Endochronolgy - Main

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Questions and Answers

Which condition is characterized by the enlargement of facial features and extremities in adulthood due to excessive growth hormone?

  • Hypopituitarism
  • Cushing's disease
  • Acromegaly (correct)
  • Addison's disease

Hypopituitarism is diagnosed when there is underactivity of the pituitary gland affecting at least how many hormonal axes according to the provided text?

  • Two (correct)
  • Four
  • Three
  • One

Diabetes Insipidus is directly related to the deficiency or reduced action of which hormone?

  • Antidiuretic Hormone (ADH) (correct)
  • Thyroid Hormone
  • Growth Hormone (GH)
  • Insulin

Exophthalmos, a symptom characterized by protruding eyeballs, is most closely associated with which endocrine disorder?

<p>Hyperthyroidism (A)</p> Signup and view all the answers

Hashimoto's disease is most directly linked to which endocrine condition?

<p>Hypothyroidism (D)</p> Signup and view all the answers

Which of the following is a dental manifestation specifically listed as being associated with thyroid disorders in children?

<p>Enamel hypoplasia (C)</p> Signup and view all the answers

Secondary hyperparathyroidism, as described in the text, is most frequently caused by:

<p>Tumors (C)</p> Signup and view all the answers

Considering the symptoms listed for hypothyroidism, which of the following pairs of symptoms are paradoxical, representing opposite physiological effects?

<p>Fatigue and difficulty sleeping (B)</p> Signup and view all the answers

If a patient presents with symptoms including fatigue, weight gain, cold sensitivity, and muscle cramps, and is diagnosed with Myxedema, which of the following hormonal imbalances is the MOST likely underlying cause?

<p>Deficient thyroid hormone (A)</p> Signup and view all the answers

Which of the following is a rare, tertiary symptom associated with a specific condition?

<p>Kidney stones and sequelae (C)</p> Signup and view all the answers

A patient is experiencing polyuria, polydipsia, and is diagnosed with Diabetes Insipidus. If further tests reveal no issues with ADH production in the pituitary gland, the MOST probable form of Diabetes Insipidus is:

<p>Nephrogenic Diabetes Insipidus (B)</p> Signup and view all the answers

A patient reports tingling sensations in their fingertips, toes, and lips. This symptom is most likely associated with:

<p>Hypocalcemia (B)</p> Signup and view all the answers

Which of the following is a potential oral manifestation of hypercortisolism?

<p>Alveolar bone loss (C)</p> Signup and view all the answers

Excessive androgens are associated with which of the following conditions?

<p>Adrenogenital or Virilizing Syndromes (A)</p> Signup and view all the answers

Oral candidiasis occurs at elevated rates in patients with hypercortisolism because they are more susceptible to what type of infection?

<p>Fungal (C)</p> Signup and view all the answers

A patient presents with muscle pains, particularly in their legs and feet, alongside mood changes and dry skin. Which condition is most likely?

<p>Hypocalcemia (C)</p> Signup and view all the answers

What is the primary function of the adrenal glands?

<p>To produce and circulate natural steroids (C)</p> Signup and view all the answers

Which of the following is characterized by a tumor overproducing epinephrine and norepinephrine?

<p>Phaeochromocytoma (B)</p> Signup and view all the answers

A dentist is evaluating a panoramic radiograph and notices a large radiolucent lesion in the posterior mandible, distal to the first molar. Given the patient’s history of tertiary hyperparathyroidism, what is the most likely diagnosis?

<p>Central Giant Cell Lesion (B)</p> Signup and view all the answers

What is the primary risk associated with abruptly stopping steroid medication, especially in individuals with very low steroid levels in the body?

<p>Adrenal Crisis (C)</p> Signup and view all the answers

A patient exhibiting coarse hair that breaks easily, along with fingernails that also break easily, is MOST likely experiencing a deficiency related to which mineral imbalance?

<p>Hypocalcemia (B)</p> Signup and view all the answers

Which treatment is typically prescribed for a patient diagnosed with hypoparathyroidism?

<p>Calcium and Vitamin D (D)</p> Signup and view all the answers

A pregnant patient presents with a pyogenic granuloma. What is the recommended initial course of action?

