Podcast
Questions and Answers
Which of the following best describes endocrine glands?
Which of the following best describes endocrine glands?
- Glands that produce and secrete sweat onto the skin surface.
- Glands that secrete products via a ductal system to an epithelial surface.
- Glands that secrete products directly into the bloodstream. (correct)
- Glands that secrete digestive enzymes into the stomach.
Which of the following is NOT a primary function regulated by endocrine glands?
Which of the following is NOT a primary function regulated by endocrine glands?
- Metabolism
- Growth and development
- Reproduction
- Regulation of body temperature (correct)
Which gland secretes melatonin?
Which gland secretes melatonin?
- Adrenal gland
- Pituitary gland
- Thyroid gland
- Pineal gland (correct)
Which hormone is NOT secreted by the pituitary gland?
Which hormone is NOT secreted by the pituitary gland?
What is the term for excessive hormone production by an endocrine gland?
What is the term for excessive hormone production by an endocrine gland?
Which of the following is NOT a potential cause of endocrine gland dysfunction?
Which of the following is NOT a potential cause of endocrine gland dysfunction?
Acromegaly is typically caused by an excess of which hormone?
Acromegaly is typically caused by an excess of which hormone?
Hypopituitarism can result in which of the following conditions?
Hypopituitarism can result in which of the following conditions?
Diabetes insipidus is most directly related to a deficiency in which hormone?
Diabetes insipidus is most directly related to a deficiency in which hormone?
Which condition is associated with exophthalmos (protrusion of the eyeballs)?
Which condition is associated with exophthalmos (protrusion of the eyeballs)?
What is the most common cause of hypothyroidism?
What is the most common cause of hypothyroidism?
Which of the following is a symptom of hypothyroidism?
Which of the following is a symptom of hypothyroidism?
In children, which oral manifestation is typically associated with hypothyroidism?
In children, which oral manifestation is typically associated with hypothyroidism?
Which of the following is a potential symptom of hyperparathyroidism?
Which of the following is a potential symptom of hyperparathyroidism?
What oral manifestation is associated with hyperparathyroidism?
What oral manifestation is associated with hyperparathyroidism?
Which manifestation is NOT typically associated with hypoparathyroidism?
Which manifestation is NOT typically associated with hypoparathyroidism?
Which of the following is a typical characteristic of endocrine glands?
Which of the following is a typical characteristic of endocrine glands?
Which of the following hormones is produced by the placenta during pregnancy?
Which of the following hormones is produced by the placenta during pregnancy?
If a patient presents with polyuria and polydipsia due to a deficiency in ADH, and their condition is not responsive to ADH administration, which type of diabetes insipidus is most likely present?
If a patient presents with polyuria and polydipsia due to a deficiency in ADH, and their condition is not responsive to ADH administration, which type of diabetes insipidus is most likely present?
A patient experiencing muscle weakness, fatigue, constipation, and bone pain is suspected of having an endocrine disorder. Blood tests reveal elevated levels of calcium and parathyroid hormone (PTH). Which of the following is the MOST likely diagnosis?
A patient experiencing muscle weakness, fatigue, constipation, and bone pain is suspected of having an endocrine disorder. Blood tests reveal elevated levels of calcium and parathyroid hormone (PTH). Which of the following is the MOST likely diagnosis?
A 10-year-old child presents with accelerated tooth eruption, increased appetite but weight loss, and behavioral changes. Which endocrine disorder is MOST likely?
A 10-year-old child presents with accelerated tooth eruption, increased appetite but weight loss, and behavioral changes. Which endocrine disorder is MOST likely?
A patient presents with a constellation of symptoms including fatigue, weight gain, constipation, dry skin, and brittle nails. Further questioning reveals a history of autoimmune disease. Based on this presentation, which of the following is the most likely underlying endocrine disorder?
A patient presents with a constellation of symptoms including fatigue, weight gain, constipation, dry skin, and brittle nails. Further questioning reveals a history of autoimmune disease. Based on this presentation, which of the following is the most likely underlying endocrine disorder?
A patient is diagnosed with nephrogenic diabetes insipidus. Which of the following mechanisms is the most likely cause of their polyuria and polydipsia?
A patient is diagnosed with nephrogenic diabetes insipidus. Which of the following mechanisms is the most likely cause of their polyuria and polydipsia?
An extremely rare presentation: A patient has both low parathyroid hormone AND low calcitonin. Assuming both values are appropriately low for the given calcium level, which single gland is most likely dysfunctional?
An extremely rare presentation: A patient has both low parathyroid hormone AND low calcitonin. Assuming both values are appropriately low for the given calcium level, which single gland is most likely dysfunctional?
A patient presents with advanced acromegaly primarily affecting the mandible. After surgical removal of the causative pituitary adenoma, the surgeon contacts a prosthodontist. Why?
A patient presents with advanced acromegaly primarily affecting the mandible. After surgical removal of the causative pituitary adenoma, the surgeon contacts a prosthodontist. Why?
Which of the following characteristics distinguishes endocrine glands from exocrine glands?
Which of the following characteristics distinguishes endocrine glands from exocrine glands?
Which of the following is the primary focus when studying endocrine glands?
Which of the following is the primary focus when studying endocrine glands?
Which gland is located in the brain and is responsible for the regulation of other endocrine glands?
Which gland is located in the brain and is responsible for the regulation of other endocrine glands?
Which of the following best describes the function of hormones released by endocrine glands?
Which of the following best describes the function of hormones released by endocrine glands?
Which of the following hormones is NOT produced by the hypothalamus?
Which of the following hormones is NOT produced by the hypothalamus?
Which of the following is an example of a genetic cause of endocrine dysfunction?
Which of the following is an example of a genetic cause of endocrine dysfunction?
What is the term for a condition characterized by abnormally low hormone production?
What is the term for a condition characterized by abnormally low hormone production?
Which of the following is a potential cause of hypopituitarism?
Which of the following is a potential cause of hypopituitarism?
A patient presents with polyuria and polydipsia. The physician suspects diabetes insipidus. What laboratory test would be MOST useful in differentiating between cranial and nephrogenic causes?
A patient presents with polyuria and polydipsia. The physician suspects diabetes insipidus. What laboratory test would be MOST useful in differentiating between cranial and nephrogenic causes?
Which of the following is a common symptom of hyperthyroidism?
Which of the following is a common symptom of hyperthyroidism?
During a dental examination of a child, the dentist notices delayed tooth eruption and micrognathia. Considering the information provided, which endocrine disorder might be suspected?
During a dental examination of a child, the dentist notices delayed tooth eruption and micrognathia. Considering the information provided, which endocrine disorder might be suspected?
Elevated parathyroid hormone (PTH) levels typically lead to increased:
Elevated parathyroid hormone (PTH) levels typically lead to increased:
Which of the following is a typical symptom of hypoparathyroidism?
Which of the following is a typical symptom of hypoparathyroidism?
