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CMS! > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

what are the 3 main problems that can occur in the endocrine system?

A
  • excess hormone
  • reduced hormone
  • physical gland enlargement
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2
Q

which of these 3 problems that can occur in the endocrine system can give widespread effects?

A
  • excess and reduced hormone level
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3
Q

what are the 3 thyroid diseases?

A
  1. hyperthyroidism (excess thyroxine)
  2. hypothyroidism (lack of thyroxine)
  3. thyroid mass (goitre)
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4
Q

what is the common age range to get diagnosed with hyperthyroidism?

A

20-40 years old

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5
Q

is hyperthyroidism more or less common in women that in men?

A

more common in women (2.3% compared to 0.2%)

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6
Q

what are the 3 possible causes for hyperthyroidism?

A
  1. auto-immune
  2. goitre or toxic adenoma (benign tumour)
  3. pituitary driven
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7
Q

if hyperthyroidism is auto-immune then what is it called?

A

graves disease

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8
Q

give some symptoms of hyperthyroidism?

A
  • sweating -irritability
  • heat intolerance -anxiety
  • palpitations -poor sleep
  • breathlessness -excess appetite
  • diarrhoea -weight loss
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9
Q

what are some of the signs of hyperthyroidism?

A
  • warm moist skin
  • high blood pressure
  • tachycardia
  • heart failure
  • fine tremor
  • goitre
  • pre-tibial myoedema
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10
Q

what is an addition symptoms of graves disease?

A

eye disease

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11
Q

which 2 ways can hyperthyroidism be diagnosed?

A
  • clinical

- blood tests

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12
Q

which two sets of blood tests would you request for hyperthyroidism?

A
  1. thyroid function tests

2. auto-antibodies

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13
Q

what are the two main things to look for in a thyroid function test?

A
  • low TSH (thyroid stimulating hormone)

- high T4 (thyroxine)

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14
Q

what are the 2 groups of drugs given to manage hyperthyroidism?

A
  1. anti-thyroid drugs

2. beta-blockers

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15
Q

why are beta blockers given to those with hyperthyroidism?

A

to help control symptoms

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16
Q

in which 2 patient categories should you be cautious about using radioactive iodine as treatment of hyperthyroidism?

A
  1. younger patients

2. pregnant/breast-feeding

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17
Q

what is the mean age of diagnosis of hypothyroidism?

A

60

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18
Q

is hypothyroidism more or less common in women than men?

A

more (2% compared to 0.2%)

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19
Q

what are the 4 possible causes of hypothyroidism?

A
  • auto immune
  • iatrogenic (surgery/radioiodine)
  • iodine deficiency
  • pituitary disease (rare)
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20
Q

what are the signs and symptoms of hypothyroidism?

A
  • reduced metabolism (weight gain)
  • cold intolerance
  • mental slowness
  • poor memory
  • hoarse voice
  • thin, dry hair (or hair loss)
  • large tongue
  • goitre
  • constipation
  • puffed face and extremities
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21
Q

what are the 2 acute signs of hypothyroidism?

A
  • coma

- hypothermia

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22
Q

what are the 2 ways to test for hypothyroidism?

A
  1. clinical

2. blood tests

23
Q

what are you looking for in the blood tests for hypothyroidism?

A
  • high TSH
  • low T3, T4
  • auto-antibodies
24
Q

name 2 anti-thyroid drugs?

A
  • carbimazole

- propylthiouracil

25
Q

what are the dentally relevant points about anti-thyroid drugs?

A

they can cause

  • taste disturbances
  • neutropenia and agranulocytosis ( both increasing infection risk)
26
Q

what are the drugs given to patients who have hypothyroidism?

A
  • thyroxine (T4)

- levothyroxine

27
Q

what are the 3 subgroups from thyroid masses?

A
  1. no association with intrinsic thyroid disease
  2. associated with intrinsic thyroid disease
  3. malignancy
28
Q

what are the 2 causes of thyroid masses not associated with intrinsic thyroid disease?