<p>Postponement of removal until after pregnancy (B)</p> Signup and view all the answers

In managing a patient with acromegaly, which hormonal imbalance is the primary target of treatment?

<p>Growth Hormone (GH) (A)</p> Signup and view all the answers

A patient undergoing treatment for hyperparathyroidism develops hypercalcemia unresponsive to rehydration and bisphosphonates. Furthermore, imaging reveals an enlarged parathyroid gland. What is the MOST likely next step in the management of this patient?

<p>Surgical intervention (A)</p> Signup and view all the answers

What is the primary distinction between endocrine and exocrine glands?

<p>Endocrine glands release products directly into the bloodstream, whereas exocrine glands use a ductal system to reach epithelial surfaces. (B)</p> Signup and view all the answers

Which of the following is NOT directly controlled or coordinated by hormones?

<p>Reflex actions (D)</p> Signup and view all the answers

The thymus gland undergoes significant changes throughout a person's life. Which of the following statements accurately describes this change?

<p>The thymus is largest in childhood and decreases in size with age. (C)</p> Signup and view all the answers

Which term describes a condition characterized by an increased production of hormones?

<p>Hyper- (B)</p> Signup and view all the answers

Tissue destruction of the thyroid can lead to decreased hormone production. Which of the following is an iatrogenic cause of such destruction?

<p>Surgical removal (D)</p> Signup and view all the answers

A patient presents with symptoms of hormone imbalance. Testing reveals the presence of a benign growth on one of their endocrine glands. Which of the following is the MOST likely cause of the patient's hormone imbalance?

<p>Tumor (B)</p> Signup and view all the answers

A researcher is investigating the effects of a novel drug on hormone production. They observe that the drug significantly reduces the expression of a specific enzyme involved in the synthesis of a particular hormone within the adrenal gland. Which of the following outcomes is MOST likely to occur as a direct result of this drug's action?

<p>Decreased hormone production due to reduced enzymatic activity (D)</p> Signup and view all the answers

A patient who has undergone a partial thyroidectomy maintains approximately one-third of their original thyroid tissue. Post-operatively, the patient exhibits symptoms of hypothyroidism. Assuming no other complications, which of the following mechanisms BEST explains the development of hypothyroidism in this patient?

<p>The reduced mass of thyroid tissue is insufficient to meet the body's hormonal demands, resulting in decreased thyroid hormone levels. (A)</p> Signup and view all the answers

Hyperpigmentation is a notable symptom associated with which of the following conditions?

<p>Addison's disease (A)</p> Signup and view all the answers

An Addisonian crisis is most likely triggered by what factor in a dental setting?

<p>Patient stress during the dental procedure (A)</p> Signup and view all the answers

What is the general recommendation regarding the dosage of corticosteroid medication for patients with Addison's disease on the day of a dental appointment?

<p>Double the normal dose, after consulting with their GP (B)</p> Signup and view all the answers

The Hypothalamus-Pituitary-Adrenal (HPA) axis primarily regulates the release of which hormone in response to stress?

<p>Cortisol (A)</p> Signup and view all the answers

What physiological effect is least likely to result from increased cortisol levels due to prolonged stress?

<p>Increased potassium retention (C)</p> Signup and view all the answers

Why is the abrupt withdrawal of corticosteroids dangerous?

<p>The adrenal glands need time to recover their function. (C)</p> Signup and view all the answers

Which of the following is NOT a typical sign or symptom of an Addisonian crisis?

<p>Hypertension (D)</p> Signup and view all the answers

In the context of Addison's disease, 'secondary' adrenal insufficiency is often linked to:

<p>Prolonged use of exogenous corticosteroids (A)</p> Signup and view all the answers

A patient with Addison's disease presents with severe vomiting and diarrhea. Which electrolyte imbalance is most likely to be observed?

<p>Hyperkalemia (B)</p> Signup and view all the answers

Which of the following is the most accurate description of the feedback loop involving the adrenal glands, pituitary gland, and hypothalamus (HPA axis)?

<p>Increased cortisol from the adrenal gland inhibits the hypothalamus and pituitary, reducing ACTH release and thus cortisol production. (B)</p> Signup and view all the answers

Which of the following scenarios would MOST likely result in a state of hormone hyperproduction due to genetic factors?