Which condition is related to hyperthyroidism and presents with protruding eyeballs?
Which condition is related to hyperthyroidism and presents with protruding eyeballs?
Hashimoto’s disease primarily leads to which endocrine disorder?
Hashimoto’s disease primarily leads to which endocrine disorder?
In a patient with diabetes insipidus, what clinical finding is MOST directly linked to the underlying hormonal imbalance?
In a patient with diabetes insipidus, what clinical finding is MOST directly linked to the underlying hormonal imbalance?
A 35-year-old female presents with irregular menstrual cycles, hirsutism, and acne. Which endocrine disorder is MOST likely?
A 35-year-old female presents with irregular menstrual cycles, hirsutism, and acne. Which endocrine disorder is MOST likely?
Which of the following best describes the mechanism of action of hormones secreted by endocrine glands?
Which of the following best describes the mechanism of action of hormones secreted by endocrine glands?
Which of the following hormones is primarily responsible for the development of male secondary sexual characteristics?
Which of the following hormones is primarily responsible for the development of male secondary sexual characteristics?
A patient who has undergone a complete thyroidectomy is MOST at risk of developing which of the following complications if replacement hormone therapy is inadequate?
A patient who has undergone a complete thyroidectomy is MOST at risk of developing which of the following complications if replacement hormone therapy is inadequate?
What primary issue results from a diet deficient in iodine?
What primary issue results from a diet deficient in iodine?
A teenage patient is diagnosed with precocious puberty. From the list, what is the MOST likely additional sign or symptom the patient might exhibit?
A teenage patient is diagnosed with precocious puberty. From the list, what is the MOST likely additional sign or symptom the patient might exhibit?
A patient presents with muscle cramps, fatigue, and paresthesia. Blood tests reveal hypocalcemia. Further investigation reveals deficiency of only a single hormone, but the gland appears histologically normal. Which of the following is the BEST explanation for the hormonal deficiency?
A patient presents with muscle cramps, fatigue, and paresthesia. Blood tests reveal hypocalcemia. Further investigation reveals deficiency of only a single hormone, but the gland appears histologically normal. Which of the following is the BEST explanation for the hormonal deficiency?
A researcher is studying the impact of a novel drug on endocrine function. They administer the drug to lab animals and observe a significant decrease in the size of the thymus gland. Which of the following hormone levels would MOST likely be affected by this change?
A researcher is studying the impact of a novel drug on endocrine function. They administer the drug to lab animals and observe a significant decrease in the size of the thymus gland. Which of the following hormone levels would MOST likely be affected by this change?
Insanely Difficult: A researcher discovers a novel hormone that appears to selectively inhibit the function of osteoclasts without affecting osteoblasts. If this hormone were administered chronically, what would be the MOST LIKELY long-term consequence, assuming ALL other homeostatic mechanisms remain normal?
Insanely Difficult: A researcher discovers a novel hormone that appears to selectively inhibit the function of osteoclasts without affecting osteoblasts. If this hormone were administered chronically, what would be the MOST LIKELY long-term consequence, assuming ALL other homeostatic mechanisms remain normal?
What is a key characteristic of endocrine glands that differentiates them from exocrine glands?
What is a key characteristic of endocrine glands that differentiates them from exocrine glands?
Which of the following is a primary secretion of the pineal gland?
Which of the following is a primary secretion of the pineal gland?
Which gland is responsible for producing releasing and inhibiting hormones that control the anterior pituitary gland?
Which gland is responsible for producing releasing and inhibiting hormones that control the anterior pituitary gland?
Which of the following is a potential cause of endocrine dysfunction related to tissue destruction?
Which of the following is a potential cause of endocrine dysfunction related to tissue destruction?
Which of the following hormones is NOT secreted by the anterior pituitary gland?
Which of the following hormones is NOT secreted by the anterior pituitary gland?
What is a common characteristic associated with hyperthyroidism?
What is a common characteristic associated with hyperthyroidism?
Which of the following is a recognized potential outcome of hypopituitarism?
Which of the following is a recognized potential outcome of hypopituitarism?
Which hormone directly affects water reabsorption in the kidneys?
Which hormone directly affects water reabsorption in the kidneys?
What is a common cause of hypothyroidism in developed countries?
What is a common cause of hypothyroidism in developed countries?
Which of the following symptoms is MOST indicative of hypoparathyroidism?
Which of the following symptoms is MOST indicative of hypoparathyroidism?
Which endocrine condition is characterized by an excess of cortisol?
Which endocrine condition is characterized by an excess of cortisol?
Which of the following is a potential oral manifestation of hyperparathyroidism?
Which of the following is a potential oral manifestation of hyperparathyroidism?
A patient exhibits symptoms of fatigue, weight gain, cold intolerance, and constipation. Which endocrine disorder is MOST likely?
A patient exhibits symptoms of fatigue, weight gain, cold intolerance, and constipation. Which endocrine disorder is MOST likely?
What is the primary physiological effect of parathyroid hormone (PTH)?
What is the primary physiological effect of parathyroid hormone (PTH)?
A patient with acromegaly is likely to exhibit which of the following oral and maxillofacial features?
A patient with acromegaly is likely to exhibit which of the following oral and maxillofacial features?
Which dietary factor is most commonly associated with goiter development?
Which dietary factor is most commonly associated with goiter development?
Which of the following is the primary function coordinated by hormones?
Which of the following is the primary function coordinated by hormones?
What is the consequence of untreated acromegaly on the skeletal system?
What is the consequence of untreated acromegaly on the skeletal system?
Which of the following conditions is associated with decreased T-lymphocyte differentiation?
Which of the following conditions is associated with decreased T-lymphocyte differentiation?
Following surgical removal of a pituitary adenoma causing acromegaly, what is a potential long-term effect on the dentition that a prosthodontist would address?
Following surgical removal of a pituitary adenoma causing acromegaly, what is a potential long-term effect on the dentition that a prosthodontist would address?
Which of the following best explains how tumors can cause endocrine disorders?
Which of the following best explains how tumors can cause endocrine disorders?
Insanely Difficult: A previously healthy patient develops a pituitary adenoma secreting excessive Melanocyte-Stimulating Hormone (MSH). Which of the following signs would you expect to see?
Insanely Difficult: A previously healthy patient develops a pituitary adenoma secreting excessive Melanocyte-Stimulating Hormone (MSH). Which of the following signs would you expect to see?
Insanely Difficult: A researcher is studying a newly discovered hormone that appears to specifically target and inhibit the production of thyroid-stimulating hormone (TSH) by the pituitary, without affecting other pituitary hormones. Prolonged exposure to this hormone would MOST likely result in:
Insanely Difficult: A researcher is studying a newly discovered hormone that appears to specifically target and inhibit the production of thyroid-stimulating hormone (TSH) by the pituitary, without affecting other pituitary hormones. Prolonged exposure to this hormone would MOST likely result in:
Which of the following scenarios would MOST likely result in iatrogenic endocrine dysfunction?
