Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y2 Endocrinology > Amine Hormones > Flashcards

Amine Hormones Flashcards

1
Q

Cause of exophthalmos in TED

A

Due to increase GAGs via TSH receptors when TRAbs bind to them.( Due to production of fibroblasts).
Also due to adipocytes producing adipose tissue.
All these causes swelling in muscles and tissue behind the eye.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Cause of thyroid signs in pregnancy despite low TRab

A

Due to high hCG that induces transient hyperthyroidism - increases T 3 and T4 and decreases TSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causes of temporary thyoriditis

A

Viral or pospartum,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Causes of thyroiditis

A

Pregnancy, infection, autoimmune or drugs like amiodarone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Changes to deiodinase in illness

A

Conversion of T4 to T3 is impaired due to oxidative stress, altered redox state of cell and cytokine release so T3 levels also fall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Common causes of hypoT

A

Thyroiditis accounts for 90%- Hashimoto’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Do thyroid hormones behave more like steroid hormones or peptide hormones

A

Steroid hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Four actions of thyroid hormone and pathogenic effects

A

Growth and development
Basal metabolic rate - hot and sweaty, rapid heart rate, bowels move too fast (diarrhea)
Thermogenesis in brown adipose tissue(feel hot)
Activate mental processes ( nervous and irritable, reduce concentration, slowed down thinking, low mood and depression)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does free hormones fraction change in illness

A

Rises due to binding proteins like albumin being affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does illness affect TRH levels

A

Release from hypothalamus suppressed by cytokine (IL-1 and TNFa) and glucocorticoids like cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how is fT4 in NTI

A

usually within reference range or moderately raised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How many Tyrosine rings in each hormone? What else is included

A

Catecholamines-1
Thyroid hormone- 2 + Iodine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How to differentiate TFTs in I’ll patients and patients with thyroid disease

A

Illness may increase fT4 and suppress TSH but will have low T3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Is glucose likely to be high or low in hyperT and why

A

Low due to increased metabolism of Cortisol in liver and increased metabolic demands which increases glucose uptake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Is TRAb high in thyroiditis

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Is TSH high or low for all cases of hyperthyroidism
fT4

A

Low
High

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Is tT3 or fT4 preferred for diagnosing Hyperthyroidism and why?

A

tT3 may be raised in patients with OCOP because of increased synthesis of thyroid binding globulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Main cause of subclinical hypothyroidism

A

Autoimmune chronic thyroiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Main management of TED and additional measure

A

Manage in joint thyroid eye clinic
Achieve euthyroidism
Cease smoking
Topical lubricants for dry eyes
Selenium (200mcg daily as antioxidant)
Steroids for active eye disease

Add- rituximab and other additional immunosuppressants
Orbital dadiotherapy
Surgical decompression if raised intraocular pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Main signs of thyroiditis

A

Neck discomfort and prodromal flu symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Past medical history to check in thyorid cases

A

Asthma- propranolol contraindicated
Rheart disease- risk of AF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Percentage of free T4

A

0.05%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Problems of I131

A

Need to avoid pregnancy for 6 months and restrict contact with children under 12 and pregnant women
Need to limit close contact with partner for 11 days
Risk of long term hypoT- higher for graves than TMNG or solitaryi nodule (80% for graves)
Risk of TED flaring up after treatment for Graves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Problems with hypothyroidism in pregnancy (overt Vs subclinical)

A

Infertility, miscarriage, pre-eclampsia, premature delivery, increased foetal mortality and impaired neurological development Vs neurodevelopmental delays and placental abruption

25
Q

Risks of surgery for hyper T

A

Damage to recurrent laryngeal nerve and PT glands
May need thyroxine treatment

26
Q

Symptoms and signs of hyperthyroidism

A

Weight loss despite very good appetite
Tiredness
Tremor
Hot and sweaty
Light or absent menses
Irritable or anxious
Eye disease (red, gritty, painful, double vision)
Muscle wasting