<p>A patient inherits a mutation causing uncontrolled proliferation of hormone-secreting cells in an endocrine gland. (D)</p> Signup and view all the answers

If a patient who has undergone removal of two-thirds of their thyroid gland subsequently exhibits hypothyroidism symptoms, what is the MOST likely underlying mechanism, assuming no additional complications are present?

<p>The remaining thyroid tissue is insufficient to meet the body's hormonal demands, despite functioning normally. (C)</p> Signup and view all the answers

A researcher is investigating the impact of a novel drug on adrenal gland function. The drug significantly reduces the expression of a key enzyme involved in cortisol synthesis. Assuming no compensatory mechanisms are activated, which cascade of events is MOST likely to follow?

<p>Decreased cortisol leads to increased ACTH, resulting in adrenal gland hypertrophy and eventual restoration of cortisol levels. (D)</p> Signup and view all the answers

A patient's medical history reveals a slowly growing, benign tumor located on one of their adrenal glands. Despite its benign nature, the patient is experiencing symptoms indicative of hormone imbalance. Which of the following is the MOST probable mechanism by which this tumor is causing hormonal dysregulation?

<p>The tumor is actively secreting hormones autonomously, leading to hormone excess and disruption of normal endocrine control. (B)</p> Signup and view all the answers

Following a motor vehicle accident with significant trauma, a previously healthy individual develops acute adrenal insufficiency. Which of the following pathogenic pathways is MOST likely responsible for this endocrine dysfunction?

<p>Hemorrhage and infarction within the adrenal glands secondary to the traumatic injury. (A)</p> Signup and view all the answers

A patient presents with persistent fatigue, constipation, depression, and reports increased sensitivity to cold. The patient's nails are brittle, and their hair is dry and coarse. These symptoms are MOST indicative of which of the following conditions?

<p>Myxedema, caused by severe hypothyroidism. (B)</p> Signup and view all the answers

A dentist notes enamel hypoplasia, delayed tooth eruption, and micrognathia during a routine check-up of an 8-year-old patient. Considering the information provided, which endocrine disorder is MOST likely associated with these dental findings?

<p>Thyroid disorders, due to the crucial involvement of thyroid hormones in growth and development. (C)</p> Signup and view all the answers

A patient complaining of heart palpitations, difficulty sleeping, and increased irritability is diagnosed with hyperthyroidism. What underlying pathological mechanism is MOST likely contributing to these signs and symptoms?

<p>The presence of autoantibodies that mimic TSH, causing the thyroid gland to overproduce thyroid hormones. (A)</p> Signup and view all the answers

A patient with diagnosed hypopituitarism reports symptoms suggesting both hypothyroidism and adrenal insufficiency. Considering the interplay within the endocrine system, what is the MOST likely underlying mechanism causing dual endocrine deficiencies in this patient?

<p>A single lesion or malfunction affecting the pituitary gland's ability to secrete multiple tropic hormones (D)</p> Signup and view all the answers

Which of the following best describes the underlying mechanism leading to nephrogenic diabetes insipidus?

<p>The kidneys' inability to respond appropriately to antidiuretic hormone (ADH). (A)</p> Signup and view all the answers

In the intricate landscape of endocrine physiology, imagine a scenario where a novel synthetic peptide, designed to selectively bind to a G protein-coupled receptor (GPCR) on a specific endocrine cell type, paradoxically elicits sustained receptor internalization without activating downstream signaling cascades. Assuming no confounding variables and a fully functional cellular protein degradation machinery, what is the MOST likely long-term consequence of chronic exposure to this peptide on the affected endocrine gland's hormonal output?

<p>Progressive decline in hormone secretion due to depletion of intracellular hormone stores secondary to impaired receptor signaling and eventual cell apoptosis from trophic hormone withdrawal. (D)</p> Signup and view all the answers

Consider a patient presenting with a complex endocrine anomaly characterized by concurrent hypersecretion of both cortisol and growth hormone (GH), alongside paradoxical suppression of adrenocorticotropic hormone (ACTH) and GH-releasing hormone (GHRH). Advanced imaging reveals the presence of two distinct, non-contiguous tumors: one in the adrenal cortex and another in the anterior pituitary. Assuming both tumors are monoclonal and responsive to standard endocrine therapies, which therapeutic strategy would MOST effectively address the hormonal imbalances while minimizing iatrogenic complications?