Which of the following scenarios would MOST likely result in iatrogenic endocrine dysfunction?
What class of hormones is synthesized in the zona glomerulosa of the adrenal cortex?
What class of hormones is synthesized in the zona glomerulosa of the adrenal cortex?
Which of the following hormones primarily regulates glucose metabolism?
Which of the following hormones primarily regulates glucose metabolism?
Which adrenal hormone contributes most significantly to masculinization?
Which adrenal hormone contributes most significantly to masculinization?
Which of the following hormones is produced by the adrenal medulla?
Which of the following hormones is produced by the adrenal medulla?
What is the primary effect of mineralocorticoids released by the adrenal glands?
What is the primary effect of mineralocorticoids released by the adrenal glands?
Which of the following conditions is characterized by excessive cortisol production?
Which of the following conditions is characterized by excessive cortisol production?
Hyperpigmentation, low blood pressure, and weight loss are characteristic signs of which adrenal gland disorder?
Hyperpigmentation, low blood pressure, and weight loss are characteristic signs of which adrenal gland disorder?
Which oral manifestation is associated with hypercortisolism?
Which oral manifestation is associated with hypercortisolism?
What is the primary focus of dental management for patients with Addison's disease?
What is the primary focus of dental management for patients with Addison's disease?
A patient with Cushing's syndrome is at an increased risk for which oral infection?
A patient with Cushing's syndrome is at an increased risk for which oral infection?
Which of the following is a typical dental consideration for patients with adrenal insufficiency undergoing a major dental procedure?
Which of the following is a typical dental consideration for patients with adrenal insufficiency undergoing a major dental procedure?
A patient taking oral prednisone for several weeks is likely to experience what change in adrenal function?
A patient taking oral prednisone for several weeks is likely to experience what change in adrenal function?
Which of the following signs and symptom combinations is MOST indicative of Addisonian crisis?
Which of the following signs and symptom combinations is MOST indicative of Addisonian crisis?
What is the recommended dental management adjustment for a patient with Addison's disease undergoing a routine scaling and polishing?
What is the recommended dental management adjustment for a patient with Addison's disease undergoing a routine scaling and polishing?
Which of the following pre-operative needs is unique to major dental surgery on an Addison's patient?
Which of the following pre-operative needs is unique to major dental surgery on an Addison's patient?
Why might a dentist adjust the position of a patient with endocrine dysfunction?
Why might a dentist adjust the position of a patient with endocrine dysfunction?
What systemic change would result in stimulation of the HPA axis?
What systemic change would result in stimulation of the HPA axis?
A patient presents with a 'moon face,' fat deposits on the face and back of the shoulders, and purple striae. Which condition is MOST likely?
A patient presents with a 'moon face,' fat deposits on the face and back of the shoulders, and purple striae. Which condition is MOST likely?
A patient undergoing long-term glucocorticoid therapy is scheduled for a tooth extraction. What is the primary concern regarding their adrenal function?
A patient undergoing long-term glucocorticoid therapy is scheduled for a tooth extraction. What is the primary concern regarding their adrenal function?
Chronically suppressed ACTH will result in:
Chronically suppressed ACTH will result in:
Insanely Difficult: A patient with a known pituitary tumor undergoes surgical removal of the mass. Post-operatively, the patient develops severe hyponatremia, hypotension, and altered mental status. Urinalysis reveals elevated urine sodium levels despite the hyponatremia. What is the MOST likely hormonal deficiency causing this presentation?
Insanely Difficult: A patient with a known pituitary tumor undergoes surgical removal of the mass. Post-operatively, the patient develops severe hyponatremia, hypotension, and altered mental status. Urinalysis reveals elevated urine sodium levels despite the hyponatremia. What is the MOST likely hormonal deficiency causing this presentation?
Insanely Difficult: A patient presents with clinical signs including hypertension, hypokalemia, and metabolic alkalosis, but has normal aldosterone and renin levels. Further investigation reveals the patient is surreptitiously ingesting a substance that mimics the effects of mineralocorticoids. Discontinuing use of THIS substance would MOST likely result in rebound:
Insanely Difficult: A patient presents with clinical signs including hypertension, hypokalemia, and metabolic alkalosis, but has normal aldosterone and renin levels. Further investigation reveals the patient is surreptitiously ingesting a substance that mimics the effects of mineralocorticoids. Discontinuing use of THIS substance would MOST likely result in rebound:
What long-term sequalae or treatment can result in dry mouth? (Select all that apply)
What long-term sequalae or treatment can result in dry mouth? (Select all that apply)
Under normal conditions, what direct effect would increased cortisol have on the anterior pituitary?
Under normal conditions, what direct effect would increased cortisol have on the anterior pituitary?
What is the mechanism by which chronic glucocorticoid therapy can lead to osteoporosis?
What is the mechanism by which chronic glucocorticoid therapy can lead to osteoporosis?
Which zone of the adrenal cortex is primarily responsible for the production of mineralocorticoids like aldosterone?
Which zone of the adrenal cortex is primarily responsible for the production of mineralocorticoids like aldosterone?
What is the primary hormone produced by the zona fasciculata of the adrenal cortex?
What is the primary hormone produced by the zona fasciculata of the adrenal cortex?
Which category of hormones is synthesized in the zona reticularis of the adrenal cortex?
Which category of hormones is synthesized in the zona reticularis of the adrenal cortex?
What is the primary function of the hormones produced by the adrenal medulla?
What is the primary function of the hormones produced by the adrenal medulla?
Which of the following signs or symptoms is NOT typically associated with Cushing's syndrome?
Which of the following signs or symptoms is NOT typically associated with Cushing's syndrome?
Hyperaldosteronism (Conn's syndrome) is characterized by an excess of which hormone?
Hyperaldosteronism (Conn's syndrome) is characterized by an excess of which hormone?
What is the underlying cause of adrenogenital or virilizing syndromes?
What is the underlying cause of adrenogenital or virilizing syndromes?
A phaeochromocytoma is a tumor that causes an overproduction of which hormones?
A phaeochromocytoma is a tumor that causes an overproduction of which hormones?
What oral manifestation is MOST associated with hypercortisolism?
What oral manifestation is MOST associated with hypercortisolism?
Increased rates of what oral condition are associated with hypercortisolism?
Increased rates of what oral condition are associated with hypercortisolism?
What is a significant dental consideration for patients with adrenal insufficiency (Addison's disease)?
What is a significant dental consideration for patients with adrenal insufficiency (Addison's disease)?
What is the MOST likely oral sequalae of long-term steroid treatment?
What is the MOST likely oral sequalae of long-term steroid treatment?
What is the primary treatment strategy for Addison's disease?
What is the primary treatment strategy for Addison's disease?
What physiological event directly activates the Hypothalamus-Pituitary-Adrenal (HPA) axis?
