Exam 4-Endocrine Flashcards
What are 2 endocrine disorders that can cause a patient to die in the dental chair within 30 minutes?
- Thyroid Storm 2.Addison Crisis
Why are there typically GENERALIZED affects of endocrine disorders in the body (instead of focal)?
No duct system is present, the hormones are secreted directly into the blood
Which part of the brain is constantly regulating the level of hormones?
hypothalmus
What are two ways an endocrine gland can hyperfunctioo?
- tumor (hyperplasia or neoplasia-typically benign) 2.loss of negative feedback
What are the two ways an endocrine gland can hypo function?
1.destruction of the tissue 2.loss of positive feedback loop
What is the most common cause of a hypo functioning endocrine gland?
infarction
Where is the Pituitary gland? What are the three divisions?
the sellica turcica…1.anterior (FLAT-LG) 2.Intermediate (MSH) 3.Posterior (ADH, Oxytocin)
The anterior portion of the pituitary gland was actually derived from the oral mucosa…what is the name of this structure?
Rathke’s pouch
Which GH hyperfuncion is from PRE-pubertal onset and which is from POST-pubertal onset?
Pre = Gigantism….Post = Acromegaly
What type of bone growth is associated with gigantism?
endochondrial ossification (long bones)
What type of bone growth is associated with acromegaly?
intramembranous ossification (skull/jaws)
What are the two oral manifestations of gigantism?
1.macrodontia 2.Mandibular enlargement with prognathism
What are the 5 oral manifestations of ACROMEGALY?
1.Enlargement of skull and jaws 2.mandibular prognathism 3.Anterior open bite 4.diastemas 5.macroglossia
What in the world is McCune-Albright syndrome associated with??
Gigantism (1/5 w/ gigantism have it)
What are 4 oral manifestations of Dwarfism?
1.delayed eruption/retaining primary teeth 2.microdontia 3.failure of dev. of 3rd molars 4.crowding of teeth
What are the two systemic conditions that arise from hyperthyroid?
1.Graves Disease 2.Toxic Multinodular Goiter
What is the MAJOR complication in dental treatment that is associated with hyperthyroidism?
THYROID STORM (increase in T4=increase metabolism=increase in body temp)
The two causes of glossopyrosis (burning tongue) we have discussed this section are?
1.Hyperthyroidism 2.Sickle Cell Anemia
What are 3 oral manifestations of hyperthyroidism?
1.U-shaped mass in middle of neck 2.Glossopyrosis 3. Tremor of tongue
What is the name for a CONGENITAL hyperthyroidism?
Cretinism
What is the name for AQUIRED hyperthyroidism?
Myxedema (wtf? greek: mucus, swelling)
Even though you won’t see a ton of these Pt’s unless you work with Special Needs, what are 3 oral manifestations of cretinism?
1.Large/Protruding tongue 2.delayed dev/eruption of teeth 3.caries and perio disease
What are 2 oral manifestations of acquired hypothyroidism (myxedema)
1.enlarged tongue 2.lingual thyroid nodule (10% of people have residual thyroid tissue on tongue!)
Typically how many parathyroid glands are there? What is their main duty?
4-6 of them…to regulate BLOOD CALCIUM levels
What is the most likely endocrine disorder we will see in dental practice?
parathyroid hormone disorders
What are three oral manifestations of hyperparathyroidism?
1.Radiolucent lesions in the jaw (often multiple) 2.loss of normal trabecular bone pattern-becomes GROUND GLASS 2.Loss of lamina dura
Which endocrine disorder is associated with ground glass bone formation?
hyperparathyroidism
What are the three oral manifestations of hypoparathyroidism?
1.partial adontia 2.malformed/hypoplastic teeth 3.Candidiasis
Which endocrine disorder is associated with “brown tumors”?
hyperparathyroidism
What are each of the three stages of hyperparathyroidism caused by? Which one is most common?
PRIMARY-most common, tumor in the gland…SECONDARY-during renal failure….TERTIARY-rare, post-renal transplant
Which portion of the adrenal gland is responsible for Electrolyte (sodium, chloride, potassium, and bicarbonate) and fluid balance? What is the hormone called (category and specific name)?
the adrenal CORTEX…Minralocorticoid (Aldosterone)
Which portion of the adrenal gland is responsible for Glucose utilization (stress management) and control of inflammatory responses? What is the hormone called (category and specific name)?
adrenal CORTEX…glucocorticoid (cortisol)
Which portion of the adrenal gland is responsible for regulation of cardiac output and blood pressure? Which hormones are there?
the adrenal MEDULLA…norepinephrine and epinephrine
What is the name of the syndrome seen with adrenal-cortical hyperfunction? What are the 2 oral manifestations?
Cushing’s syndrome…1.moon face 2.decreased mobility of tongue and muscles of mastication (CCCortex = CCushing)
What are the two diseases associated with adreno-cortical hypOfunction? Which one are you NOT likely to see?
- Waterhouse-Friderichsen’s disease (probably won’t see them-its very acute, no oral manifestations) 2.Addison’s Disease
What is another name/way of describing Addison’s disease?
Chronic Adrenocortical Insufficiency
What is the term for a MAJOR potential complication of dental treatment for a patient with hypo-adrenocortico disease?
Addisonian Crisis (Blood pressure DROPS to 60/40)
What are 2 oral manifestations of Addison’s disease?
1.bronzing of skin and face 2.multiple macular pigmented lesions of the oral mucosa
What is bronzing of the face and melanin pigments in Addison’s disease a result of?
Excess ACTH being stimulated
What are two good ways to steer clear of an Addisonian Crisis in the dental chair?
1.Schedule in the morning 2.supplement with steroids (so the body doesnt have to)
What is the only cause of hyper function of the adrenal medulla? What are the oral manifestations?
a pheochromocytoma…no oral manifestations
What is the result of hypo function of the adrenal medulla?
none reported, not compatible with life
