1060 week 12

Endocrine disorders

Affects glands that secret hormones

Pituitary, thyroid, diabetes, steroids

People with ED's have PTSD

Hyperpituitarism

Excessive growth, gigantism (kids), acromegaly (adults)

Enlarged limbs, bones, tongue

Hyperthyroidism (graves)

Premature teeth exfoliation, osteoporosis, sweaty

Hypothyroidism

Cretin, enlarged lips/tongue, delayed to tooth eruption

Hyperparathyroidism

Excessive parathyroid

Primary from hyperplasia or tumor

Secondary from renal disease or lack of vitamin D

Females, loss of lamina dura. ground glass bone, ↑ Ca+

Bernie can't get hyperparathyroid because primary is from growth and she's small and secondary is from renal and ↓ vit D and she's always pooping out in the sun

Diabetes mellitus

Lack of insulin from pancreatic beta cells

Type 1 diabetes

Peak onset 20, insulin dependent

3 P- polydipsia (thirst), polyuria, polyphagia (appetite)

Too much insulin can cause insulin shock (hypoglycemia)

Type 2 diabetes

40+, non insulin dependent, ↑ insulin resistance ( reduce # of receptors for insulin)

Obesity, India and china will have highest numbers

Clinical diabetes

Xerostomia, immune comp (↑ perio and caries, wound healing), brown skin/mucosa, salivary gland enlargement, eye damage, stroke, atherosclerosis

Gestational diabetes

↑ birth rate

Addison disease

↓ adrenal steroid production from tumor, tuberculosis, autoimmunity

Brown mucosa

Addison has brown mouth from her autoimmune tumor and TB

iron deficiency anemia (B-1)

Fatigue, angular chelitis, pallor, depapilated tongue

From ↓ iron or blood loss

Iron deficiency is #1 in young girls, that's why they need lip gloss for their dry chelitis and stop sticking out their tongue to show its depapilated

Plummer-vinson (iron deficiency)

Develops from long term IDA

Difficultly swallowing and in N. European/Scandi women

European Plummers scandi wives have a hard time swallowing cause of their long term IDA

Pernicious anemia

↓ intrinsic factor from parietal cells of stomach or autoimmune

Fatigue, dizzy, mlahrrea, weight loss, angular chelitis, depapilated tongue, ulcers

Intrinsic factor is necessary for B12 absorption for bone marrow

Promiscuous girls w/ anemia are actually nasty w/ diaharea, ulcers, angular chelitis, depap tongue

Folic acid and B12 deficiency anemia

From malautaton, clinically same as pernicious

Dietary supplements necessary bc folic acid and B12 is needed for DNA synthesis

Thalassemia

Inherited

Yellow, prominent cheekbones, flaring of Max anteriors, XR salt and pepper and thinning of lamina dura

People w/ thalassemia are scared of seeing big yellow creatures w/ prominent cheekbones and flared Max anteriors with speckled look and thin lamina dura

Sickle cell anemia (B-2)

Inherited, abnormal hemoglobin in RBC, sickle shaped RBC

Mostly black women

Weak, short breath, joint pain, nausea

The girl who said he has no hemoglobin was black w/ sickle cell and at the time she was pregnant with her 2yr old making her weak nauseous, short breath, joint pain

Celiac pie

Gluten sensitivity causing injury to intestine mucosa so B12 and folic acid can't absorb (cause anemia)

Atrophy of papilla of tongue, ulcer

Aplastic anemia

↓ circulating blood cells from bone marrow suppression

Primary - young adult, secondary- any age

Spontaneous bleeding, petichia

Young adults are the primary users of plastic but it ↓ blood cells from ↓ bone marrow

Polycythemia

↑ in circulating RBC

1. Primary- cause unknown

2. Secondary- physiologic response to lack of O2 (↑ altitude, smoking, pulmonary disorder)

3. Third- ↓ plasma volume but no increase in RBC from weight, stress, smoke

Deep red gingival, bleed easily, petichia, hematoma, dizzy

Treat with phlebotomy (blood letting)

Cynthia is In a weird poly relationship where they blood let. To get more RBC's to share she breathes less 02, and gets rid of plasma by loosing weight and stress smoking

Agranulocytosis (B-3)

↓ neutrophils, fever, perio, gingival bleeding

Jimmy neutron had a grand at 3yr old but he spent it fixing his ging and perio to make him hot

Cyclic neutropenia

Similar to agranulocytosis

↓ of neutrophilic leukocytes

Mutation of gene ELA-2

Gingival inflame, tongue and mucosa ulcer

Ella has cyclic neutropenia and the hides her ulcers and inflammation

Leukemia

Oncogenic virus, ↑ WBC

Acute lymphoblastic (children)- immature lymphocytes

Myoblastic (adolescent)- mainly neutrophils

Chronic leukemia (adult)- slow onset

ANUG, weak, enlarged lymph nodes, gingival enlargement, oral infections, spontaneous bleed,pale gums

Acute lymphoblastic leukemia

Immature lymphocytes, children, good prognosis

All children W/ lymph cancer live

Acute myeloblastic leukemia

Immature granulocytes, young adult, poor prognosis

My acute young adult daughter was immature and took grains of drugs giving her leukemia W/ poor prognosis

Chronic myeloid leukemia

Ass w/ Philadelphia chromosome abnormality

In Philly they create mailed letters

Chronic lymphocytic leukemia

Most common form

Calls are more common than creating mailled letters

Homeostasis

Bleed time- measures function not number, 1-6 min

Prothrombin time - ability to form clot (calcium and tissue factors), 11-16 sec

Partial prothrombin time - effectiveness of clot, 25-40 sec

INR ratio- ratio of prothrombin time to thromboplastin activity

Purpura

Red-blue discoloration of skin mucosa from defect in platelets or ↑ in capillary fragility

Pom Pom purin was supposed to be red/blue

Petichiae

Red spot on skin or mucous mem

Eccymosis

Hemorrhagic patch on skin or mucous mem

Thromboytopenic purpura

↓ platelets, autoimmune drugs

Gingival bleed, nose bleed, hemorrhage lesions, bruise

Riley always says to tom pura vida Purpura- platelets from her autoimmune drugs

Hemophilia (B-4)

Prolonged clot time, X linked mom→son

Type A: most comm w/ deficiency of factor VIII

Type B: Christmas disease, deficiency of factor IX

Her 4 yr old son wouldn't stop bleeding and she's so type A w/ her 8yr old but also doesn't give her 9 yr old Christmas gifts

Bruton disease

B cells don't mature

Primary immunodeficiency

Bruton better b immune

Di George syndrome

Thymus deficiency so T lymphocytes don't mature

Primary immunodeficiency

George doesn't like thyme T

Severe immunodeficiency

Most infants die 1st year of life

Primary immunodeficiency

Secondary immunodeficiency

More common than primary

From malnutrition, renal disease, cancer, viral infection, immunosupression, drugs, AIDS, radiation

Radiation therapy

Destruction of major salivary gland (Xerostomia), caries, candidiasis, mucositis

Chemotherapy

↓ R/WBC

Opportunistic infection, candidiasis, mucositis and ulcers

Xerostomia

BP drugs, antianxiety, antihistamine

Candidiasis

Prednisone- supress immune

Antibiotic /antifungal

Gingival enlargement

Phenytoin (Dilantin)

Nifedipine (Procardia)

Cyclosporine (immunodepressant)

Osteonecrosis

Biphosphonate therapy