Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medically Complex Patient > Thyroid and Adrenal Disease > Flashcards

Thyroid and Adrenal Disease Flashcards

1
Q

The thyroid and adrenal gland both get stimulation from

A

pituitary gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

More common, thyroid or adrenal disease?

A

thyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Fxns of thyroid:

A

metabolism, growth/ maturation of tissues, cell turnover, nutrients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Calcitonin comes from:

A

thyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What regulates serum Ca and P?

A

calcitonin, parathyroid hormone, V. D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Fxns of calcitonin:

A

Blood Ca, P levels, skeletal remodeling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Active form T3 or T4?

A

T4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Wo sufficient iodine, a person will develop:

A

goiter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where is T3 produced?

A

follicular cells of thyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What regulates the release of T3?

A

pituitary TSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Fxn of T3:

A

metabolic processes, O2 use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is needed for T3 to fxn?

A

iodine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hyperthyroid results in:

A

excessive thyroid hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Symptoms of hyperthyroidism:

A

SWEATING, heat intolerance, inc bowel movements, tremor, nervousness, agitation, rapid HR, weight loss, fatigue, dec concentration, irregular/ scant menstrual flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Most common cause of endogenous hyperthyroidism:

A

Graves’ disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Other causes of hyperthyroidism:

A

Toxic multinodular goiter, Toxic adenoma, Pituitary adenoma, Metastatic tumors, Thyroiditis, Overmedication (synthetic thyroid hormone, hypo to hyper possible)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How can adenoma lead to hyperthyroidism?

A

acc release of TH, pituitary gland TSH inc, too much

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Symptoms of Graves Disease:

A

hyperthyroidism, enlarged thyroid, lymphocytic infiltration, ophthalmopathy, exophthalmos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What causes Grave’s disease?

A

AI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Hyperthyroidism leads to:

A

enlargement of thyroid, lymphocytic infiltration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

TF? Most cases of exophthalmos due to Graves disease resolve after the disease is managed.

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Tx for hyperthyroidism:

A

radioactive iodine uptake, 6-18mo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Indications that hyperthyroidism is poorly controlled:

A

Inc HR & BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

TF? Pulse rate is a measure of thyroid function.

A

T, hyperthyroidism: above 100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Caution for treating pts w uncontrolled hyperthyroidism:

A

don’t use epi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Goal of surgery for hyperthyroidism:

A

leave enough thyroid for normal function, too much excised is better

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

The use of epi w a pt w hyperthyroidism could lead to:

A

Palpitations, Arrhythmias, Chest pains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Mgmt of pts w hyperthyroidism:

A

limit psychological / surgical stress, aggressive infections tx (reserve is not great)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

TF? Infections should be treated aggressively in pts w DM or hyperthyroidism.

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Ppl most likely to enter thyrotoxic crisis:

A

elderly women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Incidence of thyrotoxic crisis a overt hyperthyroid.

A

1-2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Mortality rate of thyrotoxic crisis:

A

10-20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Thyrotoxic crisis is aka:

A

thyroid storm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

presentation, thyrotoxic crisis:

A

Inc HR, BP, fever, neurological / GI symptoms, N, abdominal pain, anxiety, seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Decompensated state of TH-induced hypermetabolism:

A

thyrotoxic crisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

symptoms of hypothyroid:

A

weight gain, lethargy, cold intolerance, bradycardia, EDEMA, SWEATING

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Causes of hypothyroid:

A

Hashimoto’s, lymphocytic thyroiditis, thyroid destruction, pituitary or hypothalamic disease, meds, iron deficiency (severe)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Hashimoto’s disease leads to __ and Grave’s disease leads to ___.

A

hypo, hyper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

TF? Hashimoto’s and Graves disease are both AI diseases.

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Types of inflammation that Hashimoto’s and Graves leads to:

A

lymphocytic and AI inflammation (in gland and autoantibody production)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Hashimoto’s can lead to:

A

myxedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

TF? Hashimoto’s disease can lead to Grave’s disease.

A

F. vice versa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Hypothyroidism in infancy can cause:

A

cretinism, developmental delay, frontal bossing (swelling) , big tongue, small jaw, short, hypertelorism (inc distance bw eyes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Oral manifestations of hypo:

A

delayed eruption, enamel hypoplasia, ant open bite, small jaw, big tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

How to treat hypo:

A

No tx if euthyroid w autoantibodies, Levothyroxine (Synthroid, replacement hormone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Which is more common, hypo or hyper?