<p>Bilateral adrenalectomy followed by long-acting somatostatin analog administration and subsequent pituitary microsurgery if somatostatin fails to normalize GH levels. (B)</p> Signup and view all the answers

A research team is investigating the impact of chronic exposure to a novel environmental endocrine disruptor on zebrafish development. They hypothesize that this compound competitively binds to thyroid hormone receptors (TRs) but only weakly activates them, exhibiting partial agonist activity. Which of the following experimental findings would provide the STRONGEST evidence supporting their hypothesis, assuming all other factors are controlled and measured accurately?

<p>Increased expression of TR-responsive genes at low concentrations of the disruptor, followed by a plateau at higher concentrations, and a concurrent decrease in endogenous T3 hormone levels. (D)</p> Signup and view all the answers

Consider a scenario in which a patient with long-standing, well-controlled type 1 diabetes mellitus develops progressive autonomic neuropathy affecting the adrenal medulla. Which of the following physiological responses to a hypoglycemic event (e.g., induced by an insulin overdose) would be MOST significantly impaired in this patient, thereby increasing the risk of severe and prolonged hypoglycemia?

<p>Epinephrine secretion from the adrenal medulla, reducing the stimulation of hepatic glucose production and peripheral glucose utilization. (C)</p> Signup and view all the answers

A researcher is investigating the effects of a novel synthetic glucocorticoid on osteoblast differentiation in vitro. They observe that while the glucocorticoid initially stimulates osteoblast differentiation at low concentrations, prolonged exposure or high concentrations paradoxically inhibit mineralization and promote osteocyte apoptosis. Furthermore, they discover that this biphasic effect is mediated through a non-genomic mechanism involving direct interaction with a transmembrane receptor distinct from the classical intracellular glucocorticoid receptor (GR). Which of the following molecular pathways is MOST likely responsible for the observed switch from osteoblast differentiation to osteocyte apoptosis under chronic, high-dose glucocorticoid exposure?

<p>Activation of the MAP kinase pathway and subsequent upregulation of pro-apoptotic proteins like Bax, triggered by the non-genomic glucocorticoid receptor. (C)</p> Signup and view all the answers

Which of the following best describes the primary mechanism by which endocrine glands deliver their products to target tissues?

<p>Directly into the bloodstream, allowing hormones to reach target cells throughout the body. (B)</p> Signup and view all the answers

Which of the following BEST illustrates the role of hormones as 'chemical messengers'?

<p>Transmitting signals between distant organs to coordinate complex physiological processes. (B)</p> Signup and view all the answers

Which of the following scenarios would MOST likely result in hormone hyperproduction due to genetic factors?

<p>A mutation causing constitutive activation of a hormone receptor, leading to amplified downstream signaling. (B)</p> Signup and view all the answers

A patient presents with symptoms of hormone imbalance after undergoing partial removal of an endocrine gland. Assuming no complications, which factor is MOST influential in determining whether the patient develops a hormone deficiency?

<p>The amount of functional glandular tissue remaining post-surgery. (C)</p> Signup and view all the answers

Consider a scenario in which a novel drug selectively inhibits the transport of thyroid hormones into target cells, without affecting hormone synthesis or secretion. Assuming no compensatory mechanisms are activated, which of the following outcomes is MOST likely to occur at the level of target tissues?

<p>Development of localized hypothyroidism-like symptoms in affected tissues despite normal circulating hormone levels. (C)</p> Signup and view all the answers

Which of the following conditions results from decreased production of Antidiuretic Hormone (ADH)?

<p>Diabetes Insipidus (A)</p> Signup and view all the answers

What is a goitre?

<p>Enlargement of the thyroid gland (B)</p> Signup and view all the answers

Which of the following oral manifestations is associated with thyroid disorders in children?

