Endocrinology

Question 1

what is the purpose of the endocrine system?

Answer 1

controls growth and development during childhood, regulation of bodily functions in adulthood, and the reproductive process.

Question 2

what causes an endocrine disorder?

Answer 2

the improper function of the endocrine system, which includes the glands that secrete hormones, the receptors that respond to hormones and the organs that are directly impacted by hormones

Question 3

what is multiple endocrine neoplasia (MEN)?

Answer 3

rare disorders of the endocrine system

Question 4

what can MEN cause?

Answer 4

increase in likeliness to develop benign or malignant tumors in the endocrine glands

Question 5

what are the 3 main types of MEN syndromes?

Answer 5

MEN 1
MEN 2a
MEN 2b

Question 6

what diseases come under MEN 1?

Answer 6

Parathyroid tumors, pancreatic tumors, and pituitary tumors

Question 7

What diseases come under MEN 2a?

Answer 7

Medullary thyroid cancers (MTC), pheochromocytoma, and parathyroid tumors

Question 8

What diseases come under MEN 2b?

Answer 8

Medullary thyroid cancers, pheochromocytoma and neuromas

Question 9

Which MEN is most interesting to the dental community and why?

Answer 9

MEN 2b
Part of the syndrome includes mucosal neuromas

Question 10

where is the pituitary gland located?

Answer 10

behind the nose in the middle of the skull base

Question 11

what is the sella turcica (“turkish seat”)

Answer 11

bony depression ion the sphenoid bone, where the pituitary gland sits

Question 12

what are the 2 components of the pituitary gland?

Answer 12

anterior
posterior

Question 13

what is the function of the pituitary gland?

Answer 13

acts as a controlling system
controls many hormones released within the body

Question 14

what controls the pituitary gland?

Answer 14

the hypothalamus

Question 15

what hormones are released by the anterior pituitary?

Answer 15

TSH - thyroid stimulating hormone
ACTH - adrenocorticotrophic hormone
GH - growth hormone
LH, FSH Prolactin

Question 16

what hormones are released by the posterior pituitary?

Answer 16

ADH - anti diuretic hormone - this can lead to diabetes insipidus
oxytocin

Question 17

what are the 2 main types of pituitary tumours?

Answer 17

functional
non - functional

Question 18

what are pituitary adenomas

Answer 18

tumors of the pituitary gland

Question 19

what is trans - sphenoidal surgery?

Answer 19

the most common procedure for removing a tumor of the pituitary gland.

Question 20

what can an excess amount of growth hormone do to both adults and kids?

Answer 20

giantism in children
acromegaly in adults

Question 21

how would you measure a person’s level of growth hormone?

Answer 21

Insulin-like growth factor 1 (IGF-1)

Question 22

General presenting changes of acromegaly

Answer 22

coarse features
enlarged supra-orbital ridges
broad nose, thickened lips and soft tissues
enlarged hands - carpal tunnel syndrome
type 2 diabetes - due to insulin resistance from increased GH
cardiovascular disease

Question 23

intra-oral changes caused by acromegaly

Answer 23

enlarged tongue
interdental spacing
‘shrunk’ dentures
reverse overbite

Question 24

what is pituitary disease?

Answer 24

a rare disorder in which your pituitary gland fails to produce one or more hormones, or doesn’t produce enough hormones

Question 25

what is thyroid disease?

Answer 25

a general term for a medical condition that keeps your thyroid from making the right amount of hormones

Question 26

what is the name given to an excess production of hormone made my the thyroid gland?

Answer 26

hyperthyroidism aka thyrotoxicosis

Question 27

what is the name given to a deficiency in hormone production from the thyroid gland?

Answer 27

hypothyroidism aka myxoedema

Question 28

what are the 3 main causes of hyperthyroidism?

Answer 28

GRAVES disease toxic multi-nodular goitre toxic adenoma

Question 29

what is GRAVES disease?

Answer 29

an autoimmune condition where your immune system mistakenly attacks your thyroid which causes it to become overactive. often seen in family history

Question 30

signs of hyperthyroidism

Answer 30

warm and moist skin tachycardia and atrial fibrillation increased BP and heart failure tremor and hyperreflexia eyelid retraction and lid lag

Question 31

symptoms of hyperthyroidism

Answer 31

hot and excess sweating, weight loss and diarrhoea palpitations, muscle weakness irritable, manic, anxious

Question 32

what is a goitre?

Answer 32

a lump or swelling at the front of the neck caused by a swollen thyroid

Question 33

causes of primary hypothyroidism

Answer 33

autoimmune (hashimoto's) thyroiditis idiopathic atrophy iodine deficiency radioiodine - used to treat hyper drugs - carbimazole, amiodarone, lithium

Question 34

causes of secondary hypothyroidism

Answer 34

hypothalamic/pituitary disease

Question 35

signs of hypothyroidism

Answer 35

dry coarse skin bradycardia, hyperlipidaemia confusion goitre delayed reflexes

Question 36

is hypothyroidism a reduced metabolism or increased metabolism?