A

hypo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Dental mgmt of pt w hypo:

A

Inc subcutaneous mucopolysaccharides –> red capillary constriction –> red hemostasis, dec fibroblast activity –> delayed wound healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

causes delayed wound healing in hypo:

A

dec fibroblast activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Causes red hemostasis in pts w hypo:

A

excess subcutaneous mucopolysaccharides –> red capillary constriction –> red homeostasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

anticoagulated, hypo or hyper and why?

A

Hypo, CV effects

51
Q

What to be aware of if pt is taking Levothyroxine:

A

inc Warfarin effects, dec oral hypoglycemics effects

52
Q

Warfarin is what type of drug?

A

anticoagulant

53
Q

Why do pts w hypo on thyroid replacement hormones need to be monitored?

A

they can become hyper

54
Q

TF? If BP & P are elevated in a pt w hypo you should avoid epi.

A

T

55
Q

Is elevated TSH hyper or hypo?

A

Hypo, body putting out more TSH since it isn’t getting response.

56
Q

neoplasms that can occur in the thyroid?

A

adenomas: benign, can produce hormones and cause hyper, usually nonfunctional, toxic adenomas produce hormones

57
Q

TF? Toxic adenomas do not produce hormone.

A

F. They do

58
Q

elevated if too much thyroid hormone is produced, t3 or T4?

A

T4

59
Q

problem if TH is tool low?

A

Pituitary or thyroid

60
Q

Cause of many thyroid neoplasms:

A

ionizing radiation

61
Q

First familial form of thyroid neoplasm?

A

yes, genetic variant, 70% get cancer

62
Q

Tx for pts with genes for familial form of thyroid neoplasm.

A

Remove thyroid

63
Q

% of pts w genetic predisposition to thyroid neoplasm that get cancer:

A

70%

64
Q

this indicates an underactive thyroid:

A

elevated TSH

65
Q

This indicates overactive thyroid:

A

elevated T4

66
Q

Effects of low T4:

A

damage thyroid or pituitary

67
Q

low T4 and elevated TSH indicates:

A

thyroid problem

68
Q

Low T4 and low TSH indicates:

A

pituitary problem (both are low, in the pits)

69
Q

What are found on top fo kidneys:

A

adrenal glands

70
Q

Adrenal glands, endocrine or exocrine?

A

endocrine

71
Q

Produced by the cortex of the adrenal glands:

A

glucocorticoids, mineralocorticoids, androgens

72
Q

Aldosterone is a:

A

mineralocorticoid

73
Q

Testosterone is a:

A

androgen

74
Q

Cortisol is a:

A

glucocorticoid

75
Q

Produced in the medulla of the adrenal glands:

A

epi and NE

76
Q

TF? There is a lot of overlay bw the adrenal glands and the thyroid.

A

T

77
Q

Fxns of cortisol:

A

regulate protein, fat, carb metabolism, homeostasis, vascular reactivity, inhibition of inflammation

78
Q

TF? Cortisol is an insulin antagonist.

A

F. insulin agonist

79
Q

Fans of both cortisol and TH:

A

homeostasis

80
Q

Steroids are prescribed for/

A

allergies, inflammation

81
Q

HPA axis sf:

A

Hypothalamus, anterior Pituitary, Adrenal cortex

82
Q

To where does cortisol exert negative feedback?

A

hypothalamus, ant pituitary gland

83
Q

How does the hypothalamus exert influence over the anterior pituitary?

A

corticotropin releasing hormone. (-CRH)

84
Q

anterior pituitary exerts influence over adrenal cortex via:

A

ACTH

85
Q

WHat is released from the pituitary?

A

both TSH and ACTH

86
Q

What is Addison’s disease?

A

Not enough hormone secretion from adrenal cortex

87
Q

What can cause the insufficiency in hormone secretion from adrenal cortex in Addison’s disease?

A

AI, infection, hypovolemia, tumor, meds

88
Q

Infection that can bring about Addison’s disease:

A

TB, HIV, fungal

89
Q

How can hypovolemia bring about?

