Human disease L14: endocrinology 3 – adrenal disease

Question 1

Q1: which of these is a feature of Cushing’s syndrome? 1

. Hypoglycaemia

2. Hypertension
3. Weight loss
4. Syncope
5. Hyperpigmentation?

Answer 1

Hypertension

Question 2

Q2: true or false people with Cushing’s syndrome are at increased risk of oral infections?

Answer 2

True

Question 3

Q3: which of these is a feature of adrenal insufficiency?

1. Weight loss
2. Striae of the skin
3. Poor wound healing
4. Hyperglycaemia
5. Hirsutism?

Answer 3

Weight loss

Question 4

Q4: true or false? People with adrenal insufficiency taking steroid replacement therapy require special consideration for dental treatment under GA.

Answer 4

True

Question 5

Q5: the adrenal glands cortex is split in to three groups what are they?

Answer 5

1. Zona glomerulosa
2. Zona fasciculata
3. Zona reticularis

Question 6

Q6: different regions of the cortex release different hormones, which region releases mineralocorticoid hormones (aldosterone)?

Answer 6

Zona glomerulosa

Question 7

Q7: different regions of the cortex release different hormones, which region releases glucocorticoids (cortisol)?

Answer 7

Zona fasciculata

Question 8

Q8: different regions of the cortex release different hormones, which region releases androgens?

Answer 8

Zona reticularis

Question 9

Q9: which hormone is the medulla responsible for releasing?

Answer 9

Epinephrine

Question 10

Q10: adrenal cortex disease is usually a result of too much or too less of these two particular hormones?

Answer 10

Glucocorticoid or mineralocorticoid hormone.

Question 11

Q11: do the adrenal glands work on a negative feedback loop?

Answer 11

Yes they do.

Question 12

Q12: cortisol is a steroid hormone, in the glucocorticoid class of hormones, what does cortisol do in the body?

Answer 12

Cortisol is the primary stress hormone, it increases sugars in the bloodstream, enhances your brains use of glucose and increases the availability of substances that repair tissue.

Question 13

Q13: aldosterone is a steroid hormone, in the mineralocorticoid class of hormone, what does aldosterone do in the body?

Answer 13

Its main role in the body is to retain salt and water in the body, thus having an effect on blood pressure.

Question 14

Q14: an excess of cortisol and aldosterone in the body results in the development of which condition?

Answer 14

Cushing’s syndrome.

Question 15

Q15: what is usually the reason for an increase in glucocorticoid steroids in the body?

Answer 15

Usually due to iatrogenic glucocorticoid administration.

Question 16

Q16: if there is an excess in adrenal mineralocorticoid in the body, this would lead to the development of which condition?

Answer 16

Hyperaldosteronism.

Question 17

Q17: what are the typical features of hyperaldosteronism?

Answer 17

1. Hypertension (aldosterone regulates the salt and water in body, excess aldosterone, results in excess retention of salt and water)
2. Hypokalaemia (muscle weakness) aldosterone retains salt and water, however it increases the loss of potassium, this causes muscle weakness.

Question 18

Q18: what would be the treatment options for Cushing’s syndrome? 1.

Answer 18

Reverse what is reversible (minimise dose of glucocorticoids if possible).

2. Surgical removal of adrenal or pituitary adenomas.

Question 19

Q19: what are the dental aspects of Cushing’s syndrome?

Answer 19

Hyperglycaemia and immune suppression – increased risk of oral infections, especially candida. Poorer wound healing.

Question 20

Q20: adrenal insufficiency is a rare disorder, which is also known as?

Answer 20

Addisons disease

Question 21

Q21: what are the early symptoms of addisons disease?

Answer 21

Early symptoms of Addison’s disease include lack of energy, weakness, increased thirst and a low mood. The symptoms can get gradually worse over time

Question 22

Q22: what is addisons disease?

Answer 22

Addisons disease is also known as primary adrenal insufficiency. It is a rare disorder of the glands not being able to produce enough hormones (cortisol and aldosterone)

Question 23

Q23: what are the features of adrenal crisis?

Answer 23

1. Hypotension
2. Hypovolaemic shock (heart unable to pump blood to they body resulting in blood not perfusing to the organs, leading to organ failure).
3. Acute abdominal pain
4. Low-grade fever
5. Vomiting
6. Hypoglycaemia

Question 24

Q24: what is the general rule for people with addison’s disease, if they are under physical stress, such as during a period of illness or strenuous exercise, to reduce the risk of adrenal crisis?

Answer 24

It is imperative for the person to increase their corticosteroid cover when under those conditions.

Question 25

Q25: what is the name of cortisol when supplied as a medication?

Answer 25

Hydrocortisone

Question 26

Q26: what is the function of mineralocorticoids:

Answer 26

they are a class of hormones that regulate salt and water balance, aldosterone is the primary mineralocorticoid.