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Medical Pathophysiology > 4 Thyroid > Flashcards

4 Thyroid Flashcards

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USMLE® Step 1 flashcards
1
Q

what is T4?

A

thyroxine

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2
Q

what is T3?

A

triiodothyronine

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3
Q

what do T4 and T3 do?

A

stimulates metabolism of all cells

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4
Q

what does calcitonin do?

A

decreased blood calcium concentration by inhibiting breakdown of bone

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5
Q

how is T3 and T4 released?

A

TRH by hypothalamus which act on thyrotrophs in anterior which then produce TSH which then stimulates thyroid gland to produce T4 and T3

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6
Q

what are the features of the TSH receptor?

A

it is a GPCR that activates a cAMP pathway to increase production of the T3/T4

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7
Q

how is TSH production regulated?

A

via negative feedback at TRH neurones in hypothalamus and at thyrotrophs

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8
Q

what are the signs of a thyroid disorder?

A

moon face, weight gain, fat accumulation of upper back, mood swings, impaired memory

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9
Q

what is the mechanism of a thyroid function test?

A

the higher the TSH the lower the thyroid function as less T3 or T4 being produced

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10
Q

what type of hypothyroidism is most common?

A

autoimmune

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11
Q

what is Hashimoto’s?

A

autoimmune hypothyroidism

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12
Q

what type of treatment may result in hypothyroidism?

A

end stage radioactive graves treatment

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13
Q

what are the indicators of hypothyroidism?

A

iodine deficiency, decreased thyroid hormones, slower metabolism, susceptible to cold as less heat generated

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14
Q

what are the symptoms of hypothyroidism?

A

weakness, fatigue, cold intolerance, decreased sweating, weight gain, impaired glucose tolerance

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15
Q

what is primary hypothyroidism?

A

issue with the thyroid

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16
Q

what is secondary hypothyroidism?

A

issue with the pituitary gland causing decreased stimulation of thyroid

17
Q

what is tertiary hypothyroidism?

A

hypothalamus no longer functioning preventing the flow of hormones

18
Q

what kind of hypothyroidism does a high TSH indicate?

A

primary as indicates that the thyroid is not working to produce hormones for negative feedback

19
Q

what is the treatment of hypothyroidism?

A

synthetic thyroxine to replace T4

20
Q

what makes type I diabetics more likely to suffer with hypothyroidism?

A

autoimmunity may damage the thyroid

21
Q

what is Grave’s disease?

A

hyperthyroidism

22
Q

what could hyperthyroidism be caused by?

A

toxic multi nodular goiter, TSH secreting pituitary tumour, molar pregnancy

23
Q

what are the common symptoms of graves disease?

A

hyperactivity, insomnia, excessive sweating, weight loss, increased defecation

24
Q

what are the less common symptoms of hyperthyroidism?

A

loose nails, impotence, nausea or vomiting

25
Q

what is a goiter?

A

swollen thyroid gland

26
Q

what does an assessment of the goiter include?

A

size, painfulness, smoothness, is it causing issues to breathing

27
Q

what things indicate diagnosis of hyperthyroidism?

A

TSH suppressed due to high T4, toxic multi nodular goiter, check T3 in case of thyrotoxicosis, check response to TSH

28
Q

what is the treatment of hyperthyroidism? how does it work?

A

radioactive iodine as this is transported to the thyroid and so will kill the tissue that is producing too much hormone

29
Q

what patients cannot have radioactive iodine treatment?

A

children or pregnant women

30
Q

what are the issues with radioactive iodine?

A

increases chances of hypothyroidism as cannot now produce enough hormone

31
Q

what drugs can be used to treat hyperthyroidism?

A

propylthiouracil and propranolol

32
Q

what does propylthiouracil do?

A

blocks thyroid hormone synthesis

33
Q

what does propranolol do?

A

blocks hormone effects by inhibiting conversion of T3 to T4

34
Q

how is thyroiditis caused?

A

by viral infections

35
Q

what are the symptoms of thyroiditis?

A

tender thyroid with fever and malaise

36
Q

how can thyroiditis be treated?

A

using beta blockers such as propranolol

37
Q

what is Hashimoto’s thyroiditis?

A

inflammation of the thyroid causing hypothyroidism

Medical Pathophysiology (16 decks)

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