Hypothalamus - ANS Diabetes Insipidus: genetic (autoimmune)
Post Pituitary. Decrease in ADH
Normal sugar levels
Increase thirst and urine (> Xerostomia)
Dehydration= similar to diabetes mellitus
HYPO-pituitarism - ANS Decrease pituitary hormones
Children - retardation
Adults - premature aging
Hypothyroidism - ANS Iodine deficiency (goiter)
Hashimoto/Thyroiditis = autoimmune disease
- Middle age white females
- SLOW CNS: decrease memory, thinking, hearing, vision
- Facial edema, *enlarged gingiva*
- Skeletal: weak stiff joints
- Pulmonary: Decrease respiration
- Renal: increase water retention
- Cardio - decrease HR and output
> ORAL: puffy lips, *macroglossia, pharyngeal edema, delayed eruption and exfoliation*
Hyper-thyroidism - ANS Autoimmune disease - Graves disease
Multifactorial - genetic, smoking.
- white female 20-40 years
- thin
-*Ocular: exophthalmos = protruding eyes*
**thyroid storm** - triggered by stress, increase HR, fever, trachycardia, angina, CNS, CHF,
arrythmia
- dental management: *dental erosion* fluoride treatment , monitor eruption, LIMIT atropine and
EPI. decrease stress. Referral for *burning mouth*
Adrenal Insufficency **Addison's Disease** - ANS Infection, trauma, autoimmune, cancer
- Primary (rare)
- secondary to hypo/pituitary or suppression (common)
- *hyper-pigmentation: brown/black/blue skin (bronzing)*
- only with primary not with secondary Addison
Adrenocortical Insufficiency - Acute adrenal insufficiency (Adrenal crisis) - ANS Primary adrenal
insufficiency + long-term steroid therapy = highest risk.
Life threatening - provoked by stress!
Weakness, vomiting, confusion, decreased blood pressure, tachycardia, lethargy, vascular
collapse, coma, death!!!!!
Watch for patients on steroids > 20 mg for > 2 weeks within last 2 years *IMPORTANT* (Rule of
2's)
Steroid supplements may be necessary to prevent crisis
Hyper-adrenalism (cushing syndrome-rare) - ANS Primary: steroids or tumors of pituitary glands
Secondary: high injections of med steroids
- *buffalo hump - weight gain MOON FACE*
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