Part II- Thyroid Disease- Endocrine and Metabolic conditions Flashcards

1
Q

What is the function of the thyroid gland?

A
  • Secretes T4, T3 and calcitonin (Thyroid hormones)
  • Affects growth and maturation of tissues, cell respiration and energy expenditures
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2
Q

What is goiter?

A

Generalized enlargement of the tyroid gland

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3
Q

What is Thyrotoxicosis?

A

Excess of T4 and T3 in the blood;
hyperthyroidism

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4
Q

What is Graves disease?

A

Autoimmune disease associated with
excess thyroid hormones and enlarged thyroid

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5
Q

What is hypothyroidism?

A

low T4 and T3 blood plasma levels

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6
Q

What is Myxedema

A

Severe hypothyroidism; dermatologic
changes that occur with hypothyroidism.

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7
Q

What is Hashimoto Thyroiditis?

A

Autoimmune disorder that
causes hypothyroidism

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8
Q

What is Thyroiditis?

A

Inflammation of the thyroid

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9
Q

What is Hyperthyroidism associated with?

A
  • associated with graves diease, toxic nodular goiter and acute thyroiditis
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10
Q

What is Hyperthyroidism caused by?

A
  • Caused by: eating large amount of ground beed or functional ectopic thyroid tissue
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11
Q

What does Hyperthyroidism cause?

A
  • Nervousness
  • Fatigue
  • Heart palpitations
  • Heat intolerance
  • weight loss
  • Sweating
  • Soft fingernails
  • Thin hair
  • Loss of vision
  • Can be continous
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12
Q

What are Hyperthyroidism symptoms for the eyes and skin?

A

Eye: staring
Infrequent blinking
Jerky eyelid movement
Failure to wrinkle the brow when gazing upward

Skin: warm, rosy complexion

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13
Q

Patients with hyperthyroidism show signs of ?

A
  • 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
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14
Q

What is “thyroid storm”?

A

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.

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15
Q

What are some medical management for Hyperthyroidism?

A
  • 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
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16
Q

What are the dental Management for hyperthyroidism?

A
  • 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
17
Q

What are some oral manifestations for Hyperthyroidism?

A
  • 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
18
Q

Thyroiditis is?

A
  • Autoimmune disorder, comes from asymptomatic goiter known as Hashimotos disease
  • affects young and middle aage women
  • progessive to hypothyroidism
  • Goiter is main symptom
19
Q

What are oral manifestations of thyroiditis?

A
  • Salivary gland disfunction
  • Dry mouth
  • Pain radiating to the ear, jaw or eyes
  • Hoarseness
  • Dysphagia
  • Enlarged, firm nodular tender thyroid
20
Q

What are signs and symptoms for hypothyroidism in older children and adults ?

A
  • 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
21
Q

What are the medical management for Hypothyroidism?

A
  • 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
22
Q

What is Myxedema coma?

A
  • Stressful situations induced in untreated hypothyroid patients
    -High mortality
    -Treated by levothyroxine injection
23
Q

What are the dental mangament for Hypothyroidism?

A
  • 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
24
Q

What are the oral manifestaion of hypothyroidism?

A

Thick lip infants
Enlarged tongue-inflants and adults
Low salovary flow- adults

25
Q

What is Thyroid cancer caused by?

A

Caused by receiving cervical radiation in
childhood including multiple dental x-rays before
1970 and mandibular imaging

26
Q

What are the risk factors for thyroid cancer?

A

History of thyroiditis, very high or low iodine intake,
and family history of thyroid cancer

27
Q

What type of cancer may metastasize to the thyroid?

A

Distant cancers

28
Q

What is the presentation of thyroid cancer?

A

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

29
Q

How is thyroid cancer diagnose and treated?

A
  • Diagnosed after ultrasound and biopsy
  • Treated surgically with lobectomy or complete
    thyroid removal