A
  1. simple cysts (adenoma)

2. iodine deficiency

29
Q

what are the 2 causes of goitre that is associated with intrinsic thyroid disease?

A
  • autoimmune (graves)

- toxic multi-nodular goitre (adenoma)

30
Q

how common is goitre malignant?

A

rare

31
Q

what are the dentally relevant points about goitres?

A

rarely have retro-sternal extension (compression) which will cause

  1. dyspahgia
  2. breathing difficulties
  • can have lymphadenopathy (ominous sign)
32
Q

what are the 3 ways to investigate goitre?

A
  1. blood tests
  2. fine needle aspiration
  3. radiology (ultrasound/ radioisotope scan)
33
Q

what are the 2 treatment options for goitre?

A
  • address underlying cause

- surgery to remove

34
Q

the adrenal gland produces what?

A

corticosteroids

35
Q

what is the disease that can occur due to a deficiency in the production of corticosteroids?

A

addisons disease

36
Q

cushings syndome is…

A

when there is an excess in corticosteroid production

37
Q

what are some of the causes of cushings syndrome?

A
  • excess ACTH

- excess corticosteroids

38
Q

where is ACTH produced? what affect does it have?

A

the anterior pituitary gland

brings about cortisol production in the adrenal gland during stressful situations

39
Q

what may cause an excess in ACTH?

A
  1. pituitary adenoma (benign tumour)

2. ectopic production by cancers ie lung

40
Q

what may cause an increase in corticosteroids?

A

adrenal carcinoma or adenoma

41
Q

what are the normal uses of cortisol?

A
  • maintain BP
  • inhibit Bone formation
  • anti-Inflammatory
  • decreases Immune function
  • increases gluceogenesis
42
Q

in cushings syndrome where there is a prolonged period of high cortisol levels what are 3 negative consequences?

A
  • diabetes
  • hypertension
  • prone to infection
43
Q

what are some of the signs and symptoms of cushings syndome?

A
  • moon face
  • purple striae
  • easy bruising
  • impaired wound healing
  • hair thinning
  • acne
  • weight gain
  • increased body/facial hair
  • red cheeks
  • thin skin
  • buffalo hump
  • bronze skin
44
Q

what are the 2 ways to manage cushings syndrome by addressing underlying cause?

A
  1. iatrogenic? - ie taking to many corticosteroids
    tx = reduce dose
  2. non-iatrogenic - surgery best option
45
Q

what is the definition of addisons disease?

A

where steroid hormones are failed to be produced by the adrenal cortex

46
Q

what are some of the causes of addisons disease?

A
  1. auto immune adrenal destruction
  2. iatrogenic (withdrawal from long term steroid use)
  3. hypopituitary due to
    - cancer
    - infection
    - vascular issues
    - trauma
47
Q

name two groups of steroid hormones and example from each

A

glucocorticoids - cortisol

mineralocorticoids - aldosterone

48
Q

what is the symptoms of chronic addisons disease?

A

general malaise

49
Q

what are the symptoms of acute addisons disease?

A

shock
hypoglycaemia
vomiting
abdominal pain

50
Q

what are some of the causes of ACUTE addisons disease

A

usually in response to stress

  • infection
  • trauma
  • surgery
51
Q

what are some of the signs of addisons disease?

A

hyperpigmentation

  • scars
  • buccal mucosa
  • pressure points
  • skin creases
52
Q

how can addisons disease be managed?

A

replacement therapy

  1. hydrocortisone - glucocorticoid (20mg am & 10mg pm)
  2. fludrocortisone - mineralocorticoid
53
Q

an acute addisonian crisis needs what?

A
  • urgent medical attention!
  • fluid replacement
  • glucose
  • hydrocortisone injection
  • tx of infection
54
Q

what 2 ways can the dental professional recognise undiagnosed adrenal diseases?

A
  1. hyperpigmentation of the buccal mucosa (addisons)

2. oral infections (cushings)

CMS! (23 decks)

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