Endocrine Disorders and Neoplasms

Autoimmune Destruction

• Autoimmune processes are the most common reason for hormone deficiency.
• Genetic predisposition and an environmental trigger seem to be necessary for autoimmune processes to occur.

Hypersecretion and Hyposecretion

• Hypersecretion of hormones occurs when endocrine cells become cancerous and produce excessive amounts of hormones.
• Hyposecretion of hormones occurs when a neoplasm destroys hormone-producing cells.

Neoplasms

• Craniopharyngiomas and null-cell tumors are examples of neoplasms.
• Craniopharyngiomas are slow-growing tumors that originate from remnants of Rathke's pouch above the sella.

Ischemia and Infarction

• Ischemia is an inadequate blood supply to an organ or part of the body.
• Infarction refers to the death of tissue due to insufficient blood supply.

Infiltrative Disease

• Infiltrative disease refers to a diffuse disease process that spreads throughout an entire organ.

Osteocytes

• Osteocytes are mature bone cells derived from osteoblasts that have secreted osteoid around themselves.

Osteoclasts

• Osteoclasts are bone-resorbing cells derived from monocytes.

Osteons

• Osteons are the structural units of compact bone, serving as tiny weight-bearing pillars.

Lamellae

• Lamellae are concentric rings of compact bone tissue that help form the osteons.

Lacunae

• Lacunae are bony depressions in the lamellae where bone cells reside.

Haversian (Central) Canal

• The Haversian canal is located in the core of osteons and serves as a passageway for blood vessels and nerves.

Volkmann's (Perforating) Canals

• Volkmann's canals connect osteons and provide a passageway for blood vessels and nerves to enter and leave the bone.

Osteoporosis

• Osteoporosis occurs when bone resorption is faster than bone formation, leading to deterioration of bone quality.

DEXA Scan

• A DEXA scan is used to measure bone density.

Zona Fasciculata

• The zona fasciculata is responsible for producing glucocorticoids like cortisol.

Zona Reticularis

• The zona reticularis produces adrenal androgens like DHEA and androstenedione.

Chromaffin Cells

• Chromaffin cells are the cell type found in the adrenal medulla.

Epinephrine and Norepinephrine

• The adrenal medulla produces epinephrine and norepinephrine.

Glucocorticoids (Cortisol)

• Glucocorticoids (cortisol) are essential for life and help us cope with stress.
• Glucocorticoids protect against hypoglycemia by increasing glucose production in the liver, increasing protein breakdown, and increasing fat breakdown.
• The biggest surge of glucocorticoids occurs an hour before waking up.

Cushing Syndrome

• Cushing syndrome is characterized by excess cortisol, resulting in elevated blood glucose levels and high insulin levels.
• Cushing syndrome is the primary form of hypersecretion.
• Cushing syndrome is caused by a problem in the adrenal cortex.

Addison's Disease and Adrenal Crisis

• Dental aspects associated with Addison's disease and adrenal crisis include patchy brown pigmentation on the oral mucosa, increased pigmentation of lips, gingival margins, buccal mucosa, and palate.
• Stress should be reduced prior to dental treatment for patients with Addison's disease.
• Surgery for patients with primary adrenal insufficiency should be scheduled in the morning.
• Adrenal crisis is treated with immediate infusion of cortisol and supportive care.
• Addison's disease is treated with hydrocortisone (oral cortisol) and fludrocortisone (mineralocorticoid).

Aldosterone

• Aldosterone is the primary mineralocorticoid.

Non-Proliferative Diabetic Retinopathy

• Non-proliferative diabetic retinopathy comprises 90-95% of retinopathy cases and does not cause visual loss.
• It is characterized by venous dilation, exudates, small hemorrhages, microinfarcts, and/or microaneurysms.

Proliferative Diabetic Retinopathy

• Proliferative diabetic retinopathy accounts for 5-10% of cases and is more severe, potentially causing retinal detachment and blindness.
• It exhibits the same characteristics as non-proliferative diabetic retinopathy, in addition to neovascularization caused by vascular occlusion and/or ischemia.

Diabetic Nephropathy

• Diabetic nephropathy results from damage to the glomerulus capillaries due to chronically high blood sugar levels in diabetes mellitus.
• It is the leading cause of end-stage renal disease.

Microalbuminuria

• Microalbuminuria is the earliest clinical evidence of diabetic nephropathy.

This quiz covers various endocrine disorders including autoimmune destruction, hypersecretion and hyposecretion of hormones, and the impact of neoplasms. It also explores concepts like ischemia, infarction, infiltrative disease, and the role of osteocytes in bone health. Test your understanding of these critical topics in endocrinology!