Oral Manifestations Of Endocrine Disorders Multiple Choice Questions

Question 1. Ground glass appearance is a radiographic feature of.

1. Hyperparathyroidism
2. Hyperthyroidism
3. Hypoparathyroidism
4. Hypothyroidism

Answer: 1. Hyperparathyroidism

Read And Learn More: Oral Medicine and Radiology Question And Answers

Question 2. Moth-eaten appearance or mottled appearance in a radiograph suggests.

1. Hyperparathyroidism
2. Hyperthyroidism
3. Hypoparathyroidism
4. Hypothyroidism

Answer: 1. Hyperparathyroidism

Question 3. A stippled-bone pattern resembling a pepper¬pot skull in hyperparathyroidism is due to.

1. Osteoporosis of the skull vault
2. Osteopetrosis of the skull vault
3. Osteopenia of the skull vault
4. Osteoid osteoma of the skull vault

Answer: 3. Osteopenia of the skull vault

Question 4. Pitting type of enamel hypoplasia is a feature of.

1. Hyperparathyroidism
2. Amelogenesis imperfecta
3. Hypoparathyroidism
4. Turner’s hypoplasia

Answer: 3 Hypoparathyroidism

Question 5. Persistent oral candidiasis in a young individual is a sign of.

1. Hyperparathyroidism
2. Hyperthyroidism
3. Hypoparathyroidism
4. Hypothyroidism

(Note: Persistent oral candidiasis in a young individual is a sign of hypoparathyroidism and is known as endocrine—candidiasis syndrome).

Answer: 3. Hypoparathyroidism

Question 6. Metastatic calcification develops when cal¬cium phosphate solubility product (Ca x P) is.

1. Above 100
2.  Above 70
3. Equal to 1
4. Zero

Answer: 2. Above 70

Question 7. Normal ion product or calcium phosphate solubility product is.

1. Equal to 100
2. An average of 35
3. Equal to 10
4. An average of 135

Answer: 2. An average of 35

Question 8. Patients on corticosteroid therapy are at risk of developing complications related to Cushing’s syndrome.

1. Noonan syndrome
2. Borjeson-Forssman-Lehmann syndrome
3. Comorbid syndrome
4. Cushing’s syndrome

Answer: 4. Cushing’s syndrome

Question 9. Hypothyroid patients are not immuno-compromised.

1. Myxedematous
2. Immunocompromised
3. Treated with synthetic thyroxine
4. Treated with iodine

Answer: 2. Immunocompromised

Question 10. The total amount of body calcium is.

1. 9-11g
2. 9-11 m
3. 100-170 mg
4. 100-170 g

Answer: 4. 100-170g.

Question 11. Normal serum calcium level is.

1. 9-11 mg/dL
2. 9-11 g/dL
3. 100-170 mg/dL
4. 100-170 mmol/dL

Answer: 2. 9-11 mg/dL

Question 12. Parathyroid glands control blood.

1. Calcium level
2. Phosphorus level
3. Calcium-phosphate level
4. Thyrocalcin level

Answer: 1. Calcium level

Question 13. Low serum calcium levels stimulate.

1. Parathyroid glands
2. Thyroid glands
3. Pituitary gland
4. Adrenal axis

Answer: 1. Parathyroid glands

Question 14. An elevated level of glucocorticoid is associated with.

1. Manic depression
2. Affective disorder
3. Euphoria
4. Morphea

Answer: 3. Euphoria

Question 15. Glucocorticoid excess causes.

1. Hypotension and collapse
2. Obesity and Moon face
3. Orthostatic hypotension
4. Disorientation

Answer: 2. Obesity and moon face

Question 16. Adrenal insufficiency causes.

1. Dysphoria
2. Euphoria
3. Cushing’s syndrome
4. Galactorrhea

Answer: 1. Dysphoria

Question 17. Glucocorticoid withdrawal results in.

1. Mental retardation
2. Mental disturbance
3. Hyperkinesias
4. Dystonia

(Note: Glucocorticoid withdrawal results in mental disturbances like dysphoria and depression, memory, and learning deficits).

Answer: 2. Mental disturbance

Question 18. An alternate-day dosage regimen is not applicable for multiple daily dosing.

1. Morphine
2. Clopidogrel
3. Insulin
4. Glucocorticoids

Answer: 4. Glucocorticoids

Question 19. The maximum production of pituitary ACTH production is during.

1. Daytime
2. Night time
3. Infancy
4. Pregnancy

Answer: 2. Nighttime

Question 20. Congenital hypothyroidism is associated with.

1. Excessive eating
2. Mental retardation
3. Warm skin
4. Macroglossia

Answer: 2. Mental retardation

Question 21. The hormone which depends on dietary intake of micronutrients for its production is.

1. Thyroxine
2. Cortisol
3. Estrogen
4. Insulin

Answer: 1. Thyroxine

Question 22. Production of thyroxine depends on dietary intake of.

1. Vitamins
2. Alanine
3. Arginine
4. Iodine

Answer: 4. Iodine

Question 23. Iodine deficiency results in.

