcium

30
Q

What are the 2 disorders for the parathyroids?

A

Hypoparathyroidism and hyperparathyroidism

31
Q

Describe hypoparathyroidism?

A

Generalised osteoporosis
Focal bone resorption - brown tumour
metastatic calcification - renal stones

32
Q

Describe hyperparathyroidism?

A

Tetany
Facial twitch - Chvosters sign
Facial parasthesia

33
Q

What is acromegaly?

A

hyperplasia or neoplasia of anterior pituiatry (prolonged and excessive secretion of growth hormone)

34
Q

What are the signs of acromegaly?

A

reactivation of bone growth in adults
SKULL - enlarged, thickened, visual disturbances
JAWS - prognathic
HANDS / FEET - soft tissues thicken and enlarge

Human Disease (54 decks)

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