METABOLIC DISORDERS (manla) Part 1 Flashcards by Love Dog | Brainscape

Q

The sum of tissue activity in terms of physical and chemical changes that happens inside your body associated with the use of protein, fat, carbohydrate, vitamins, minerals, water, and hormones in whatever is taken by the body.

A

METABOLISM

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Q

T/F

Everything is metabolized before it exits in your bowel or excretion (saliva, sweat, anything that comes out of the body is a product of metabolism).

A

T

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Q

Metabolic disorders may be caused by abnormal functions of glands:

A

• Pituitary
• Thyroid
• Parathyroid
• Adrenal
• Pancreas

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Q

Cretinism

A. Hypothyroidism
B. Hyperthyroidism

A

A

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Q

o Juvenile myxedema

A. Hypothyroidism
B. Hyperthyroidism

A

A

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Q

Myxedema

A. Hypothyroidism
B. Hyperthyroidism

A

A

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Q

Exophthalmic goiter - One where in the eyes are bulging

A. Hypothyroidism
B. Hyperthyroidism

A

B

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Q

Toxic adenoma

 Tumor
 Grows inside
 Impinging your esophagus and having
a difficulty in speaking, breathing, and swallowing

A. Hypothyroidism
B. Hyperthyroidism

A

B

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Q

Primary hyperparathyroidism

Secondary hyperparathyroidism

What abnormal functions of glands?

A

PARATHYROID GLANd

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Q

“There is really something wrong with the gland
itself”

A. Primary hyperparathyroidism
B. Secondary hyperparathyroidism

A

A

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Q

It’s only a secondary to or a result of another
condition”

A. Primary hyperparathyroidism
B. Secondary hyperparathyroidism

A

B

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Q

Hypofunction of the gland, Hyperfunction of the gland

What abnormality?

A

ADRENAL GLAND

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Q

Diabetes Mellitus

What organ?

A

PANCREAS

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Q

Addison’s disease (chronic) - Take 6 years to develops

A. Hypofunction of the gland
B. Hyperfunction of the gland

A

A

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Q

Waterhouse-Friderichsen syndrome (acute)
*Symptoms suddenly appear

A. Hypofunction of the gland
B. Hyperfunction of the gland

A

A

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Q

Cushing’s syndrome

A. Hypofunction of the gland
B. Hyperfunction of the gland

A

B

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Q

Adrenogenital syndrome

A. Hypofunction of the gland
B. Hyperfunction of the gland

A

B

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Q

Adaptation syndrome

A. Hypofunction of the gland
B. Hyperfunction of the gland

A

B

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Q

Secretes insulin

A

Diabetes Mellitus

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Q

Disturbance in protein metabolism (2)

A

o Marasmus
o Kwashiorkor

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Q

Disturbance in carbohydrate metabolism (2)

A

o Hurler’s syndrome
o HEREDITARY FRUCTOSE INTOLERANCE

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Q

Disturbance in non-lipid metabolism (3)

A

o Letterer-Siwe disease
o Hand-Schuller-Christian Disease
o Eosinophilic granuloma

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Q

Master gland of the body

A

PITUITARY GLAND

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Q

Decreased secretion of pituitary hormone

A

HYPOPITUITARISM

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Q

Clinical Features of Hypopituitarism:

A

o Dwarfism
o Sparse hair
o Wrinkled skin
o Delayed tooth eruption
o Microdontia
o Malocclusion
o Short roots
o Retarded growth of jaws
o Thin eyebrows
o Thin lips
o Immobile expression
o Loss of eyelashes

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Q

True or false

One of clinical features of HYPOPITUITARISM are:

o Malocclusion
o Short roots
o Retarded growth of jaws
o Immobile expression

A

T

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Q

T/F

ACROMEGALY is a Rare

A

T

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Q

Due to oversecretion of growth hormone AFTER closure of epiphyseal plates.

A

ACROMEGALY

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Q

Due to oversecretion of growth hormone BEFORE closure of epiphyseal plates.