1. Hypoglycemia
2. Wilms tumor
3. Goiter
4. Fibrolamellar adenoma

(Note: Iodine deficiency results in goiter and hypothyroidism).

Answer: 4. Goiter

Question 24. Examination of the thyroid gland should be carried out

1. Superior to the cricoid cartilage
2. Inferior to the cricoid cartilage
3. Superior to the sternal notch
4. Inferior to the sternal notch

Answer: 3. Superior to the sternal notch

Question 25. An autoimmune disease of the thyroid is.

1. Goiter
2. Graves’ disease
3. Thyroid storm
4. Riedel’s thyroiditis

(Note: Autoimmune diseases of the thyroid are Hashimoto’s thyroiditis and Graves’ disease).

Answer: 2. Graves’ disease.

Question 26. In Graves disease, autoantibodies are produced.

1. Thyroxine
2. Triiodothyronine
3. Thyrotropin-releasing hormone
4. Thyroid-stimulating hormone

Answer: 4. Thyroid-stimulating hormone

Question 27. Salivary gland disorder that tends to coexist with Hashimoto’s thyroiditis is.

1. Sjogren’s syndrome
2. Sialadenitis
3. Sialadenosis
4. Carcinoma ex pleomorphic adenoma

Answer: 1. Sjogren’s syndrome

Question 28. The primary thyroid screening test for adults is.

1. Thyroid antibody screening
2. TSH testing
3. Thyroglobulin test
4. T3 and T4 tests

Answer: 2. TSH testing

Question 29. Diabetes insipidus is caused by decreased secretion or function of.

1. Insulin
2. Oxytocin
3. Vasopressin
4. Glucagon

(Note: Vasopressin is an antidiuretic hormone).

Answer: 3. Vasopressin

Question 30. The symptom of diabetes insipidus is the production of.

1. Abnormally increased thirst
2. The large volume of dilute urine
3. Hunger and dry mouth
4. Fatigue and blurred vision

Answer: 2. Large volume of dilute urine

Question 31. Multiple neuromas of oral commissural mucosa are characteristics of.

1. Lloyd’s syndrome
2. Multiple adenoma syndrome
3. Multiple endocrine neoplasia syndrome
4. Goltz syndrome

(Note: Multiple neuromas of oral commissural mucosa are characteristics of MEN 2B (or) MEN 3).

Answer: 3. Multiple endocrine neoplasia syndrome

Question 32. A salivary steroid hormone that can be corre¬lated to free serum level is and has diagnostic significance is.

1. Estradiol and cortisol
2. Cortisol and aldosterone
3. Aldosterone and corticosterone
4. Cortisol and corticosterone

Answer: 2. Cortisol and aldosterone

Question 33. Salivary levels of hormones that can be assessed and can be substituted for diagnostic purpose is.

1. Prolactin
2. Vasopressin
3. Epinephrine
4. Growth hormone

[Note: Salivary levels of lipid hormones (like estradiol, testosterone, aldosterone, cortisol, tyrosine, tryptophan, epinephrine, and norepinephrine) can be assessed accura¬tely and can be substituted for diagnostic purposes but not protein hormones (antidiuretic hormone, growth hormone, follicle-stimulating hormone, gonadotrophin, and prolactin)].

Answer: 3. Epinephrine

Question 34. Fluoride application and fluoridated tooth¬paste should be avoided in patients with.

1. Thyroid disorder
2. Turner hypoplasia
3. Salivary gland disorder
4. Renal diseases

(Note: Fluoride mimics thyrotropin).

Answer: 1. Thyroid disorder

Question 35. Hypoparathyroidism patients are highly susceptible to.

1. Sialolithiasis
2. Dental caries
3. Periodontitis
4. Brown’s tumor

Answer: 2. Dental caries

Question 36. Calcitonin inhibits.

1. Bone calcium content
2. Blood sodium level
3. Osteoclastic bone resorption
4. Osteotropic hormone level

(Note: Calcitonin decreases serum levels of calcium and inhibits osteoclastic bone resorp¬tion).

Answer: 3. Osteoclastic bone resorption

Question 37. An increase in serum calcium increases the secre¬tion of.

1. Parathormone
2. Thyroxine
3. Vitamin D
4. Calcitonin

Answer: 4. Calcitonin

Question 38. Increased urinary phosphoethanolamine level is a diagnostic marker for.

1. Hypophosphatasia
2. Hyperphosphatemia
3. Pseudohypoparathyroidism
4. Primary hyperparathyroidism

Answer: 1. Hypophosphatasia

Question 39. Osteopetrosis is a.

1. Qualitative bone disorder
2. Quantitative bone disorder
3. Regenerative bone disorder
4. Degenerative bone disorder

Answer: 2. Quantitative bone disorder

Oral Manifestations Of Endocrine Disorders Viva Voce

Question 1. What are the precaution for patients with thyroid disorders during dental extraction?
Answer:

• Chronic hypothyroidism: Patients may manifest prolonged bleeding from small vessels and require prolonged local pressure application. This is due to a defect in the contracting ability of the small vessels because of excess subcutaneous mucopolysaccharides.
• Patients with long-standing hyperthyroidism may have elevated blood pressure. This necessitates the preference for limited use of vasoconstrictors and longer application of local pressure to stop bleeding.