<p>Delayed tooth eruption (D)</p> Signup and view all the answers

Panhypopituitarism is characterized by a deficiency in multiple hormones produced by the pituitary gland. Beyond the hormones explicitly mentioned, which of the following clinical manifestations would MOST likely also be present in an individual with panhypopituitarism?

<p>Impaired stress response and increased susceptibility to infections (D)</p> Signup and view all the answers

A hypothetical individual is genetically predisposed to developing an autoimmune disorder targeting endocrine glands. Further suppose that this individual's immune system mistakenly recognizes a crucial enzyme involved in the synthesis of steroid hormones within both the adrenal cortex and the gonads. If this autoimmune process leads to substantial destruction of hormone-producing cells in both tissues, which of the following hormonal profiles would MOST likely be observed in this patient?

<p>Decreased cortisol, decreased androgens, decreased estrogens (D)</p> Signup and view all the answers

Flashcards

Endocrine Glands

Ductless glands that secrete products directly into the bloodstream.

Exocrine Glands

Glands that secrete products into a ductal system leading to an epithelial surface.

Hormones

Chemical messengers that control and coordinate various bodily functions.

Hyper-

Increased production of a hormone by a gland.

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Hypo-

Decreased production of a hormone by a gland.

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Autoimmune (Endocrine)

Autoimmune diseases can cause a destruction/loss of tissue that can affect the endocrine glands.

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Tumors (Endocrine)

Random growths that sometimes release hormones, disrupting normal endocrine function.

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Genetic (Endocrine)

Can cause hormone production to increase.

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Adrenal Crisis

A life-threatening condition due to very low steroid levels in the body, potentially caused by abruptly stopping steroid medication.

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Steroid Tapering

Gradual reduction of a medication dosage to prevent withdrawal symptoms or other adverse effects.

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Periodontal Disease & Hormones

Inflammatory condition affecting the tissues surrounding the teeth, potentially exacerbated by hormonal changes.

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Pyogenic Granuloma/Pregnancy Epulis

Benign lesion of the oral cavity that is more common during pregnancy.

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Endocrine Replacement Therapy

Using medication to restore the body's hormonal balance.

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Acromegaly

Enlargement of bones in hands, feet, and face due to excess growth hormone.

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Hypopituitarism

Underactivity of the pituitary gland, leading to deficiency in one or more hormones.

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Diabetes Insipidus

Condition where the body produces insufficient ADH, leading to frequent urination.

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Hyperthyroidism

Overactivity of the thyroid gland, producing excess thyroid hormones.

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Hypothyroidism

Underactivity of the thyroid gland, resulting in insufficient thyroid hormones.

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Exophthalmos

Eye bulging, often associated with hyperthyroidism (Graves' disease).

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Goitre

Enlarged thyroid gland, can occur in both hyper- and hypothyroidism.

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Hashimoto's disease

Autoimmune cause of hypothyroidism.

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Delayed Tooth Eruption

Delayed or abnormal tooth development due to thyroid issues in children.

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Hyperparathyroidism

Overactivity of the parathyroid glands.

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Addison's Disease (Hypo)

Reduced cortisol levels due to adrenal gland dysfunction.

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Hyperpigmentation

Increased skin pigmentation often seen in primary adrenal insufficiency.

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Addisonian Crisis

A life-threatening condition due to severe cortisol deficiency.

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Fever

Elevated body temperature.

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Syncope

Fainting or loss of consciousness.

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Convulsions

Seizures due to abnormal brain activity.

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Hypoglycemia

Low blood sugar level.

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Hyponatremia

Low sodium levels in the blood.

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HPA Axis

The body's feedback system involving the hypothalamus, pituitary, and adrenal glands to regulate cortisol.

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Cortisol increase results in

Increased glucose, sodium retention, potassium excretion and immune system suppression

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Tertiary Hyperparathyroidism Symptoms

Rare symptoms; includes depression, fatigue, sickness, muscle weakness, tummy pain, constipation, drowsiness, confusion, HBP, irregular heartbeat, osteoporosis, bone fractures, kidney stones, stomach ulcers, pancreatitis, and brown tumors of the bone.

