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Questions and Answers

What can precipitate myxoedema coma in hypothyroidism?

  • Sedatives like midazolam and diazepams (correct)
  • Carbimazole
  • Thyroxine treatment
  • LA

    • What is the main way of pain control in dental management of hypothyroidism?

  • Tranquillizers
  • General Anesthesia
  • Conscious sedation
  • Local Anesthesia (correct)

    • Why is conscious sedation desirable in dental management of hypothyroidism?

  • To reduce anxiety (correct)
  • To reduce bleeding
  • To reduce sympathetic overactivity
  • To provide pain relief

    • What should be avoided in dental management of hyperthyroidism?

    <p>Povidine iodine and similar compounds</p> Signup and view all the answers

    What is a potential side effect of carbimazole?

    <p>Agranulocytosis</p> Signup and view all the answers

    When should general anesthesia be postponed in dental management of hypothyroidism?

    <p>Until thyroxine treatment is initiated</p> Signup and view all the answers

    In primary hypothyroidism, what is the level of TSH?

    <p>High</p> Signup and view all the answers

    Which of the following is a complication of hypothyroidism?

    <p>Dry skin</p> Signup and view all the answers

    What is the term for congenital hypothyroidism?

    <p>Cretinism</p> Signup and view all the answers

    Which of the following is a symptom of hyperthyroidism?

    <p>Tremor</p> Signup and view all the answers

    What is the term for adult hypothyroidism?

    <p>Myxedema</p> Signup and view all the answers

    Which of the following is a complication of hyperthyroidism?

    <p>Cardiac failure</p> Signup and view all the answers

    What is the term for the production of antibodies that mimic TSH?

    <p>Grave's disease</p> Signup and view all the answers

    Which of the following is associated with hyperthyroidism?

    <p>Diffuse autoimmune goitre</p> Signup and view all the answers

    Where does the thyroid gland normally develop from?

    <p>The foramen caecum at the junction of the posterior third with the anterior two-thirds of the tongue</p> Signup and view all the answers

    What is the likelihood of a lingual thyroid transforming into malignancy?

    <p>Rare</p> Signup and view all the answers

    What is a common symptom of a lingual thyroid?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is NOT a method of diagnosing a lingual thyroid?

    <p>X-ray</p> Signup and view all the answers

    What is the prevalence of hypothyroidism in people with a lingual thyroid?

    <p>About 1/3</p> Signup and view all the answers

    Where can a lingual thyroid be located?

    <p>In the midline between the foramen caecum and epiglottis, oropharynx, infra-hyoid region, or larynx</p> Signup and view all the answers

    What is the gender that is more likely to have a lingual thyroid?

    <p>Female</p> Signup and view all the answers

    What is the usual presentation of a lingual thyroid?

    <p>Asymptomatic</p> Signup and view all the answers

    What is the primary symptom of myxedema coma?

    <p>Altered mental status and low body temperature</p> Signup and view all the answers

    What is the treatment for thyroid crisis?

    <p>Potassium iodide and beta blockers</p> Signup and view all the answers

    What is the cause of thyroid crisis in untreated cases of hyperthyroidism?

    <p>All of the above</p> Signup and view all the answers

    What is the treatment for hypothyroidism?

    <p>Daily oral thyroxine sodium</p> Signup and view all the answers

    What is the complication of hypothyroidism that can be precipitated by daily oral thyroxine sodium?

    <p>Thyroid crisis</p> Signup and view all the answers

    What is the primary symptom of thyroid crisis?

    <p>Hyperthermia and tachycardia</p> Signup and view all the answers

    What is the treatment for hyperthyroidism?

    <p>Carbimazole and propylthiouracil</p> Signup and view all the answers

    What is the complication of hyperthyroidism that can be precipitated by pain, anxiety, trauma, or general anesthesia?

    <p>Thyroid crisis</p> Signup and view all the answers

    What is the main objective of studying thyroid gland diseases?

    <p>To diagnose and treat hyperthyroidism and hypothyroidism</p> Signup and view all the answers

    What type of hypothyroidism is caused by a problem in the thyroid gland itself?

    <p>Primary hypothyroidism</p> Signup and view all the answers

    What is the primary laboratory test used to diagnose thyroid gland diseases?

    <p>Thyroid function test (TFT)</p> Signup and view all the answers

    What is the diagnosis of hypothyroidism based on?

    <p>Low serum levels of T3 and T4</p> Signup and view all the answers

    What is the complication of hyperthyroidism?

    <p>Circulating autoantibodies in Graves' disease</p> Signup and view all the answers

    What is the diagnosis of hyperthyroidism based on?

    <p>Raised serum levels of T3 and T4</p> Signup and view all the answers

    What is the treatment of hyperthyroidism?

    <p>Thyroid surgery</p> Signup and view all the answers

    What is the diagnosis of hypothyroidism based on?

    <p>Serum antibodies for Hashimoto's thyroiditis</p> Signup and view all the answers

    Study Notes

    Thyroid Gland Diseases

    • Types of thyroid gland diseases: Hyperthyroidism and Hypothyroidism

    Anatomy and Physiology

    • The thyroid gland produces thyroid hormones (T3 and T4)
    • Thyroid hormone production is regulated by TSH (Thyroid-Stimulating Hormone)

    Hypothyroidism

    • Definition: Underactive thyroid gland
    • Causes:
      • Primary (thyroid disease)
      • Secondary (hypothalamic or pituitary)
    • Diagnosis:
      • Low serum T3 and T4 levels
      • High TSH levels in primary hypothyroidism
      • Presence of serum antibodies for Hashimoto's thyroiditis
    • Complications:
      • Myxedema (adult hypothyroidism): puffy face, slow heart rate
      • Cretinism (congenital hypothyroidism)
      • Hypothermia, dry skin, hair loss, and lethargy
    • Treatment:
      • Daily oral thyroxine sodium
      • Precipitation of myxedema coma by sedatives, opioids, and tranquillizers should be avoided

    Hyperthyroidism

    • Definition: Overactive thyroid gland
    • Causes:
      • Grave's disease (production of antibodies that mimic TSH)
      • Multinodular goitre
      • Thyroiditis
    • Diagnosis:
      • Raised serum T3 and T4 levels
      • Presence of circulating autoantibodies in Grave's disease
      • Radioactive iodine uptake test and thyroid scan
    • Complications:
      • Thyroid crisis: tremor, dyspnoea, hyperthermia, and tachycardia
      • Heart failure, ischaemic heart disease, and bradycardia
      • Exopthalmus (bulging eyes), warm moist skin, and excess sweating
    • Treatment:
      • Beta blockers, propylthiouracil, and iodine
      • Surgery

    Dental Management

    • Hypothyroidism:
      • Precipitation of myxoedema coma should be avoided
      • Conscious sedation is desirable
      • LA is satisfactory for pain control
    • Hyperthyroidism:
      • Sympathetic overactivity may lead to fainting
      • Beta blockers and potassium iodide can be used
    • Lingual thyroid:
      • Rare occurrence of ectopic thyroid tissue in the tongue
      • Diagnosis confirmed by iodine-123 or -131, technetium-99 uptake, biopsy, and MRI
      • Treatment: surgical removal

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