What physiological event directly activates the Hypothalamus-Pituitary-Adrenal (HPA) axis?
Which laboratory finding is MOST consistent with Addison's disease?
Which laboratory finding is MOST consistent with Addison's disease?
A patient with Cushing's syndrome would MOST likely exhibit which facial characteristic?
A patient with Cushing's syndrome would MOST likely exhibit which facial characteristic?
What is a key pre-operative consideration for a major dental surgery on a patient with Addison's disease?
What is a key pre-operative consideration for a major dental surgery on a patient with Addison's disease?
What is the primary concern when managing a pregnant dental patient?
What is the primary concern when managing a pregnant dental patient?
Which of the following is the MOST appropriate dental management for a patient with Addison's disease undergoing a routine scaling and polishing?
Which of the following is the MOST appropriate dental management for a patient with Addison's disease undergoing a routine scaling and polishing?
A patient on long-term oral prednisone is scheduled for a tooth extraction. What is the GREATEST risk related to their adrenal function?
A patient on long-term oral prednisone is scheduled for a tooth extraction. What is the GREATEST risk related to their adrenal function?
Insanely Difficult: A previously healthy individual undergoes treatment with high-dose glucocorticoids for several weeks due to a severe allergic reaction. After discontinuing the medication, the patient experiences profound fatigue, muscle weakness, and dizziness. Their blood pressure is notably low. Which of the following best explains the patient's symptoms?
Insanely Difficult: A previously healthy individual undergoes treatment with high-dose glucocorticoids for several weeks due to a severe allergic reaction. After discontinuing the medication, the patient experiences profound fatigue, muscle weakness, and dizziness. Their blood pressure is notably low. Which of the following best explains the patient's symptoms?
What would be the expected outcome of a surgery to remove the adrenal gland?
What would be the expected outcome of a surgery to remove the adrenal gland?
What is the primary role of the adrenal cortex?
What is the primary role of the adrenal cortex?
Why is it important for a dentist to consider the length and time of day for appointments when treating patients with endocrine disorders?
Why is it important for a dentist to consider the length and time of day for appointments when treating patients with endocrine disorders?
Insanely Difficult: A patient with a history of Addison's disease requires a full-mouth extraction under general anesthesia. Preoperatively, they receive stress-dose hydrocortisone. Postoperatively, the patient develops severe hypertension, tachycardia, and agitation despite adequate pain control. What is the MOST likely underlying cause of this patient’s acute decompensation?
Insanely Difficult: A patient with a history of Addison's disease requires a full-mouth extraction under general anesthesia. Preoperatively, they receive stress-dose hydrocortisone. Postoperatively, the patient develops severe hypertension, tachycardia, and agitation despite adequate pain control. What is the MOST likely underlying cause of this patient’s acute decompensation?
Endocrine glands are characterized by which of the following?
Endocrine glands are characterized by which of the following?
Which of the following is a key focus when studying endocrine glands?
Which of the following is a key focus when studying endocrine glands?
Which of the following does NOT directly coordinate and control the function of the endocrine glands?
Which of the following does NOT directly coordinate and control the function of the endocrine glands?
What is the primary role of hormones as secreted by endocrine glands?
What is the primary role of hormones as secreted by endocrine glands?
Which of the following pairs is correctly matched?
Which of the following pairs is correctly matched?
What term describes abnormally high hormone production?
What term describes abnormally high hormone production?
Which of the following conditions is NOT identified as causing endocrine dysfunction?
Which of the following conditions is NOT identified as causing endocrine dysfunction?
Accelerated tooth eruption may indicate issues with the hormone produced by which of the following glands?
Accelerated tooth eruption may indicate issues with the hormone produced by which of the following glands?
A patient presents with depression, fatigue, constipation, and bone fractures. These symptoms could be due to a problem with which of the following?
A patient presents with depression, fatigue, constipation, and bone fractures. These symptoms could be due to a problem with which of the following?
What is often the result of insufficient iodine in the diet?
What is often the result of insufficient iodine in the diet?
A patient with diabetes insipidus is likely to present with which of the following?
A patient with diabetes insipidus is likely to present with which of the following?
What is a common oral manifestation of hypothyroidism in children?
What is a common oral manifestation of hypothyroidism in children?
Which of the following symptoms is MOST indicative of of hyperthyroidism?
Which of the following symptoms is MOST indicative of of hyperthyroidism?
Which hormone is produced by the parathyroid glands?
Which hormone is produced by the parathyroid glands?
Which oral manifestation is typically associated with hyperparathyroidism?
Which oral manifestation is typically associated with hyperparathyroidism?
A patient presents with muscle cramps and tingling sensations in their fingertips. Which condition might be suspected?
A patient presents with muscle cramps and tingling sensations in their fingertips. Which condition might be suspected?
Which of the following conditions is associated with exophthalmos (protrusion of the eyeballs)?
Which of the following conditions is associated with exophthalmos (protrusion of the eyeballs)?
What is the most common cause of hypothyroidism in developed countries?
What is the most common cause of hypothyroidism in developed countries?
What is the primary concern regarding adrenal function for a patient undergoing long-term glucocorticoid therapy and scheduled for a tooth extraction?
What is the primary concern regarding adrenal function for a patient undergoing long-term glucocorticoid therapy and scheduled for a tooth extraction?
What are the dental management considerations for a pregnant dental patient?
What are the dental management considerations for a pregnant dental patient?
Given a patient with advanced bone loss, what treatment would a dentist be LEAST likely to recommend?
Given a patient with advanced bone loss, what treatment would a dentist be LEAST likely to recommend?
Which gland is responsible for T-lymphocyte differentiation?
Which gland is responsible for T-lymphocyte differentiation?
What is the MOST appropriate dental management for a patient with Addison's disease undergoing a routine scaling and polishing?
What is the MOST appropriate dental management for a patient with Addison's disease undergoing a routine scaling and polishing?
According to the graphic, from what area are mineralocorticoids released?
According to the graphic, from what area are mineralocorticoids released?
According to the graphic, what is the main hormone regulating sugar metabolism?
According to the graphic, what is the main hormone regulating sugar metabolism?
According to the graphic, what class of adrenal hormones has the primary role of stimulating masculinization?
According to the graphic, what class of adrenal hormones has the primary role of stimulating masculinization?
According to the graphic, what is the primary role of the adrenal medulla?
According to the graphic, what is the primary role of the adrenal medulla?
Hyperpigmentation is MOST likely to be associated with which of the following?
Hyperpigmentation is MOST likely to be associated with which of the following?
The graphic demonstrates that increased rates of what oral condition are associated with hypercortisolism?
The graphic demonstrates that increased rates of what oral condition are associated with hypercortisolism?
When planning a dental surgery on a patient using bisphosphonates, which is MOST important to consider?
When planning a dental surgery on a patient using bisphosphonates, which is MOST important to consider?