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Hypoparathyroidism Symptoms

Tingling in fingertips, toes, and lips; twitching facial muscles/tongue, muscle pains/cramps (legs, feet, tummy), tiredness, mood changes, dry/rough skin, coarse hair that easily breaks/falls out, and fragile nails.

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Adrenal Glands

Sit atop the kidneys and produce/circulate natural steroids, regulating bodily functions.

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Cushing Syndrome

Excess cortisol, can be exogenous (steroids) or endogenous (body overproduction).

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Exogenous Cushing Syndrome

Too many steroids from an outside source.

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Hyperaldosteronism

Excess aldosterone (Conn's syndrome).

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Adrenogenital/Virilizing Syndromes

Excess of androgens.

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Phaeochromocytoma

Tumor overproducing epinephrine and norepinephrine.

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Alveolar Bone Loss (Hypercortisolism)

Osteoporosis of the jaw.

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Oral Candidiasis (Hypercortisolism)

Elevated rates of fungal infections in the mouth.

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Exocrine System

A system of ducts that carry secretions onto an epithelial surface.

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Major Endocrine Glands

The hypothalamus, pituitary, pineal, thyroid, parathyroid, thymus, pancreas, adrenals, and gonads (ovaries/testes).

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Causes of Endocrine Disorders

Genetic factors, tumors, tissue destruction/loss/suppression due to autoimmunity, infection, trauma, or medical interventions.

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Thyroid Gland

Gland producing hormones that regulate metabolism, growth, and other functions.

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Ductless Glands

Glands that secret hormones straight into the bloodstream.

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Thymus Gland

A gland which is larger in childhood that shrinks as you age.

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Hormones Definition

Chemical messengers that control bodily functions such as metabolism and growth.

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Chemical Messengers (Hormones)

Chemical messengers that control and coordinate bodily functions.

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Study Notes

Endocrine Glands

  • Ductless glands secrete products directly into the bloodstream, unlike exocrine glands.
  • Scattered throughout the body.

Endocrine Glands - Where?

  • Includes the hypothalamus, pituitary, pineal, thyroid, parathyroid, thymus, pancreas, adrenals, ovaries, testes, and placenta.
  • Thymus is larger in childhood and gets smaller as you age

Endocrine Glands - What Product/Action?

  • Hormones are chemical messengers.
  • Chemical messengers control and coordinate metabolism, energy levels, reproduction, growth, development, mood, sleep, and response to injury and stress.
  • The hypothalamus produces TRH, GnRH, GHRH, CRH, somatostatin, and dopamine.
  • The pituitary gland produces GH, prolactin, ACTH, TSH, LH, FSH, ADH, and oxytocin.
  • The pineal gland produces melatonin.
  • The thyroid produces thyroid hormone
  • The parathyroid glands produce parathyroid hormone
  • The thymus produces T-lymphocytes for differentiation.
  • The pancreas produces insulin
  • The adrenal glands produce epinephrine and corticosteroids.
  • The ovaries produce estrogen and progesterone.
  • The testes produce testosterone.
  • The placenta produces estrogen, progesterone, hCG, HPL, PGH, relaxin, and kisspeptin.

Endocrine Glands - Disorders/Other

  • Production can be affected genetically, with tumors releasing hormones, or by tissue destruction/loss/suppression. Also pregnancy not generally a disorder
  • Acromegaly is related to growth hormone.
  • Hypopituitarism is underacting piutary
  • Diabetes Insipidus is related ADH levels
  • Hyperthyroidism is related to T3 & T4 thyroxine levels.
  • Hypothyroidism is a T3 & T4 thyroxine deficiency
  • Hyperparathyroidism is related to high PTH levels
  • Hypoparathyroidism is related to low PTH levels
  • Cushing's disease is related to elevated cortisol levels
  • Addison's disease a adrenal hormone deficiency
  • Amenorrhea can occur
  • Polycystic Ovary Syndrome causes multiple cysts on the ovaries
  • Precocious Puberty is defined as early onset of puberty.
  • Premature Ovarian Failure is when the ovary stops working early in a woman's life
  • Hypogonadism is a deficiency of sex hormones
  • Polyglandular Deficiency Syndromes (PDS) happens when multiple endocrine glands don't function properly
  • Multiple Endocrine Neoplasia (MEN) causes multiple tumors to grow
  • Osteoporosis is a condition that causes bone to become weak and brittle

Hypopituitarism

  • Two of the symptoms need to be present for diagnosis with possible panhypopituitarism.

