Part II- Thyroid Disease- Endocrine and Metabolic conditions Flashcards
What is the function of the thyroid gland?
- Secretes T4, T3 and calcitonin (Thyroid hormones)
- Affects growth and maturation of tissues, cell respiration and energy expenditures
What is goiter?
Generalized enlargement of the tyroid gland
What is Thyrotoxicosis?
Excess of T4 and T3 in the blood;
hyperthyroidism
What is Graves disease?
Autoimmune disease associated with
excess thyroid hormones and enlarged thyroid
What is hypothyroidism?
low T4 and T3 blood plasma levels
What is Myxedema
Severe hypothyroidism; dermatologic
changes that occur with hypothyroidism.
What is Hashimoto Thyroiditis?
Autoimmune disorder that
causes hypothyroidism
What is Thyroiditis?
Inflammation of the thyroid
What is Hyperthyroidism associated with?
- associated with graves diease, toxic nodular goiter and acute thyroiditis
What is Hyperthyroidism caused by?
- Caused by: eating large amount of ground beed or functional ectopic thyroid tissue
What does Hyperthyroidism cause?
- Nervousness
- Fatigue
- Heart palpitations
- Heat intolerance
- weight loss
- Sweating
- Soft fingernails
- Thin hair
- Loss of vision
- Can be continous
What are Hyperthyroidism symptoms for the eyes and skin?
Eye: staring
Infrequent blinking
Jerky eyelid movement
Failure to wrinkle the brow when gazing upward
Skin: warm, rosy complexion
Patients with hyperthyroidism show signs of ?
- Being nervous or easily to lose temper or cry
- Difficulty sitting still
- Hand and tongue tremors
- Increase bone loss due to excretion of calcium in urine
- intolerant to gluclose
What is “thyroid storm”?
If hyperthyroidism not controlled can become a medical emergency because PT may have restlessness, fever, tachycardia, pulmonary edmea, tremor, sweating, stupor, coma and or death.
What are some medical management for Hyperthyroidism?
- Anti-thyroid agents: Propylthiouracil and Methimazole
- Radioactive iodine (RAI)
- Thyroidectomy (after antithyroid drug treatment)
- Management of thyrotoxic crisis as indicated: Serious complication of hyperthyroid treatment
What are the dental Management for hyperthyroidism?
- Risk for infection is no greater; consult with physician if the patient is not controlled before treating an infection
- Bleeding is not a concern unless taking Coumadin
- Able to provide care if controlled; risk of thyroid storm medical emergency is not controlled
- Epinephrine is okay if the condition is controlled- consult with physician if not controlled
- Be prepared to manage thyroid storm by recognizing the signs
- Activate emergency medical treatment and call 911
What are some oral manifestations for Hyperthyroidism?
- Babies may have teeth at birth
- Children: teeth and jaws develop faster
- Deciduous teeth are lost early, and permanent teeth erupt early
- Lingual thyroid may be present
- Possible change in taste and smell
- May develop periodontal disease and caries more rapidly
Thyroiditis is?
- Autoimmune disorder, comes from asymptomatic goiter known as Hashimotos disease
- affects young and middle aage women
- progessive to hypothyroidism
- Goiter is main symptom
What are oral manifestations of thyroiditis?
- Salivary gland disfunction
- Dry mouth
- Pain radiating to the ear, jaw or eyes
- Hoarseness
- Dysphagia
- Enlarged, firm nodular tender thyroid
What are signs and symptoms for hypothyroidism in older children and adults ?
- Weight gain
- muscle weakness
- Deafness
- Anemia
- Constiplation
- Dull expression
- Puffy eyelids
- Dry rough skin
- Dry, Brittle hair
- Alopecia of eyebrows
- increase tongue size
- slowing of activity
- slurred hoarse speech
- Increase sensitivity to cold
What are the medical management for Hypothyroidism?
- Synthetic thyroid hormone: Sodium levothyroxine (LT4): Sodium liothyronine (LT3)
- Need lower insulin or glucose lowering medications for diabetic patients
- Myxedema may lead to CHF; Levothyroxine can help decrease
- Hypothyroidism causes sensitivity to narcotics, barbiturates, and tranquilizers
- Smoking makes condition worse
What is Myxedema coma?
- Stressful situations induced in untreated hypothyroid patients
-High mortality
-Treated by levothyroxine injection
What are the dental mangament for Hypothyroidism?
- No antibiotics if uncontrolled; risk for myxedema coma
- Minimal bleeding risk
- Do not treat if not controlled or no medical management: May result in myxedematous coma
- If uncontrolled/untreated patient may experience exaggerated response to some drugs
- Be prepared to manage medical emergency: myxedema coma; know signs and symptoms
What are the oral manifestaion of hypothyroidism?
Thick lip infants
Enlarged tongue-inflants and adults
Low salovary flow- adults
What is Thyroid cancer caused by?
Caused by receiving cervical radiation in
childhood including multiple dental x-rays before
1970 and mandibular imaging
What are the risk factors for thyroid cancer?
History of thyroiditis, very high or low iodine intake,
and family history of thyroid cancer
What type of cancer may metastasize to the thyroid?
Distant cancers
What is the presentation of thyroid cancer?
Firm irregularly shaped nodules in the thyroid that
are fixed to the underlying tissue, hard painless
max, attached to other local structures, enlarged
lymph nodes
How is thyroid cancer diagnose and treated?
- Diagnosed after ultrasound and biopsy
- Treated surgically with lobectomy or complete
thyroid removal