A

GIGANTISM

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Q

• Hyperhidrosis
• Muscle weakness
• Paresthesia
• Carpal tunnel syndrome
• Dysmenorrhea
• Decreased libido
• Sleep apnea
• Hypertension
• Heart disease
• Skin tag formation

A

CLINICAL FEATURES of HYPERPITUITARISM

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Q

ORAL MANIFESTATIONS
• Enlarged mandible and maxilla
• Diastemas
• Condylar hyperplasia
• Dental malocclusion
• Complete posterior crossbite
• Thick oral mucosa
• Increased salivary gland tissue
• Macroglossia
• Prominent lips
• Speech abnormalities

A

HYPERPITUITARISM

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Q

TREATMENT of HYPERPITUITARISM

A

• Normalize the level of growth hormones
• Preserve the pituitary gland function

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Q

HYPERTHYROIDISM Two kinds

A

Exophthalmic
Toxic Adenoma

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Q

Diffused hyperplasia of thyroid gland

A. Exophthalmic
B. Toxic Adenoma

A

A

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Q

Tumor of thyroid gland

A. Exophthalmic
B. Toxic Adenoma

A

B

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Q

Secretes growth hormones

A

THYROID GLAND

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Q

Hyperfunction of thyroid gland

A

HYPERTHYROIDISM

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Q

HYPERTHYROIDISM CHARACTERISTICS (3)

A

T3

T4

TSH

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Q

triiodothyronine

A. T3
B. T4
C. TSH

A

A

Q

thyroxine

A. T3
B. T4
C. TSH

A

B

Q

thyroid-stimulating hormones

A. T3
B. T4
C. TSH

A

C

Q

Results when there is excessive stimulation of thyroid gland by excessive secretion of thyroid hormone.

A

THYROTOXICOSIS

Q

Other Characteristics:
o Heat intolerance
o Hyperhidrosis
o Nervousness
o Palpitations, highly emotional o Diarrhea
o Anxiety
o Weight loss
o Menstrual dysfunction
o Thin and brittle hair

A

HYPERTHYROIDISM

Q

EYE CHANGES
• Exophthalmos
• Bright eyed stare or wide-eyed stare
• Facial expression of surprise
• Upper lid retraction
• Lid lag on normal blinking

A

HYPERTHYROIDISM

Q

CARDIAC MANIFESTATIONS
• One of the earliest and most consistent feature
• Hyperthyroidism is an increased metabolic activity which
puts great demand on the heart: o Increase stroke volume
o Pulse rate
o Cardiac output

A

HYPERTHYROIDISM

Q

ORAL MANIFESTATIONS
• Premature eruption of deciduous teeth
• Premature exfoliation
• Premature eruption of permanent teeth
• Osteoporosis of jaws
• Burning tongue
• Erosion of teeth

A

HYPERTHYROIDISM

Q

HYPERTHYROIDISM TREATMENT

A

*Drug therapy
o E.g., thiocarbamades

*Radioactive iodine administration
*Reduce stress to minimize the occurrence of THYROID
CRISIS

Q

T/F

Use of Epinephrine and Atropine is contraindicated in patients with hyperthyroidism due to patient’s increased sensitivity to epinephrine

A

T

Q

T/F

Use of Epinephrine and Atropine may precipitate THYROID STORM which is a thyroid hormone induced hypermetabolism that is life threatening

A

T

Q

Thyroid can’t produce amount of
hormones pituitary calls for

A

Primary Hypothyroidism

Q

Thyroid isn’t being
stimulated by pituitary to produce hormones

A

Secondary Hypothyroidism

Q

occurs in infancy

A. Cretinism
B. Juvenile Myxedema
C. Myxedema

A

A

Q

occurs in childhood

A. Cretinism
B. Juvenile Myxedema
C. Myxedema

A

B

Q

in adults

A. Cretinism
B. Juvenile Myxedema
C. Myxedema

A

C

Q

• Mental defects
• Generalized edema
• Face is wide
• Underdeveloped mandible and maxilla is overdeveloped
• Brittle hair and fingernails
• Atrophic sweat glands

A

CLINICAL FEATURES OF CRETINISM:

Q

• Delayed eruption
• Retained deciduous teeth

A

CLINICAL FEATURES OF JUVENILE MYXEDEMA:

Q

• Is the atrophy of thyroid gland
• Unknown cause
• Edematous lips, nose
eyelids
• Large tongue
• Interfered speech

A

CLINICAL FEATURES OF MYXEDEMA IN ADULTS:

Q

Increased secretion of parathyroid hormone

A

HYPERPARATHYROIDISM

Q

Hyperplastic parathyroid gland causes ____

A

hyperparathyroidism

Q

Characterized by:
• Increased in number of cells
• Increase in size of cells

A

HYPERPARATHYROIDISM

Q

Consistent abnormal findings:
• Hypercalcemia
• Increased parathormone level
These 2 are needed for the confirmation of the diagnosis of _______.

A

HYPERPARATHYROIDISM

Q

ETIOLOGY •
Unknown
Other beliefs:
o Irradiation
o Decreased estrogen o Hereditary

A

HYPERPARATHYROIDISM

Q

CLINICAL FEATURES
• Fatigue
• Weakness
• Nausea (GROANS)
• Anorexia (GROANS)
• Polyuria (STONES)
o Urinal stones
• Thirst (GROANS)
• Depression (MOANS)
• Constipation (GROANS)
• Bone pain (BONES)
• Headaches (MOANS)

A

HYPERPARATHYROIDISM

Q

Lesions are found in the:
• Kidney (stones)
• Skeletal System (bones)
• Gastrointestinal System (groans) • Nervous System (moans

A

HYPERPARATHYROIDISM

Q

ORAL RADIOGRAPHIC FEATURES
• Bone demineralization of mandible and maxilla

A

HYPERPARATHYROIDISM

Q

GI MANIFESTATIONS
• Peptic ulcer

A

HYPERPARATHYROIDISM

Q

NEUROLOGIC MANIFESTATIONS
• Coma
• Parathyroid crisis
• Loss of memory
• Depression

A

HYPERPARATHYROIDISM

Q

ORAL MANIFESTATIONS
• Chief oral finding: well
defined cystic radiolucency of the jaw, monocular (1 big circle) or multilocular (many small circles)
• Loosening of teeth
• Cortical plate of bones:
thinning
• Partial loss of lamina
dura

A

HYPERPARATHYROIDISM

Q

HISTOPATHOLOGY
• Extravasation of red blood cells, thus the tumor appears reddish brown
• Thus, it is termed “BROWN TUMOR”

A

HYPERPARATHYROIDISM

Q

SHAFER:
• Radiographic features of primary hyperparathyroidism:

A

o Ground glass appearance
o Loss of lamina dura
o Abnormal alveolar bone

Q

An inherited disorder of connective tissue, characterized by joints which are hypermobile and skin that is hyperflexible

A

EHLERS-DANLOS SYNDROME

Q

• Due to defects in collagen metabolism

• This condition has been classified to 8 forms:
o The EDS type VIII is the periodontal form where:
o There is fast progress of periodontal disease resulting to complete tooth loss by the 2nd or 3rd
decade of life

A

EHLERS-DANLOS SYNDROME

Q

ETIOLOGY AND PATHOGENESIS
• Hereditary
• Defect in formation and structure of type III collagen
• Decrease in collagen hydroxylase
• Defect in collagen metabolism
• Disorder in copper metabolism

A

EHLERS-DANLOS SYNDROME

Q

CLINICAL FEATURES
• Classical: (Skin)
o Hyperplastic skin
o Skin is velvet in
appearance.
o Skin is easily bruised,
very fragile.
o Minor trauma will
cause ecchymoses, bleeding, CIGARETTE
PAPER scar formation.