Acromegaly

  • Results from increased growth hormone (GH).

Hyperthyroidism

  • Displaying Trembling Hands, also known as Graves Disease
  • Goitre is when the thyroid gland has become enlarged

Hypothyroidism

  • Hashimoto’s Disease
  • Displays tiredness, sensitivity to cold, weight gain, constipation, depression, slow movements and thoughts, muscle aches and weakness, muscle cramps, dry and scaly skin, brittle hair and nails, and loss of libido.
  • Pain, numbness, and tingling can occur in the hand and fingers (carpal tunnel syndrome).
  • Irregular or heavy periods can occur
  • Can cause hair loss and weight gain

Parathyroid Glands (Hyperparathyroidism)

  • Primary cause is rare, secondary is usually from tumors.
  • Calcium and Vitamin D regulation is affected.
  • Can show as Depression, Fatigue, appetite loss, Muscle Weakness, Tummy Pain & Constipation, Drowsiness & Confusion, HBP & Irregular Heartbeat, Osteoporosis & Bone Fractures, Kidney problems are a result, Kidney Stones & Sequalae, Stomach Ulcers & Pancreatitis

Hypoparathyroidism:

  • Displays a Tingling Sensation (paraesthesia) in Fingertips, Toes, and Lips, Twitching Facial Muscles, Muscle Pains or Cramps, particularly in Legs, Feet, or Tummy, Tiredness, Irritable mood, Anxious, or Depressed, Dry, Rough Skin, Coarse Hair that breaks easily, and Fingernails that break easily - Low Calcium
  • Can have tinging sensations in Extremities

Hyper - Cushing:

  • Can show Alveolar Bone Loss in the jaw

Cushing Syndrome Symptoms:

  • Can show Alveolar Bone Loss
  • There can linked infections
  • Has several personality traits that manifest with mood
  • Has fat deposits on Face and Back and Linked to infection

Risks with oral Candida:

  • Occurs at Elevated Rates and are more susceptible to Fungal

What happens with Addison's Disease:

  • Adrenal Glands are lazy with production.
  • Addisonian Crisis occurs as a result from Stress.
  • Can be caused by seeing a Dentist

Medication planning for Appointments:

  • Ideally DOSE of Normal Meds on day of Appointment

When using Steroid for procedure consider:

Dentist Considerations:

  • See what kind of Patient you have when dealing with Addison’s

Peak Timings in addisonian crisis:

  • Hydrocortisone emergency in steroid dependent patients (addisonian crisis).
  • Ensure a Patient has an issue that they carry an Emergency Meds

Axis feedback Loop - Stress Response:

  • Hypothalamus – Pituitary with Adrenal Gland creates the loop

Autoimmune issue to consider:

  • Adrenal glands causes Adrenal Crisis

Pregnancy:

  • Hormones are affected as well - and dental cavities are a risk

Endocrine Glands Treatment:

  • Treat the Target Organs that affect Hormone balance

Oral Complications - Diagnosis due to Bisphosphonates

Oral Complications - Diagnosis:

  • Manifestations can show as Dry mouth, Oral thrush, Caries, Glossitis, and Choice of Anesthesia.

Dentist considerations to consider

  • Planning of Appointments - Morning Middle Afternoon is a great time to treat patients.
  • Position of Patient, be mindful of posture
  • Adjusted OH - ensure oral health is kept
  • Oral Complications are common in many treatments
  • Diagnosis of the problem - should be considered
  • Extractions - maybe another solution
  • Choice of Anesthesia - may not be that important
  • Consider Primary/Secondary Care - to decide appropriate medication to prescript Dry Socket - may be present in post operation
  • LA with/without Adrenaline - depends on case requirements
  • Medical Emergency can result

When planning appointments

  • Consider Time Of Day and Length Of Appointment, try and book in the morning
  • Consider whether the Patient can Tolerate Supine Position, not all patients can comfortably
  • Consider Dexterity, Need and Anatomy when planning treatment

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