Question 2. State the types of hyperparathyroidism.
Answer: High amount of circulatory parathyroid hormone leads to hyperparathyroidism.

It is of 4 types:

1. Primary hyperparathyroidism: Benign or malignant tumor of the gland is the cause.
2. Secondary hyperparathyroidism: The low serum calcium due to either physiological causes or pathological conditions stimulates the parathyroid glands for increased parathyroid hormone production and leads to gland hyperplasia.
3. Tertiary hyperparathyroidism: The chronic state of secondary hyperplasia changes to the primary type once the underlying cause for low serum calcium is corrected.
4. Forth type is ectopic hyperparathyroidism, where parathyroid hormone levels are increased in patients with malignant diseases.

Question 3. Enumerate the various conditions that cause loss of lamina dura.
Answer:

• Hyperparathyroidism
• Paget’s disease
• Osteomalacia
• Fibrous dysplasia
• Cushing’s disease
• Addison’s disease.

Question 4. What is socket sclerosis?
Answer: Abnormal bone repair following dental extraction which radiographically manifests as lack of resorption of lamina dura and the deposition of sclerotic bone at the lamina dura is known as socket sclerosis. This condition occurs in renal disease patients.

Question 5. What are the features of Cushing’s syn¬drome?
Answer:

• Cushing’s syndrome is caused due to the increased amount of ACTH from ectopic secretion (for example malignant pulmonary tumor), from adrenal tumors or from iatro¬genic glucocorticoids.
• The symptoms include obesity, osteo¬porosis, hypertension, diabetes mellitus, immunosuppression, psychiatric symptoms, muscle wasting, and easy bruising.
• Similar symptoms also characterize Cushing’s disease but are caused by ACTH-secreting pituitary tumors.

Question 6. What is pathological calcification?
Answer:

• Abnormal calcium deposition in tissues is known as pathological calcification. It is associated with the deposition of trace amounts of iron, magnesium, and other mineral salts.
• This may occur as dystrophic calcification, metastatic calcification, and calcinosis.
• Question 7. What are the actions of corticosteroids when administered in chronic inflam¬matory diseases?
  Answer:
• When glucocorticoid therapy is instituted for chronic inflammatory autoimmune diseases, such as pemphigus, lichen planus, pemphigoid, and rheumatoid arthritis, the drug decreases the production of T-lymphocytes which leads to the prognosis of these diseases.
• It also decreases the production of cytokines like interleukin-1 (IL-1), interleukin-2 (IL- 2), interleukin-6 (IL-6), and TNF-a which precipitate the disease’s process.

Question 8. What is an alternate day dosage regimen for glucocorticoids?
Answer:

• An alternate day steroid regimen is given for stable chronic inflammatory diseases like pulmonary fibrosis, rheumatoid arthritis, and asthma. This regimen allows the reactivation of adrenal and pituitary functions on the days when glucocorticoids are not given by limiting adrenal insufficiency.
• For the best beneficiary effect, a high morning dose of prednisone or any other short-acting glucocorticoids should be used.
• Also, this regimen is used to maintain the total steroid dose constant by gradually raising on day dose and tapering the off-day dose.

Question 9. Mention the signs and symptoms of hyperthyroidism.
Answer: Anxiousness, excess sweating, warm-moist skin, heat intolerance, fine tremors of hands, muscle wasting, weight loss, tachycardia, atrial fibrillation, goiter.

Question 10. Mention the signs and symptoms of hypothyroidism.
Answer: Lethargy, dry skin, cold intolerance, decreased hearing, low-hoarse voice, weight gain, increased blood cholesterol level, increased subcutaneous tissue, slow pulse rate, goiter.

Question 11. What is subclinical adrenal insufficiency?
Answer:

• Subclinical adrenal insufficiency was defined as an elevated ACTH: Cortisol ratio.
• When patients are on a short course (5 days) of high potency glucocorticoid therapy (>60 mg prednisone), they maybe in a state of adrenal insufficiency but they would not manifest any symptoms, but in acute stressful conditions, it produces serious complications.

Question 12. What are the diagnostic tests indicated to assess bone density?
Answer:

• Dual-energy X-ray absorptiometry (DEXA)
• Quantitative computed tomography (Q-CT)

Oral Manifestations Of Endocrine Disorders Highlights

• Endocrine glands secrete hormones that are highly specific in function by exhibiting a signaling pathway. Hormones (in Greek meaning, to set in motion) coordinate the activities of other organs and systems, whereas the hypothalamus regulates the activities of endocrine glands.
• The synthesis of hormones is affected by glandular diseases (like autoimmune disorders, tumors, etc.) or defects in the hypothalamus-pituitary pathway, characterized by either increase or decrease in secretion. This chapter highlights the manifestations of hormonal disorders in the oral cavity.