A

EHLERS-DANLOS SYNDROME

Q

CLINICAL FEATURES

On joints:
o Hypermobility
o Dislocation of joints
o Back knee
o Flat feet
o Kyphoscoliosis
o Skeletal deformities

A

EHLERS-DANLOS SYNDROME

Q

OROFACIAL FEATURES:
• Narrow maxilla
• Flattened midface
• Wide nasal bridge
• Hypertelorism
• Epicanthal folds
• Hollowed appearance of eyes
• Scarring of the forehand and
chin
• Fragile gingiva
• Problematic mucosal tissues
• TMJ dysfunction
• Tongue can extend too much
(tip to nose)

A

EHLERS-DANLOS SYNDROME

Q

DENTAL FINDINGS:
• Deep anatomic grooves
• Very high cusps height of
molars and premolars
• Stunted or dilacerated roots

A

EHLERS-DANLOS SYNDROME

Q

EHLERS-DANLOS SYNDROME TREATMENT

A

• Monitor the heart because usually patients die due to aneurysms
• Sudden bursting of arteries which is aneurysms

Q

PROGNOSIS
• Wound healing is usually delayed
• Prolonged bleeding
• Osteoarthritis develops in repeated TMJ luxations

A

EHLERS-DANLOS SYNDROME

Q

Also called Chronic Cortical Insufficiency

A

ADDISON’S DISEASE (CHRONIC)

Q

• Low level of adrenal cortex hormones
• Primary symptom: BRONZE SKIN
o Bronzing of the Skin

A

ADDISON’S DISEASE (CHRONIC)

Q

• Clinical manifestations of

o Bronze skin
o Pigmented mucous membranes
o Deep chocolate pigmentation of oral mucosa
from buccal area to angles of mouth spreading to gingiva tongue and lips

A

ADDISON’S DISEASE (CHRONIC)

Q

When there is bilateral hyperplasia of adrenal glands it is called?

A

CUSHING’S SYNDROME

Q

CLINICAL MANIFESTATIONS:
• Mooning of the face
• Round shoulders thus a “Buffalo hump” at the base of the
neck
• Altered hair distribution
• Muscular weakness
• Hypertension
• Glycosuria
• Albuminuria

A

CUSHING’S SYNDROME

Q

Dexamethasone Test:

• Low dose at 12 PM fails to suppress 8 AM cortisol production
• High dose at 12 PM suppresses ACTH - producing pituitary adenoma only

A

CUSHING’S SYNDROME

Q

ORAL MANIFESTATIONS
• Osteoporosis
• Premature cessation of epiphyseal growth

A

CUSHING’S SYNDROME

Q

Hormone involved:

o Insulin
o Other endocrine glands also play a role in its
production

A

DIABETES MELITUS

Q

• A disorder of carbohydrate metabolism
• Characterized by hyperglycemia and glycosuria

A

DIABETES

Q

There is a disturbance in:
o Use of glucose by tissues
o Release of glucose by liver
o Production and release of pancreatic, pituitary
and adrenocortical hormones
o This disturbance lowers the resistance of tissue
to infection

A

DIABETES

Q

EFFECTS ON THE ORAL CAVITY
• Periodontitis
• If untreated, periodontal abscess, inflamed, painful,
hemorrhagic gingival papillae

A

DIABETES MELITUS

Q

CLINICAL MANIFESTATIONS
• 3P’s: Polyuria, Polydypsia, Polyphagia
• Due to excessive fluid loss: dry mouth

A

DIABETES MELITUS

Q

T/ F

• There are no oral manifestations for patients with controlled diabetes
• But controlled diabetic patients should only undergo dental operations only after consultations with the physician who is treating the patient

A

T

Q

diffuse hyperplasia of thyroid gland

A

Exophthalmic Goiter

Q

tumor of thyroid gland

A

Toxic Adenoma

Q

Lipid Reticuloendotheliosis (2)

A

→ Gaucher’s Disease
→ Niemman-Pick Disease

Q

• Coronal pulp stones that are
floating
• Irregular composition of
dentinal tubules
• Denticles
• Enamel hypoplasia

A

EHLERS-DANLOS SYNDROME