t/f addisons disease is a deficiency in aldosterone and cortisol
true
cushings disease is an excess of glucocorticoid
true
all of theses are signs or symptoms of chushing's syndrom except one
moon shaped face
acne
hirsutism
weight loss
weight loss is the exception
when should a pt with adrenal disorders be scheduled for treatment
in the morniing when cortisol levels are higher
t/f most goiters cause hyperthyroidism
false
t/f the primary goiter accounts for 75% of all thyroid swellings
true
causes of hypothyroidsim occur from:
congenital
radiation
iatrogenic
all of the above
all of the above
what is an oral complication of thyrotoxicosis
babies born with erupted teeth from mothers that have hyperthyroidism
what is diabetes caused by?
defect in insulin secretion
defect in insulin action
t/f glycosuria and polyuria are both effects of diabetes
true
t/f glycosuria is an absence of glucose in the urea
false
which genetic syndrom is associated with diabetes
down syndrome
what is considered a safe level of glucose for dental treatment
between 70-126 mg/dL
what disease is a deficiency of aldosterone and cortisol (hypoadrenalism)
addison's
what disease has signs and symptoms of weakness, fatigue, abnormal pigmentation of skin and mucous membranes, hypertension, anorexia, weight loss, delayed healing and increased susceptiblity to infection
addisons disease
if a pt with _____ disease is challeneged by stress they will have sunken eyes, sweating, weak pulse, cyanosis, nausea, vomiting, headache, dehydration, fever, dyspnea, myalgia, arthralgia, hypernatremia, eosinophilia
addisons
if a pt with addisons disease is not treated rapidly what can they develop? 4
hypothermia, hyptension, hypoglycemia and circulatory collapse that can result in death
what are the risk factors for primary insufficiency?
idiopathic destruction of adrenal cortex
hemorrhage
sepsis
infectious disease (HIV, TB)
malignancy
adrenalectomy
drugs
what are the risk factors for secondary adrenal insufficiency
hypothalmic or pituitary disease
administration of exogenous corticosteroids
administration of specific drugs (desforrioxamine)
what is the medical management of primary adrenal insufficiency
eliminate infectious agent or malignant disease
homral replacement therapy
encourage pt to ingest adequate sodium
glucocorticoid replacement is based on what three factors
the duration and severity of surgery and level of pain control
the amount of cortisol produced during the physiologic response to surgical stress
the overal health of the pt who takes dialy steriods
what is the glucocorticoid target of hydrocortisone on the day of minor surgical stress?
25 mg
what is the glucocorticoid target of hydrocortisone per day for 102 dayse for moderate surgical stress
50-75 mg
what is the glucocorticoid targe of mydrocoritsone daily for 2-3 days for major surgical stress
100-1500 mg
what is the excess of glucocorticoid due to hyperadrenalis
cushings disease
what is abnormal hair growth on women
hirsutism
what disease has a buffalo hump on the upper back
cushings
an adrenal crisis requires immediate injection of what?
glucocorticoid, fluid and electrolytes
what should the the pt with adrenal disorder take before a stressful procedure
glucocorticoid
when should a pt with andrenal disorder schedule appts
AM because cortisol levels are higher
what can be used in the dental office for the adrenal disorder pt to help decrease stress
N2O and benzodiazepines
what should be used with caution with an adreanal disease
barbiturates used with CAUTION
what should not be used as an analgesic for the adrenal disorder pt who is a long term steroid user
aspirin and anti-inflammatory
what should be provided at the end of a procedure fot he adrenal disorder
long acting anesthetic
when does a stress response usally occur with adrenal disorders
1-5 hours after procedure has started
if surgery was to be done on a pt with adreanl disorder what must be done
discontinue corticoidsteriod inhibitors
what is a gneralized enlargement of the thyroid gland
goiter
what functions to secrete hormones for growth and maturation of tissues, cell respiration and tatla energy expenditure
throid gland
what are the three types of goiters
primary goiter
thyrostimulatory secondary goiter
thyroinvasive secondary goiter
what is a simple goiter and is thyroid cancer?
primary goiter
what type of goiter accounts for 75% of all thyroid swellings
primary goiter
t/f most primary goiters are nonfunctional and do not cause hyperthyroidism
true
what type of goiter is associated with graves disease, hashimoto;s thyroiditis and congenital hereditary goiter
thyrostimulatory secondary goiter
t/f graves disease is associated with hypothyriodism
false! HYPERthyroidism
what are the signs and symptoms of graves disease associated with hyperthyroidism