Answer 36

reduced

Question 37

is hyperthyroidism a reduced metabolism or increased metabolism?

Answer 37

increased

Question 38

symptoms of hypothyroidism

Answer 38

tired cold tolerance weight gain constipation hoarse voice puffed face angina poor memory hair loss

Question 39

how do you test for thyroid disease

Answer 39

blood tests ultrasound to check for cysts radioisotope to see gland uptake biopsy

Question 40

What hormones are looked at when taking bloods to investigate thyroid disease?

Answer 40

TSH T3 T4

Question 41

treatment used for hyperthryroidism

Answer 41

carbimazole beta blockers radioiodine surgery - thyroidectomy

Question 42

treatment used for hypothyroidism

Answer 42

thyroxine (T4 tablets)

Question 43

dental aspects of hyperthyroid

Answer 43

pain anxiety and psychiatric problems caution for treatment until controlled

Question 44

dental aspects of hypothyroid

Answer 44

avoid the use of sedatives if severe

Question 45

symptoms of thyroid cancer

Answer 45

A lump in the neck, sometimes growing quickly. Swelling in the neck. Pain in the front of the neck, sometimes going up to the ears. Hoarseness or other voice changes that do not go away. Trouble swallowing. Trouble breathing. A constant cough that is not due to a cold.

Question 46

treatment for thyroid cancer

Answer 46

radiotherapy chemotherapy

Question 47

what are the two pain types of thyroid cancer?

Answer 47

papillary (80%) folicular (more common in younger)

Question 48

where does the adrenal gland sit?

Answer 48

on the renal gland (kidney)

Question 49

the adrenal gland is divided into 2 parts, what are they?

Answer 49

outer cortex inner medulla

Question 50

what is addison's disease?

Answer 50

when the adrenal tissue is destroyed and no hormones can be produced

Question 51

what is the term given to an excess adrenal action?

Answer 51

cushings disease/syndrome

Question 52

treatment for adrenal issues

Answer 52

therapeutic corticosteroids

Question 53

what hormones are produced by the adrenal gland?

Answer 53

aldosterone cortisol adrenal androgens (adrenaline)

Question 54

what zone of the adrenal gland secretes aldosterone?

Answer 54

glomerulosa

Question 55

what zone of the adrenal gland secretes cortisol?

Answer 55

fasicularis

Question 56

what zone of the adrenal gland secretes adrenal androgens (adrenaline)?

Answer 56

reticularis

Question 57

purpose of aldosterone

Answer 57

It helps control the balance of water and salts in the kidney by keeping sodium in and releasing potassium from the body

Question 58

purpose of cortisol

Answer 58

the primary stress hormone, increases sugars (glucose) in the bloodstream, enhances your brain's use of glucose and increases the availability of substances that repair tissues. Cortisol also curbs functions that would be nonessential or harmful in a fight-or-flight situation

Question 59

types of therapeutic steroids

Answer 59

hydrocortisone prednisolone triamcinolone dexamethasone betamethasone

Question 60

adrenal hyperfunction

Answer 60

aka cushings syndrome causes excess cortisol secretion by the adrenal gland

Question 61

adrenal hypofunction

Answer 61

aka Addison's disease is an uncommon illness that occurs when the body doesn't make enough of certain hormones.

Question 62

what is cushing's syndrome?

Answer 62

a disorder that occurs when your body makes too much of the hormone cortisol over a long period of time

Question 63

Dental aspects of cushings disease

Answer 63

candidiasis oral pigmentation steroid precautions may be needed

Question 64

dental aspects of addisons disease

Answer 64

oral pigmentation

Question 65

what is diabetes mellitus?

Answer 65

abnormality of glucose regulation your body doesn't make enough insulin or can't use it as well as it should

Question 66

what is diabetes insipidus?

Answer 66

abnormality of renal function (water)

Question 67

what is tests are carried out to diagnose diabetes?

Answer 67

random sugar test fasting sugar test glucose tolerance test (GTT) HbA1C

Question 68

what result from an RPG indicates diabetes?

Answer 68

>11.1mmol/L on 2 occassions

Question 69

before the GTT what results state normal, impaired fasting glucose and diabetes

Answer 69

normal - < 6.1 mmol/L impaired fasting glucose - 6.1-7.0 mmol/L diabetes - >7.0 mmol/L

Question 70

what are the 2 hour plasma glucose results that state normal, impaired glucose tolerance and diabetes

Answer 70

normal - < 7.8 mmol/L IGT - 7.8-11.1 mmol/L diabetes - > 11.1

Question 71

What is Type 1 diabetes

Answer 71

an insulin deficiency autoimmune destruction of pancreatic B cells

Question 71

What is Type 2 diabetes

Answer 71

an impairment in the way the body regulates and uses sugar (glucose) as a fuel