A

shut down communication bw pituitary and adrenal gland

90
Q

Meds that can bring about Addison’s disease:

A

anticoagulants

91
Q

How can anticoagulants bring about Addison’s disease?

A

dec circulating cortisol/steroid in system (?)

92
Q

Signs and symptoms of Addison’s disease:

A

change in pulse and dec BP, GI symptoms inc D, N, V, weakness, fatigue, confusion, pigmentation of skin and oral mucosa

93
Q

Oral manifestation of Addison’s disease:

A

pigmentation of skin and oral mucosa, brown spots on lips and spotches inside

94
Q

Tx for Addison’s disease:

A

replacement corticosteroids

95
Q

What is Cushing syndrome?

A

too much cotisol

96
Q

Can lead to Cushing syndrome:

A

overmedication, excessive ACTH production from pituitary, adrenal tumors

97
Q

TF? Cushing syndrome and Addison’s disease can both be medically induced.

A

T

98
Q

Diseases that are treated with steroids:

A

Lupus, Sarcoid, Sjogren’s syndrome, MS, Cushing syndrome (all immunosuppressants, AI components)

CMLSS

99
Q

Steroid use can lead to problems of the:

A

skeletal system (dm, hyperglycemia, too, right?)

100
Q

Most steroids we use are:

A

topical

101
Q

Most obvious sign of Cushing syndrome:

A

moon face

102
Q

Signs and symptoms of Cushing syndrome:

A

hypertension, obesity, moon face, slow growth rate, bone pain/ fractures, muscle weakness, mental status change, fat deposition on back “Buffalo hump”

103
Q

Cancer pts can be on high doses of these for a short period of time.

A

Steroids

104
Q

Tx for Cushing syndrome:

A

wean from excessive meds, remove or radiate tumor

105
Q

What is adrenal crisis?

A

acute adrenal insufficiency, rare, liffe-threatening, requires immediate tx

106
Q

What type of pt with Addison’s is at highest risk for adrenal crisis?

A

1’ Addison’s

107
Q

Adrenal crisis can be precipitated by:

A

inc stress –> inc need for cortisol –> adrenal gland can’t provide it

108
Q

Normal output of cortisol from adrenal cortex:

A

25mg hydrocortisone (or 7.5mg prednisolone)

109
Q

How can high dose steroids induce adrenal crisis:

A

high dose shuts down ability to produce steroids, more stress than the pills will compensate for, system shuts down

110
Q

TF? We must treat Addison’s pts w steroid augmentation for routine dentistry.

A

F

111
Q

TF? Pts taking endogenous steroids have adrenal function suppressed.

A

F. exogenous

112
Q

Adrenal suppression may occur if:

A

pt took at least 20mg hydrocotisone for at least 2wk within past 2yr

113
Q

Rule of 2’s applies to what disease?

A

Addison’s

114
Q

What is the Rule of 2’s?

A

pt took at least 20mg hydrocotisone for at least 2wk within past 2yr

115
Q

Effects of low cortisol on body:

A

dec liver fxn/ stomach digestive enzymes, V, D, cramps, very low sugar, coma, death

116
Q

Levels of what will be low in the body if the adrenal glands aren’t functioning:

A

cortisol, aldosterone

117
Q

Affects of aldosterone being very low in body:

A

water and Na loss in kidney, irregular heart beat and output, low fluid, low BP, shock, coma, death

118
Q

Explain the premise of steroid augmentation:

A

pt taking steroids at a high enough dose for even a brief period, endogenous steroid production will be suppressed, unable to produce steroid if under additional stressor, adrenal crisis

119
Q

When to consider steroid augmentation:

A

general anesthesia, extensive surgery, anticipate significant post-op pain

120
Q

All cases of adrenal crisis in dentistry involved:

A

general anesthesia, 1.5-5h post-op, only 4 cases in 35y, no controls

121
Q

Why is pain management important for pts w impaired adrenal function?

A

bc pain is a major stressor and wo steroid augmentation, they may go into adrenal crisis

122
Q

This is the target dose for hydrocortisone equivalent:

A

50-100mg/d

123
Q

Freq req for pts w adrenal insufficiency for surgical proc:

A

double dose of steroid on day of, and maybe day after, surgery

Medically Complex Patient (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions