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ENR Biweekly 3 > Balczon- Thyroid > Flashcards

Balczon- Thyroid Flashcards

1
Q

hormones produced from thyroid gland

A

T3 and T4
calcitonin

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2
Q

unique to thyroid gland; how it stores T3 and T4

A

extracellularly

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3
Q

thyroid gland extends down from what that takes origin in tongue

A

thyroglossal duct

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4
Q

blood supply to thyroid

A

superior and inferior thyroid a.

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5
Q

neural input to thyroid

A

sympathetics

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6
Q

lymphatic drainage of thyroid

A

prethyroid and prelaryngeal nodes

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7
Q

basic functional unit of thyroid

A

follicles

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8
Q

protein that is storage form of T3 and T4 in colloid of follicle

A

thyroglobulin

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9
Q

cells that produce T3 and T4

A

follicular

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10
Q

cells that produce calcitonin

A

parafollicular cells

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11
Q

_____ is stored in secretory granules of parafollicular cells

A

calcitonin

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12
Q

derived from 4th pharyngeal pouch

A

parafollicular cells

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13
Q

standard protein producing cell
rER to golgi to secretory granules

A

parafollicular cells

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14
Q

controlled directly by extracellular calcium

A

parafollicular cells

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15
Q

secreted when there is elevated Ca2+ in blood and blocks osteoclasts to allow Ca2+ to go from blood to bone and bring levels down

A

calcitonin

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16
Q

antagonist of parathyroid hormone

A

calcitonin

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17
Q

steps of thyroid hormone production

A
  1. thyroglobulin is made and released into lumen of follicle
  2. uptake of iodine through Na+/I symporter
  3. pendrin brings iodine into lumen
  4. thyroperoxidase takes iodine and attaches it to tyrosine residues on thyroglobulin
  5. thyroperoxidase couples iodinated phenol rings to another making T3 and T4
  6. TSH binds and causes endocytosis of thyroglobulin
  7. lysosomes digest thyroglobulin and release T3 and T4
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18
Q

tyrosine residue with 3 iodines attached

A

T3

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19
Q

tyrosine with 4 iodines attached

A

T4

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20
Q

how many month supply of iodinated thyroglobulin

A

3-4 months

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21
Q

main cause of hypothyroidism in developed countries

A

Hashimoto’s

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22
Q

main cause of hypothyroidism in underdeveloped countries

A

iodine deficiency

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23
Q

caused by autoantibodies generated against thyroperoxidase (T3 and T4 not being produced)

A

Hashimoto’s disease

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24
Q

to diagnose hashimoto’s disease

A

elevated TSH
low to zero T4

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25
Q

_____% T3 and _____% T4

A

10% T3
90% T4

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26
Q

____ from hypothalamus is released and goes through hypophyseal portal vein to anterior pituitary and causes release of TSH

A

TRH (thyrotropin releasing factor)

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27
Q

alpha/beta dimer with the beta portion having specificity for the hormone

A

TSH

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28
Q

released _____ goes to thyroid gland and binds to TSH receptor

A

TSH

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29
Q

what 2 things happen when TSH binds to its receptor on follicle of thyroid

A
  1. thyroglobulin uptake and digestion (release of T3 and T4)
  2. activates thyroglobulin synthesis
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30
Q

when T3 and T4 levels are increased what is the feedback inhibition

A

neg. feedback to TSH and TRH

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31
Q

Gs (cAMP) receptor on basolateral surface of follicular cells

A

TSH receptor

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32
Q

main cause of hyperthyroidism worldwide

A

Grave’s disease

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33
Q

caused by autoantibodies that stimulate TSH receptor (too much T3 and T4 produced)

A

Grave’s disease

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34
Q

to diagnose Grave’s disease

A

decreased TSH (autoantibodies doing the work without TSH input)
elevated T4

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35
Q

main transporter for T3 and T4 in the blood

A

thyroxine binding globulin (TBG)

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36
Q

what happens in pregnancy to thyroid

A

increased in thyroxine binding globulin and increase in total T4 (not free T4)

37
Q

minor transporter for T3 and T4

A

albumin

38
Q

are T3 and T4 active or inactive when bound to thyroxine binding globulin (TBG)

A

inactive

39
Q

are T3 and T4 stable or unstable when bound to TBG

A

stable

40
Q

2 monocarboxylic transporters that bring T3 and T4 into cells

A

MCT 8 and 10

41
Q

thyroid hormone receptor in the cell is a heterodimer and can bind what two things

A

thyroid hormones (T3 and T4)
retinoic acid

42
Q

does T3 or T4 bind well to its receptor

A

T3

43
Q

_______ convert T4 into T3 to allow it to bind to receptor and induce its effects

A

deiodinases

44
Q

prohormone w/ T3 being the active form

A

T4

45
Q

deiodinases type I are located at ________ and inactivate T3 and T4 by clipping off iodione

A

liver and kidney

46
Q

deiodinases type II are located where

A

at target cells

47
Q

what happens if the wrong iodine is clipped off in the liver and kidney

A

reverse T3 (it will bind to its receptor still but doesn’t activate it)

48
Q

rT3 (reverse T3) will show up as what

A

hypothyroidism

49
Q

stress causes an increase in ______ which will activate deiodinases to clip off wrong iodine and cause rT3 and hypothyroidism

A

cortisol

50
Q

type I thyroid hormone receptor is found where and activates genes to increase metabolism

A

target tissues

51
Q

type II thyroid hormone receptor is found where and is the part of the mechanism for feedback inhibition

A

hypothalamus and anterior pituitary

52
Q

effect of thyroid hormones on metabolism

A

heat

53
Q

effect of thyroid hormones on development

A

nervous system

54
Q

if deficient in thyroid hormones, what happens to baby

A

cretinism (mentally deficient and short limbs)

55
Q

______ hormone assists with IGF-1

A

thyroid hormone

56
Q

effect of thyroid hormones on adults

A

brain health

57
Q

effect of thyroid hormones on growth

A

IGF-1 production and release

58
Q

_____ also plays a role in reproductive health

A

thyroid hormones

59
Q

L and R

A

L: thyroid gland
R: parathyroid gland

60
Q

basic functional unit of thyroid gland

A

thyroid follicle

61
Q

consists of a single layer of follicular cells that surround a colloid-filled cavity

A

thyroid follicle

62
Q

main component of the colloid that is the storage form of the thyroid hormones (T3 and T4)

A

thyroglobulin

63
Q

located b/t follicles and produce calcitonin

A

parafollicular cells

64
Q

inhibits TSH secretion

A

octreotide

65
Q

inhibit thyroid peroxidase (thyroperoxidase), thyroid hormone synthesis

A

sulfonamides

66
Q

inhibit thyroid hormone release

A

Iodine and lithium

67
Q

Glucocorticoids, amiodarone, β-blockers, oral cholecystographic agents (such as sodium ipodate) inhibit ______

A

T4 to T3 conversion

68
Q

increases the synthesis of thyroid binding globulin

A

estrogen

69
Q

inhibit thyroid hormone reabsorption in gut

A

Cholestyramine

70
Q

diagnosis?

A

hypothyroidism

71
Q

main treatment of hypothyroidism (synthetic T4 hormone)

A

Levothyroxine

72
Q

treatment of myxedema coma (extreme expression of severe hypothyroidism)

A

IV T4 and T3

73
Q

diagnosis?
most common cause of this?

A

hyperthyroidism
Grave’s disease

74
Q
A

hyperthyroidism

75
Q

used to block sympathomimetic effects of hyperthyroidism used in early stages of Grave’s disease

A

beta blockers (propranolol, atenolol)

76
Q

to definitively treat Grave’s

A

total thyroidectomy, followed by thyroid replacement therapy

77
Q

another way to destroy overactive thyroid cells

A

radioactive iodine (I131)

78
Q

Inhibit iodine organification and coupling in the thyroid gland (steps catalyzed by the enzyme thyroidal peroxidase)

A

PTU and MMI (thionamides)

79
Q

_____ is drug of choice to treat Grave’s disease longer term

A

MMI

80
Q

_____ is used to treat Grave’s disease in pregnant pt in 1st trimester

A

PTU

81
Q

____ is used to treat Grave’s disease in pregnant patient in 2nd and 3rd trimester

A

MMI

82
Q

the drug of choice to treat Grave’s disease during breastfeeding, as it is not found in mother’s milk

A

MMI

83
Q

Life-threatening complication of thyrotoxicosis, often precipitated
by infection, stress, trauma, heart disease, diabetic ketoacidosis

Associated with fever, tachycardia, nausea, agitation, confusion, increase
in catecholamines, increase in blood pressure

A

Thyroid storm

84
Q

Propylthiouracil, β-adrenergic antagonists and hydrocortisone used to treat what

A

Thyroid storm

85
Q

Propylthiouracil, β-adrenergic antagonists and hydrocortisone all
inhibit _______

A

T4 to T3 conversion

86
Q

most common form of thyroid cancer

A

Papillary thyroid cancer

87
Q

to treat thyroid cancer

A

thyroidectomy
radioactive iodine ablation

88
Q

________carcinoma of the thyroid will not take up iodine and is treated with surgery, external radiation therapy, and chemotherapy including tyrosine kinase inhibitors

A

medullary

89
Q

_______is a fully humanized monoclonal antibody to the IGF-1 receptor for the treatment of proptosis, or the outward bulging of the eye, associated with Graves disease

A

Teprotumumab (Tepezza)

ENR Biweekly 3 (14 decks)

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