Topic 50

Question 1

Acromegaly (etiology)

Answer 1

• a.k.a hyperpituitarism
• due to hyperfunction of eosinophils of frontal pituitary lobe
• increase in GH
• gigantism in childhood
• acromegaly in adulthood

Question 2

Acromegaly (Symptoms)

Answer 2

• mandibular prognathism
• macroglossia
• macrocheilia
• swollen gingiva
• large ears, nose, and eyebrows
• hyperplasia of dental cement
• wide diasthema
• sialosis
• hirsutism
• dermal hyperpigmentation
• DM

Question 3

Acromegaly (diagnosis)

Answer 3

• X-ray
• CT
• MRI

Question 4

Acromegaly (therapy)

Answer 4

• surgery of pituitary gland
• irradiation
• administration of octreotid and bromocriptin
• cosmetic resection of mandible

Question 5

Cushing’s Syndrome (etiology)

Answer 5

• adrenocortical hyperfunction
• due to adenoma or carcinoma
• steroid treatment
• long term steroid treatment causes steroid collapse which should be considered during general anesthesia

Question 6

Cushing’s Syndrome (symptoms)

Answer 6

• fatty deposits (moon face, buffalo hump)
• weakness of skeletal muscles
• hypertension
• headaches
• subcutaneous hematomas
• DM
• impaired wound healing
• hirsutism on face
• osteoporosis
• hypertrophic gingiva
• swollen parotid glands
• hyperpigmented skin and mucosa
• flushed face (plump rosy cheeks)
• teleangiectasis
• fungal infections
• hemorrhagic tendencies

Question 7

Cushing’s Syndrome (diagnosis)

Answer 7

• CT

- MRI

Question 8

Cushing’s Syndrome (therapy)

Answer 8

• surgery

- hormone substitution

Question 9

Hypothyroidism (etiology)

Answer 9

• thyroid gland hypofunction
• congenital: cretinism
• acquired: myxoedema

Question 10

Hypothyroidism (symptoms)

Answer 10

• macroglossia
• macrocheilia
• dry red mucosa (mucopolysaccharide infiltration)
• difficult speech and eating
• swollen face
• dry yellowish skin (carotin deposits)
• mental retardation
• bradycardia
• sensitivity to cold or hypothermia
• predisposition to ischemic cardiac disease
• may be accompanied by chronic mucocutaneous candidiasis

Question 11

Hypothyroidism (differential diagnosis)

Answer 11

• amyloidosis

- acromegaly

Question 12

Hypothyroidism (therapy)

Answer 12

• hormone substitution (L-thyroxine)

- local and systemic antimycotic treatment

Question 13

Hyperthyroidism (etiology)

Answer 13

• thyroid gland hyperfunction
• more common among women
• accompanying diseases:
• DM
• Myasthemia gravis
• Pernicious anemia

Question 14

Hyperthyroidism (symptoms)

Answer 14

• goiter
• protruding eyes
• tachycardia
• loss of weight
• weakness
• sweating
• nervousness
• shaking
• diarrhea
• swelling of lymphatic gland
• osteoporosis
• disturbed mental states
• depression
• decrease sexual function
• vitiligo

Question 15

Hyperthyroidism (oral symptoms)

Answer 15

• shaking and burning sensation of tongue
• early eruption of deciduous and permanent teeth
• osteoporosis may cause fracture of cheek bones
• swelling of gingiva

Question 16

Hyperthyroidism (adverse effect of drugs)
antithyroid
antihypertension
tranquilizers

Answer 16

• agranulocytosis
• xerostomia
• candidiasis

Question 17

Hyperthyroidism (differential diagnosis)

Answer 17

• thyroid tumors

Question 18

Hyperthyroidism (therapy)

Answer 18

• thiocarbamide derivates
• carbimazole
• radioactive iodine therapy
• surgery

Question 19

Hashimoto’s Thyroiditis (etiology)

Answer 19

• autoimmune disorder

- most common form of thyroiditis

Question 20

Hashimoto’s Thyroiditis (symptoms)

Answer 20

• enlarged thyroid gland (not tender to touch)
• may evolve to myxoedema
• may produce symptoms of hyperthyroidism
• maybe accompanied by complcations of DM, Addison, pernicious anemia)

Question 21

Hashimoto’s Thyroiditis (differential diagnosis)

Answer 21

• thyroid tumors
• basedow disease
• goiter
• lymphoma

Question 22

Hashimoto’s Thyroiditis (therapy)

Answer 22

• L-thyroxin

Question 23

Addison’s Disease (etiology)

Answer 23

- Hypofunction or total dectruction
of the adrenal gland due to:
* tumors
* amyloidosis,
* haemorrhages,
* autoimmun origin
* infections
- decrease levels of adrenal hormones
- increased level of ACTH and MSH

Question 24

Addison’s Disease (symptoms)

Answer 24

- greyish-brown stained hyperpigmentation of the skin, mucosa
(bucca, tongue, gingiva, lips)
- lassitude
- anorexia
- nausea
- diarrhea
- anaemia
- cachexia
- orthostatic hypotension
- shock
- hypoglycemia
- hyponatremia
- hypercalcemia
- vitiligo
-aphtous ulcers

Question 25

Addison’s Disease (differential diagnosis)

Answer 25

• racial hyperpigmentation
• melanoplakia
• malignant
  melanoma
• Peutz-Jeghers sy.

Question 26

Addison’s Disease (therapy)

Answer 26

• glucocorticoid
• mineralocorticoid
• hormone substitution

Question 27

Diabetes Mellitus (etiology)

Answer 27

• decreased insulin production

- metabolic disorder

Question 28

Diabetes Mellitus (symptoms)

Answer 28

• dry skin
• xerostomia (dry mouth)
• glossodynia
• disorders of taste sensation
• angular cheilitis
• swollen parotid glands
• gingival anomalies
• itching of the gingiva
• medial rhomboid glossitis
• susceptibility to
  ischemic cardiac disease,
  hypoglicemic and diabetic coma
• lichen oris, lichenoid reactions

Question 29

Diabetes Mellitus (differential diagnosis)

Answer 29

• candidiasis
• Sjögren’s sy.
• irradiation
• disorders of the
  salivary gland

Question 30

Diabetes Mellitus (Therapy)

Answer 30

• primarily internal medical treatment

- antimicotic drugs