endocrinopathy Flashcards
endocrine root
1) endo - within
2) crine - secrete
glands with the following characteristics
1) produce hormones
2) secrete direct into the bloodstream
exocrine glands
1) exo - outside
2) crine - to separate
3) adeno - gland
4) sialo - saliva
endocrine system includes
1) pancreas
2) adrenal glands
- cortex
- medulla
3) etc
basic principle
1) two distinct clinical diseases
- hyperfunction
- hypofunction
hyperfunction
1) proliferation of the endocrine tissue
- hyperplasia
- neoplasia (functional
2) loss of negative feedback signal
hypofunction
1) destruction of endocrine tissue
- immune
- etc
2) loss of positive signal
signs and symptoms tend to be
1) generalized or multifocal rather than presenting as localized
pancreas
1) endocrine portion - the islets of langerhans
2) 5 cell types each producing a specific hormones
- alpha - glucagon
- beta cells - insulin
insulin and glucagon
1) beta hyperfunction / inadequate
2) hypoglycemia
- fast heartbeat
- shaking
- sweating
3) beta hypofunction / inadequate or resistance
- hyperglycemia
-diabetes mellitus
- carb metabolism disorder, more resistance
diabetes mellitus roots
1) dia - through, betes - siphon
2) mellitus - sweet
juvenile type I
1) immune mediated disorder
- WBC think beta cells are foreign
if there is more sugar in the blood why would you urinate more
1) more solute in the solvent that draws water into blood vessels, meaning more pee
adult type II
1) non insulin dependent
2) constant supply of glucose causes insulin receptors to stop working well
clinical signs of diabetes
1) excess sugar in blood
2) sugar in urine
3) increased thirst and water intake
diabetes systemic pathology
1 )diabetic coma
- breaks down fat and muscles
- releases ketones which can cause ketoacidosis
2) impaired wound healing
3) dry mouth
4) predisposition to bacterial and fungal infection
- neutrophils have poor chemotaxis
diabetic coma
1 )hyperglycemia
- can be exacerbated by dental treatment
insulin shock
1) hypoglycemia - carbs are not consumed after insulin and can go into shock
oral manifestation of diabetes
1 )delayed healing
2) bacterial and fungal infections
3) increased incidence of severity of gingivitis and periodontal disease
4) secondary burning mouth symptoms
5 )dry mouth
mucomycoses
1) diabetic patients with glucose in blood
- fungal organisms invade around blood vessels
adrenal gland
1) cortex
2) medulla
HPA axis
1) hypothalamus
2) anterior pituitary
3) adrenal cortex
hypoadrenocorticism
1) addisons disease
- usually immune destroys adrenal gland
2) secondary
- pituitary non functional
addisons disease
1 )autoimmune destruction of adrenal cortex
2) clinical
- hyperpigmentation of skin
- hypotension
- macular pigmented lesions of oral mucosa
3) dental
- Addisonian crisis
- WANT to make cortisol because stress, but they cant, so they go into shock
hyperadtenocorticism
1) cushing syndrome
- most commonly due to corticosteroid therapy
- adrenal atrophy due to increase in cortisol from meds
- weight gain!
2) or adrenal hyperplasia
3) lung tumor may make ATCH (rare)
adrenal medulla
1) hyperfunction
- pheochromocytoma
thyroid gland
1) controls metabolism through T4 and T3 (active form)
- required iodine
2) monitored by TSH
hyperthyroidism
1) grave’s disease
- increases thyroid hormone production
2) eight loss, tachycardia, excessive perspiration, warm smooth skin
3) thyroid storm
- complication of dental treatment
hypothyroidism
1) hashimoto thyroiditis
2) dry rough skin, bradycardia, hypothermia, weight gain
other thyroid hormones
1) calcitonin
- balances PTH from parathyroid
parathyroid glands
1) 4-6 glands
- [Ca] and [PTH]
primary hyperparathyroidism
1) primary
- parathyroid adenoma (1 grow)
- 80-90% of the cases
2) secondary
- chronic renal disease
- if the kidney is not helping make vitamin D which helps intestine absorb [Ca]
- all 4 will grow
hyperparathyroidism clinical manifestations
1) stones, bones, and abdominal groans
hyperparathyroidism treatment
1) primary form
- remove tumor surgically
2) secondary
- address the cause
- restrict dietary phosphate
- use phosphate binding agents
- pharmacologic treatment with an active vitamin D metabolite (calcitriol can bind to VDR)
hypoparathyroidism
1) stop produced PTH, less Ca2+ in blood
2) treatment
- give more vitamin D
hypoparathyroidism and dental
1) partial anodontia
2) malformed or hypoplastic teeth
3) failure of tooth eruption
gigantism
1 )clinical findings
- true macrodontia
- mandibular pronapism
2) pre pubertal onset
post pubertal onset gigantism
1) after closure of epiphyseal plates
2) similar manifestations
- mandibular prognathism
- diastemas
- macroglossia
pituitary dwarfism
1) short stature
- normal proportions roughly maintained
- not enough GF
2) still some crowding
achondroplasia
1) normal head size
2) short stature
3) body proportions not maintained
4) nonendocrine
- genetic autosomal dominant
anti-diuretic hormone
1) hyperfunction
- small cell CA of lung - SIADHs
- syndrome of inappropriate ADH secretion
- neuroendocrine tumor of the lung
2) hypofunction
- diabetes insipidus
*ADH promote resorption of water