A patient on long-term oral prednisone is scheduled for a tooth extraction. If the patient is suffering from adrenal suppression, what should the dentist be aware of?
A patient on long-term oral prednisone is scheduled for a tooth extraction. If the patient is suffering from adrenal suppression, what should the dentist be aware of?
Which of the following would MOST likely be associated with the sequaele of menopause?
Which of the following would MOST likely be associated with the sequaele of menopause?
Insanely Difficult: A patient has a tumor resulting in high levels of Mineralcorticoids, normal aldosterone, and low renin levels. Where is the MOST likely origin of the tumor?
Insanely Difficult: A patient has a tumor resulting in high levels of Mineralcorticoids, normal aldosterone, and low renin levels. Where is the MOST likely origin of the tumor?
Insanely Difficult: A patient has known Addison's. It is discovered that they additionally have tuberculosis, a common granulomatous infection that often affects the lungs. At what other site would the symptoms of TB most exacerbate the Addison's?
Insanely Difficult: A patient has known Addison's. It is discovered that they additionally have tuberculosis, a common granulomatous infection that often affects the lungs. At what other site would the symptoms of TB most exacerbate the Addison's?
Which of the following best describes the mechanism of action of ductless endocrine glands?
Which of the following best describes the mechanism of action of ductless endocrine glands?
A patient exhibits symptoms of fatigue, muscle weakness, salt craving, and hyperpigmentation of the skin. Which endocrine disorder is MOST likely indicated by these signs?
A patient exhibits symptoms of fatigue, muscle weakness, salt craving, and hyperpigmentation of the skin. Which endocrine disorder is MOST likely indicated by these signs?
A patient is diagnosed with diabetes insipidus. What symptom is MOST directly associated with diabetes insipidus?
A patient is diagnosed with diabetes insipidus. What symptom is MOST directly associated with diabetes insipidus?
During a routine dental visit, you observe noticeable macroglossia, prognathism and frontal spacing in a 45-year-old patient. Which of the following conditions is MOST likely associated with these oral manifestations?
During a routine dental visit, you observe noticeable macroglossia, prognathism and frontal spacing in a 45-year-old patient. Which of the following conditions is MOST likely associated with these oral manifestations?
Insanely Difficult: A researcher is investigating a novel compound that selectively inhibits the enzyme 11β-Hydroxysteroid dehydrogenase type 2 (11β-HSD2) in vivo. This enzyme normally converts cortisol to cortisone (an inactive metabolite). What is the MOST likely consequence of administering this compound chronically?
Insanely Difficult: A researcher is investigating a novel compound that selectively inhibits the enzyme 11β-Hydroxysteroid dehydrogenase type 2 (11β-HSD2) in vivo. This enzyme normally converts cortisol to cortisone (an inactive metabolite). What is the MOST likely consequence of administering this compound chronically?
What physiological process is directly regulated by hormones released from endocrine glands?
What physiological process is directly regulated by hormones released from endocrine glands?
If a patient is diagnosed with diabetes insipidus of nephrogenic origin, what is a possible symptom?
If a patient is diagnosed with diabetes insipidus of nephrogenic origin, what is a possible symptom?
Which of the following diagnostic methods is LEAST likely to be used as an initial step in the evaluation of an endocrine disorder?
Which of the following diagnostic methods is LEAST likely to be used as an initial step in the evaluation of an endocrine disorder?
In a patient with known hyperparathyroidism, dental radiographs are MOST likely to reveal:
In a patient with known hyperparathyroidism, dental radiographs are MOST likely to reveal:
Hashimoto's disease often results in which of the following conditions?
Hashimoto's disease often results in which of the following conditions?
The pituitary gland directly affects:
The pituitary gland directly affects:
What is a key characteristic of endocrine glands compared to exocrine glands?
What is a key characteristic of endocrine glands compared to exocrine glands?
Which of the following is LEAST likely to directly cause endocrine dysfunction?
Which of the following is LEAST likely to directly cause endocrine dysfunction?
What class of medication is used to treat the sequalae of osteoporosis?
What class of medication is used to treat the sequalae of osteoporosis?
Which hormone is targeted in management of acromegaly?
Which hormone is targeted in management of acromegaly?
For a dental patient with Addison's disease undergoing a major dental procedure, what pre-operative need is MOST critical to consider?
For a dental patient with Addison's disease undergoing a major dental procedure, what pre-operative need is MOST critical to consider?
Which hormone is often relevant to pregnancy?
Which hormone is often relevant to pregnancy?
A patient with suspected Cushing's syndrome would MOST likely exhibit which sign?
A patient with suspected Cushing's syndrome would MOST likely exhibit which sign?
What is the primary goal of management or treatment for endocrine glands?
What is the primary goal of management or treatment for endocrine glands?
What is a possible oral complication of the sequalae related to disease/treatment?
What is a possible oral complication of the sequalae related to disease/treatment?
Which of the following hormones is produced by the parathyroid glands?
Which of the following hormones is produced by the parathyroid glands?
In managing thyroid disorders in children, what oral manifestation is associated with hyperthyroidism?
In managing thyroid disorders in children, what oral manifestation is associated with hyperthyroidism?
Which of the following symptoms is caused by hyperthyroidism?
Which of the following symptoms is caused by hyperthyroidism?
Which of the following choices is NOT a symptom of hypothyroidism?
Which of the following choices is NOT a symptom of hypothyroidism?
What is of primary consideration when planning dental appointments for patients with endocrine disorders?
What is of primary consideration when planning dental appointments for patients with endocrine disorders?
A patient presents with fatigue, muscle weakness, and salt cravings. Which adrenal gland disorder might be suspected?
A patient presents with fatigue, muscle weakness, and salt cravings. Which adrenal gland disorder might be suspected?
Why is an extra dose of steroid medication required for minor dental procedures performed on a patient whom is steroid-dependent?
Why is an extra dose of steroid medication required for minor dental procedures performed on a patient whom is steroid-dependent?
What is the primary function of mineralocorticoids released by the adrenal glands?
What is the primary function of mineralocorticoids released by the adrenal glands?
Which of the following choices is NOT a dental consideration for Endocrine Glands Management/Treatment?
Which of the following choices is NOT a dental consideration for Endocrine Glands Management/Treatment?
Which of the following is a dental consideration for extraction procedures?
Which of the following is a dental consideration for extraction procedures?
A dentist diagnoses a pregnant woman with pyogenic granuloma. What is most likely indicated by this diagnosis?
A dentist diagnoses a pregnant woman with pyogenic granuloma. What is most likely indicated by this diagnosis?
What is of key consideration when prescribing for a pregnant patient?
What is of key consideration when prescribing for a pregnant patient?
What post-operative needs are required after a major dental surgery for a patient suffering from Addison's disease?
What post-operative needs are required after a major dental surgery for a patient suffering from Addison's disease?
In Addison's disease Management/Treatment, what hormonal class is administered therapeutically?
In Addison's disease Management/Treatment, what hormonal class is administered therapeutically?
What directly stimulates the sympathetic ANS (Autonomic Nervous System)?
What directly stimulates the sympathetic ANS (Autonomic Nervous System)?
What is a common dental related sequalae of menopause?
What is a common dental related sequalae of menopause?
Phaeochromocytoma (tumor) causes the overproduction of epinephrine and norepinephrine. Where is this most likely found?
Phaeochromocytoma (tumor) causes the overproduction of epinephrine and norepinephrine. Where is this most likely found?
What is a common oral manifestation of hypercortisolism?
What is a common oral manifestation of hypercortisolism?
A patient undergoing long-term glucocorticoid therapy is scheduled for a tooth extraction without alterations to their existing steroid replacement regimen. Following the procedure, the patient is MOST at risk for:
A patient undergoing long-term glucocorticoid therapy is scheduled for a tooth extraction without alterations to their existing steroid replacement regimen. Following the procedure, the patient is MOST at risk for:
Insanely Difficult: A patient with known primary adrenal insufficiency (Addison's disease) presents to the emergency room with severe abdominal pain, nausea, vomiting, and profound weakness and altered mental status. The medical history is significant for tuberculous (TB). What is the MOST likely underlying cause?
Insanely Difficult: A patient with known primary adrenal insufficiency (Addison's disease) presents to the emergency room with severe abdominal pain, nausea, vomiting, and profound weakness and altered mental status. The medical history is significant for tuberculous (TB). What is the MOST likely underlying cause?
Insanely Difficult: A researcher is studying the impact of endocrine disorders on bone remodeling. They discover that a mutation causing constitutive activation of the mineralocorticoid receptor (MR) in osteoblasts, but not in the kidneys, independently causes increased bone density. This increased bone density is primarily due to:
Insanely Difficult: A researcher is studying the impact of endocrine disorders on bone remodeling. They discover that a mutation causing constitutive activation of the mineralocorticoid receptor (MR) in osteoblasts, but not in the kidneys, independently causes increased bone density. This increased bone density is primarily due to:
Which of the following is a characteristic unique to endocrine glands?
Which of the following is a characteristic unique to endocrine glands?
To assess the function of a target organ, which diagnostic tools are most helpful?
To assess the function of a target organ, which diagnostic tools are most helpful?
Which sequence of events accurately describes the stress response system?
Which sequence of events accurately describes the stress response system?
A patient exhibits fatigue, weight gain, constipation, and dry skin. The dentist suspects hypothyroidism. If this is because of Hashimoto's, what blood component would MOST likely be elevated?
A patient exhibits fatigue, weight gain, constipation, and dry skin. The dentist suspects hypothyroidism. If this is because of Hashimoto's, what blood component would MOST likely be elevated?
Insanely Difficult: A researcher is investigating the effects of chronic stress on adrenal function in rats. They subject the rats to prolonged periods of unpredictable stressors. After several weeks, they observe significant atrophy (shrinkage) of the adrenal cortex, specifically affecting the zona fasciculata. They also take blood samples. Which of the following hormonal profiles would they most likely observe?
Insanely Difficult: A researcher is investigating the effects of chronic stress on adrenal function in rats. They subject the rats to prolonged periods of unpredictable stressors. After several weeks, they observe significant atrophy (shrinkage) of the adrenal cortex, specifically affecting the zona fasciculata. They also take blood samples. Which of the following hormonal profiles would they most likely observe?
Flashcards
Endocrine Glands
Endocrine Glands
Ductless glands that secrete products directly into bloodstream, affecting various bodily functions.
Endocrine Glands
Endocrine Glands
The study of the anatomy, physiology, and diseases related to endocrine glands.
Hormones
Hormones
Chemical messengers produced by endocrine glands that coordinate body functions.
Hyper-Production
Hyper-Production
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Hypo-Production
Hypo-Production
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Acromegaly
Acromegaly
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Hypopituitarism
Hypopituitarism
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Diabetes Insipidus
Diabetes Insipidus
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Hyperthyroidism
Hyperthyroidism
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Hashimoto's disease
Hashimoto's disease
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Hypoparathyroidism
Hypoparathyroidism
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Hyperparathyroidism
Hyperparathyroidism
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What are Endocrine Glands?
What are Endocrine Glands?
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Major Endocrine Glands Locations
Major Endocrine Glands Locations
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Hormones regulate what?
Hormones regulate what?
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What hormones does the hypothalamus produce?
What hormones does the hypothalamus produce?
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What hormones does the pituitary gland produce?
What hormones does the pituitary gland produce?
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What hormone does the pineal gland produce?
What hormone does the pineal gland produce?
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Hormone produced by the thyroid gland?
Hormone produced by the thyroid gland?
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Hormone produced by the parathyroid glands?
Hormone produced by the parathyroid glands?
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What is the role of the thymus?
What is the role of the thymus?
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What hormone does the pancreas produce?
What hormone does the pancreas produce?
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What hormones do the adrenal glands produce?
What hormones do the adrenal glands produce?
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What hormones do the ovaries produce?
What hormones do the ovaries produce?
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What hormone do the testes produce?
What hormone do the testes produce?
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What hormones does the placenta produce?
What hormones does the placenta produce?
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Endocrine Diseases - Why?
Endocrine Diseases - Why?
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What are the causes of Tissue Destruction/Loss/Suppression?
What are the causes of Tissue Destruction/Loss/Suppression?
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What is the primary cause of hyperthyroidism?
What is the primary cause of hyperthyroidism?
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Eye Bulging in Hyperthyroidism
Eye Bulging in Hyperthyroidism
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Absent menstrual period
Absent menstrual period
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Cessation of menstruation
Cessation of menstruation
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Polyglandular Deficiency Syndrome (PDS)
Polyglandular Deficiency Syndrome (PDS)
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MEN
MEN
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Brittle bones
Brittle bones
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What is an Endocrine Gland?
What is an Endocrine Gland?
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What causes Hashimoto's Disease?
What causes Hashimoto's Disease?
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What is a Goitre?
What is a Goitre?
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What is Hyperthyroidism?
What is Hyperthyroidism?
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What are Brown Tumors?
What are Brown Tumors?
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What is Hypothyroidism?
What is Hypothyroidism?
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What is Cushing's Disease?
What is Cushing's Disease?
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What is Addison's Disease?
What is Addison's Disease?
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What are the adrenal glands?
What are the adrenal glands?
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Adrenal Cortex
Adrenal Cortex
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Adrenal Medulla
Adrenal Medulla
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Mineralocorticoids
Mineralocorticoids
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Glucocorticoids
Glucocorticoids
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Androgens
Androgens
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Stress Hormones
Stress Hormones
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Aldosterone
Aldosterone
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Cortisol
Cortisol
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Epinephrine and Norepinephrine
Epinephrine and Norepinephrine
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Cushing Syndrome
Cushing Syndrome
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Hyperaldosteronism
Hyperaldosteronism
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Adrenogenital Syndrome
Adrenogenital Syndrome
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Phaeochromocytoma
Phaeochromocytoma
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Osteoporosis of the Jaw
Osteoporosis of the Jaw
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Oral Candidiasis
Oral Candidiasis
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Addison's Disease
Addison's Disease
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Addisonian Crisis
Addisonian Crisis
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Post-operative needs Major Dental Surgery
Post-operative needs Major Dental Surgery
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HPA Axis
HPA Axis
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Steroid treatment
Steroid treatment
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Adrenal atrophy
Adrenal atrophy
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Cosyntropin
Cosyntropin
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Hydrocortisone Replacement Therapy
Hydrocortisone Replacement Therapy
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Planning of appointment
Planning of appointment
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What are Adrenal Glands?
What are Adrenal Glands?
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What is the Adrenal Cortex?
What is the Adrenal Cortex?
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What is the Adrenal Medulla?
What is the Adrenal Medulla?
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What is Primary Addison's?
What is Primary Addison's?
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What is Secondary Addison's?
What is Secondary Addison's?
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What are Mineralocorticoids?
What are Mineralocorticoids?
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What are Glucocorticoids?
What are Glucocorticoids?
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What is Addisonian Crisis?
What is Addisonian Crisis?
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What are Androgens?
What are Androgens?
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Zone Glomerulosa produces?
Zone Glomerulosa produces?
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Zona Fasciculata produces?
Zona Fasciculata produces?
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Zona Reticularis produces?
Zona Reticularis produces?
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What is Exogenous Cushing's?
What is Exogenous Cushing's?
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What is Endogenous Cushing's?
What is Endogenous Cushing's?
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Moon Face
Moon Face
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What is Cosyntropin?
What is Cosyntropin?
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Endocrine Glands - What?
Endocrine Glands - What?
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Endocrine Glands Approach
Endocrine Glands Approach
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What does the hypothalamus produce?
What does the hypothalamus produce?
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Pituitary gland products
Pituitary gland products
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Symptoms of acromegaly
Symptoms of acromegaly
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Symptoms of Hypopituitarism
Symptoms of Hypopituitarism
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Cranial Diabetes insipidus
Cranial Diabetes insipidus
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Hyperthyroidism common conditions
Hyperthyroidism common conditions
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Hyperthyroidism Management
Hyperthyroidism Management
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Symptoms of hypothyroidism
Symptoms of hypothyroidism
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How to treat Hypothyroidism?
How to treat Hypothyroidism?
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Hypothyroidism in Children
Hypothyroidism in Children
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What happens to teeth in children in hyperthyroidism?
What happens to teeth in children in hyperthyroidism?
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Symptoms of Hyperparathyroidism
Symptoms of Hyperparathyroidism
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Symptoms of Hypoparathyroidism
Symptoms of Hypoparathyroidism
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What is the overall role of adrenal glands?
What is the overall role of adrenal glands?
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Addison's symptoms include?
Addison's symptoms include?
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Addisonian crisis - Time Frame?
Addisonian crisis - Time Frame?
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Dental Treatment on Addison's Patients
Dental Treatment on Addison's Patients
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Contraception can cause?
Contraception can cause?
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Pregnancy can cause?
Pregnancy can cause?
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Menopause can cause?
Menopause can cause?
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Endocrine Glands - How investigated?
Endocrine Glands - How investigated?
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Endocrine Gland - What treatments are used?
Endocrine Gland - What treatments are used?
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What should planning of appointment be
What should planning of appointment be
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Position of Dental patient considerations
Position of Dental patient considerations
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What are oral complications?
What are oral complications?
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What kind of anaesthesia, extraction
What kind of anaesthesia, extraction
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Pregnancy and breastfeeding
Pregnancy and breastfeeding
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What are Ductless Glands?
What are Ductless Glands?
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What is Thyrotoxicosis?
What is Thyrotoxicosis?
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What is Hashimoto's thyroiditis
What is Hashimoto's thyroiditis
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What are pregnancy oral considerations?
What are pregnancy oral considerations?
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What are common symptoms of Menopause?
What are common symptoms of Menopause?
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What are Endocrine Glands - Investigations?
What are Endocrine Glands - Investigations?
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Endocrine treatment
Endocrine treatment
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Hypothyroidism in newborn babies?
Hypothyroidism in newborn babies?
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Addison's - Dental guidelines
Addison's - Dental guidelines
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Medical emergency - Addisonian crisis
Medical emergency - Addisonian crisis
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Endocrine Glands - Management/Treatment
Endocrine Glands - Management/Treatment
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Nephrogenic Diabetes insipidus
Nephrogenic Diabetes insipidus
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Study Notes
- Endocrine glands are ductless glands that secrete products directly into the bloodstream
- Exocrine glands secrete products into a ductal system leading to an epithelial surface
Endocrine Gland Focus Areas
- Anatomy: Where are they located?
- Physiology: What product/action do they perform?
- Disease: Why do endocrine disorders occur?
Endocrine Gland Locations
- Hypothalamus
- Pituitary gland
- Pineal gland
- Thyroid and parathyroid glands
- Thymus
- Pancreas
- Adrenal glands
- Ovaries (in females)
- Testicles (in males)
- Placenta (during pregnancy)
Hormone Actions
- Hormones are chemical messengers to control and coordinate:
- Metabolism
- Energy levels
- Reproduction
- Growth and development
- Mood
- Sleep
- Response to injury and stress
Gland Products
- Hypothalamus produces TRH, GnRH, GHRH, CRH, somatostatin, and dopamine
- Pituitary gland produces GH, prolactin, ACTH, TSH, LH, FSH, ADH, and oxytocin
- Pineal gland produces melatonin
- Thyroid gland produces thyroid hormone
- Parathyroid glands produce parathyroid hormone
- Thymus produces T-lymphocytes for differentiation
- Pancreas produces insulin
- Adrenal glands produce epinephrine and corticosteroids
- Ovaries produce estrogen and progesterone
- Testes produce testosterone
- Placenta produces estrogen, progesterone, hCG, hPL, PGH, relaxin, and kisspeptin
Endocrine Gland Dysfunction
- Hyper: Overproduction
- Hypo: Underproduction
Etiology of Endocrine Gland Disorders
- Genetic factors
- Tumors
- Tissue destruction, loss, or suppression:
- Autoimmune disorders
- Infections
- Trauma
- Iatrogenic causes (surgery, radiation, drugs)
- Diet
Endocrine Related Disorders
- Acromegaly
- Hypopituitarism
- Diabetes insipidus
- Hyperthyroidism
- Hypothyroidism
- Hyperparathyroidism
- Hypoparathyroidism
- Cushing's disease
- Addison's disease
- Amenorrhea
- Polycystic ovarian syndrome
- Precocious puberty
- Premature ovarian failure
- Hypogonadism
- Pregnancy
- Menopause
- Polyglandular deficiency syndromes (PDS)
- Multiple endocrine neoplasia (MEN)
- Osteoporosis
Pituitary Gland: Acromegaly
- Caused by increased growth hormone (GH)
- Signs and symptoms include:
- Thickening of skull and protruding supraorbital ridges
- Coarsening of facial features and prognathism
- Headaches, diplopia, lethargy, blindness
- Goiter, enlargement of visceral organs, cardiomyopathy, diabetes mellitus
- Broadening of hands and feet and thickened heel pads
- More information on Acromegaly may be found at https://www.wapo.org/pituitary-disorders/acromegaly/
Pituitary Gland: Hypopituitarism
- Can cause the following symptoms:
- Slow growth
- Addison's disease
- Hypothyroidism
- Diabetes insipidus
- Underdevelopment of male/female characteristics
Pituitary Gland: Diabetes Insipidus
- Caused by decreased antidiuretic hormone (ADH)
- Cranial diabetes insipidus leads to polyuria and polydipsia
- Nephrogenic diabetes insipidus can cause dry mouth
Thyroid Gland: Hyperthyroidism (Thyrotoxicosis)
- Can cause the following symptoms:
- Exophthalmos
- Neck swelling
- Fatigue and mood swings
- Heart palpitations and trembling
- Irritability and difficulty sleeping
- Graves disease
- Goitre
Thyroid Gland: Hypothyroidism (Myxoedema)
- Symptoms include:
- Tiredness and sensitivity to cold
- Weight gain and constipation
- Depression and slow movements/thoughts
- Muscle aches/weakness and muscle cramps
- Dry/scaly skin and brittle hair/nails
- Loss of libido
- Pain, numbness, or tingling in hands and fingers (carpal tunnel syndrome)
- Irregular or heavy periods
- Fertility and embryo-development issues
- Hashimoto’s disease
Thyroid Gland: Disorders in Children
- Hypothyroidism symptoms include:
- Delayed tooth eruption
- Enamel hypoplasia
- Micrognathia
- Anterior open bite
- Stunted bone and tooth growth
- Hyperthyroidism symptoms include:
- Accelerated tooth eruption
- Maxillary and mandibular osteoporosis
- Changes in behavior and school performance
Parathyroid Glands: Hyperparathyroidism
- Can cause the following symptoms:
- Depression and fatigue
- Loss of appetite
- Muscle weakness
- Tummy pain and constipation
- Drowsiness and confusion
- High blood pressure and irregular heartbeat
- Osteoporosis and bone fractures
- Kidney stones
- Stomach ulcers and pancreatitis
- Brown tumors of the bone
Parathyroid Glands: Hypoparathyroidism
- Can cause the following symptoms:
- Tingling sensation in fingertips, toes, and lips (paresthesia)
- Twitching facial muscles
- Muscle pains or cramps, particularly in legs, feet, or tummy
- Tiredness
- Mood changes (irritability, anxiety, or depression)
- Dry, rough skin
- Coarse hair that breaks easily and hair loss
- Fingernails that break easily
Adrenal Glands: Hyperfunction
- Cushing syndrome is caused by excess cortisol, and can be exogenous (corticosteroids) or endogenous
- Hyperaldosteronism is caused by excess aldosterone and known as Conn’s syndrome
- Adrenogenital or virilizing syndromes are caused by excess androgens
- Phaeochromocytoma is a tumor that overproduces epinephrine and norepinephrine
Adrenal Glands: Hyper - Cushing
- Alveolar bone loss can result from hypercortisolism, contributing to tooth loss and periodontal disease via decreased white cell migration
- Oral candidiasis occurs at elevated rates
- Risk of infection may be increased with complex dental procedures
- Implications of diabetes
- Refer to https://www.cdho.org/Advisories/CDHO_Factsheet_Cushing_Syndrome.pdf for more info
Adrenal Glands: Hypofunction - Addison’s disease
- Can be primary or secondary (corticosteroids)
Medical Emergency - Addisonian Crisis
- Symptoms include fever, syncope, convulsions, hypoglycemia, hyponatremia, severe vomiting, and diarrhoea
Addison's Disease - Dental Guidelines
- Refer to https://www.addisonsdisease.org.uk/addisons-disease-advice-for-dentists for dental advice
Feedback Loops - Stress Response
- The Hypothalamus-Pituitary Gland-Adrenal Gland(HPA) axis
- An increase in Cortisol result in:
- Increased blood glucose availability
- Increased sodium retention
- Increased potassium excretion
- Increased suppression of the immune system
Feedback Loops - Steroid treatment
Contraception (drug)
- Can cause periodontal disease
- Can cause Pigmentation (facial melasma and/or intraoral)
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198473/
Pregnancy
- Can cause periodontal disease
- Can cause Pyogenic granuloma/pregnancy epulis
- Can cause Dental cavities
- Can cause Dental erosion
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3681080/ and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6883753/
Menopause
- Can cause Burning Mouth Syndrome (BMS)
- Can cause Dry mouth
- Can affect Periodontal Health
- Can cause Osteoporosis
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3793432/
Endocrine Gland - Investigations
- Blood tests to check hormone levels
- Target analysis of receptors/organs
- Function testing of target organs
- Imaging (radiographs, USS, CT/CBCT, MRI, scintigraphy)
- Biopsy if needed
Endocrine Gland - Management/Treatment
- Replacement/suppression
- Surgery on Glands
- Consideration of target organs
- Consideration of Sequalae
- Prevention
Endocrine Gland - Management/Treatment - Specific Examples
- Pituitary gland:
- Acromegaly treated with surgery
- Hypopituitarism treated with hormone replacement
- Diabetes insipidus with vassopresin
- Thyroid
- Hyper treated with carbimazole, propythiouracil
- Hypo treated with Thyroxine
- Parathyroid
- Hyper is given Primary with rehydration bisphosphonates (short term), surgery
- Adrenal
- Cushing's given surgery to lower steroids
- Addison's given steroids of hydrocortisone and fludocortisone
- Menopause is given HRT
- Osteoporosis is given Bisphosphonates
Endocrine Gland Management/Treatment - Dental Considerations
- Planning of appointments, considering time of day and length
- Position of patient, considering if they can tolerate supine position
- Adjusted Oral Hygiene (OH)
- Management of oral complications
- Manifestations
- Sequalae of disease/treatment
- Dry mouth
- Oral thrush
- Caries
- Glossitis
- Diagnosis
- Extractions considering primary/secondary care, bisphosphonates, and risk of dry socket
- Choice of anesthesia, LA with/without adrenaline, Sedation, or General Anesthesia (GA)
- Pregnancy and breastfeeding considerations:
- Position
- Oral Health Instruction
- Radiology
- Prescribing
- Medical Emergency
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