27
Q

Symptoms of hypoT

A

Tired
Weight gain and puffy eyes and skin
Cold intolerance
Bradyc
Constipation
Dry hair and skin
Heavy periods
Hyperlipidemia
Goitre

28
Q

Three kinds of thyroid binding proteins

A

Albumin 10%
Transthyretin 20%
Thyroid binding globulin 70%

29
Q

Treatment for thyroiditis

A

Treatment with beta blockers but eventually commence thyroxine

30
Q

Treatment of hypoT

A

Levothyroxine

31
Q

Treatment regimen for graves

A

ATD first (12-18 months)
If recurrent use I131

32
Q

Treatment regimen for TMNG

A

I1311 as no chance of long term remission with course of tablets

33
Q

What amino acids are amines hormones derived from?
What do they make respectively

A

Tryptophan - Melatonin in Pineal Gland
Tyrosine- Catecholamines and thyroid hormones

34
Q

What are the main treatments for hyper T

A

ATD like Carbimazole which blocks TPO

35
Q

What can secondary hypo T be due to and what should be used to judge adequate replacement

A

Non functioning pituitary macroadenoma
fT4 levels to judge adequate replacements

36
Q

What causes goitre in Graves

A

Due to trophic effects of TRABs

37
Q

What conditions have TPO present

A

Graves
Underactive thyroid disease eg. Primary autoimmune thyroid failure
Autoimmune disease like Hashimoto’s

38
Q

What drug can cause hypoT

A

Lithium

39
Q

What enzyme is involved in the conversion of T4 to T3

A

Deiodinase enzyme

40
Q

What examination sign is almost diagnostic of graves

A

Bruit over goitre- rushing noise heard with stethoscope due to increased vascular flow

41
Q

What happens after colloid reabsorption

A

Proteolysis by lysosome to release T4

42
Q

What happens to T3 on disease and why

A

T3 is reduced due to impaired T4 uptake in the liver and hence conversion of T4 to T3

43
Q

What inhibits TSH release and what happens to TSH during illness

A

DA
Carbohydrate residues on TSH may be modified in NTI- affecting biological activity and plasma half life

44
Q

What is the cause of high fT4 in thyroiditis

A

Due to damage from infection resulting in follicles spilling out

45
Q

What is the recommended management of subclinical management

A

Treat is TSH> 10 on 2 occasions and/or TPOs are strongly positive

46
Q

What is the treatment for papillary carcinomas

A

Total thyroidectomy and ablative dose of radioiodine and lifelong T4 replacement to prevent TSH from stimulating recalcitrant cancer cells

47
Q

What medications impair T4 absorption

A

PPIs like Omeeprazole and lansoprazole
H2 antagonists like ranitidine
Iron, calcium and aluminium
All must take > 4 hrs before T4

48
Q

What serum tumour marker for papillary carcinoma for thyroid

A

Thyroglobulin

49
Q

What should be normalised in primary and secondary hypoT

A

Primary - normalise TSH
secondary - normalise fT4

50
Q

When in gestation is maternal T4 used exclusively

A

Till 10/40, partially thereafter

51
Q

When is T4/T3 needed for foetus and why

A

From 4-5/50 for development of CNS and growth and metabolism of foetus

52
Q

When should surgery be considered for Hyper T

A

Patients with large goitre or eye disease or relapse of Graves r

53
Q

When to increase dose of T4 for hypo G and why

A

if starting oestrogen or anticonvulsants
Antic speeds up breakdown of T4
Oestrogen increases level of Thyroid binding globulin

54
Q

Where is T4 converted into T3

A

Liver, muscle and kidney

55
Q

Why is heart rate increased in Hyperthyroidism

A

Due to increased B receptor activation

56
Q

Why might there be dyspnoea in hyperthyroidism

A

Increased Co2 production by T4/T3

57
Q

What happens to TSH levels in disease

A

Can be suppressed acutely but rises on recovery, may be misinterpreted as hypothyroidism

58
Q

Should total or free thyroid hormone levels be measured in pregnancy and why

A

Free, as oestrogen increases synthesis of TBG

Y2 Endocrinology (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions