Chapter 76 Flashcards

1
Q

The thyroid is found below what?

A

The Larygneal prominence.

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2
Q

What 3 things will the thyroid gland control?

A
  1. How quickly the body burns energy. 2. How quickly the body makes proteins. 3. How sensitive the body should be to other hormones.
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3
Q

What is the major cell type in the thyroid gland?

A

Follicular.

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4
Q

What is the difference between T3 and T4?

A

T3 is 4 times as biologically active.

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5
Q

Thyroglobulin stores what?

A

Tyrosine

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6
Q

Where is thyroglobulin made and stored?

A

Made and stored in the thyroid gland.

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7
Q

What directly influences the trapping of iodine in the thyroid gland?

A

TSH

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8
Q

What happens to the thyroid gland in areas of the world with iodine lacking from diet?

A

They get enlarged and swollen, because there is a surge of TSH.

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9
Q

What is the Number 1 cause of thyroid problems worldwide?

A

Iodine deficiency

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10
Q

What is the Number 1 cause of thyroid problems in the U.S.?

A

Autoimmune disease.

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11
Q

93% of the hormone created in the thyroid gland is what (give both names)?

A

thyroxine aka T4

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12
Q

What is iodine recyling?

A

75% of tyrosine remains as mono- and diiodotyrosine which can be cleaved by deiodinase enzymes resulting in free iodine that can be used again.

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13
Q

An absence of deiodinase enzyme will result in what?

A

An iodine deficiency.

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14
Q

Only what form of T3 can be biologicaly active?

A

Only free thyroid hormones that don’t have a plasma protein bound to them.

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15
Q

T3 or T4 which hormone has a greater binding affinity for plasma proteins?

A

T4.

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16
Q

How long will it take for T3 and T4 hormones to be released to the tissues?

A

T3- 50% every day. T4- 50% every 6 days.

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17
Q

In general thyroid hormones do what?

A

Increase metabolic activity.

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18
Q

Hypothyroid equals what?

A

Retarded physical growth.

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19
Q

Hyperthyroid equals what?

A

Excessice growth.

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20
Q

What are the thyroid hormones effects of carbohydrates and fats?

A

They stiumulate almost all aspects of carbohydrate and fat metabolism.

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21
Q

Thyroid hormone is inversely proportional to what?

A

Total serum cholesterol levels.

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22
Q

Low levels of thyroid hormone leads to what?

A

Excessive deposition of fat in the liver and severe atherosclerosis.

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23
Q

What will excess thyroid hormone secretin do to basal metabolic rate (BMR)?

A

Can increase it up to 60-100%.

24
Q

A relative vitamin deficiency can occur when?

A

With thyroid hormone excess.

25
Q

Increased thyroid hormones will do what to cardiovascular function?

A

Increase the blood flow and therefore increase the cardiac output as much as 1.5 times normal.

26
Q

Severe hyperthyroid may lead to what?

A

Myocardial failure.

27
Q

What are the sexual effects of thyroid problems in women and men?

A

Women- menorrhagia, polymenorrhea, oligomenorrhea, or amenorrhea. Hypothyroid = low libido. Men- Hypothyroid= low libido, and hyperthyroid = impotence.

28
Q

How will hyper and hypothyroidism effect GI motility?

A

Hyper- diarrhea and hypo- constipation.

29
Q

How will hyper and hypothyroidism effect the excitation of the CNS?

A

hyper- nervousness, anxiety, paranoia. Hypo- poor memory, concentration problems.

30
Q

How will hyperthyroidism effect muscle function?

A

weakness and muscle tremors.

31
Q

how will hypothyroidism effect muscle function?

A

Sluggishness with delayed slow DTR.

32
Q

How will hyper and hypothyroidism effect sleep?

A

Hyper- insomnia and eventual exhaustion due to over-stimulated CNS. Hypo- Hypersomnia= tendency to sleep excessively.

33
Q

What happens to the endocrine glands with hyperthyroidism?

A

general spike in metabolism.

34
Q

Increased TSH can do what to the thyroid gland?

A

Increase in thyroglobulin stored and can cause T3/T4 to be released within 30 minutes.

35
Q

Is a TSH test alone enough to determine thyroid problems?

A

No.

36
Q

What other tests besides TSH should be done?

A

T3 and T4.

37
Q

Why would autoantibodies be tested in connection to thyroid problems?

A

Because autoimmune disease is the number 1 cause of thyroid problems in the U.S.

38
Q

What type of imaging is good to test glands?

A

Ultrasound.

39
Q

What will a possible cancer nodule on the thyroid gland look like?

A

Irregular border.

40
Q

What is used to perform a scintigraphy of the thyroid gland?

A

Radioactive iodine-123.

41
Q

What is the medical treatment of hypothyroidism?

A

Levothyroxine which is a stereoisomer of thyroxine (T4) once a day, and it degrades slower.

42
Q

Graves disease is an autoimmune disease of thyroditis and how is it treated?

A

Thioamide drugs.

43
Q

How are thyroid tumors and hyperthyroidism treated?

A

With radioactive iodine.

44
Q

cancer?

A

Percutaneous Ethanol injections.

45
Q

What is the perferred treatment for thyroid cancer?

A

A complete thyroidectomy.

46
Q

What happens to the Basal metabolic rate with hypothyroidism?

A

It can fall to 40-50% of normal.

47
Q

What are the symptoms of hypothyroidism that were highlighted in the notes?

A

Fatigue, weight gain, Thinning of outer 1/3 of eyebrow, Heat intolerance, impaired memory, osteoporosis, high serum cholesterol, Decreased libido, decreased sense of smell and taste.

48
Q

What is Hashimoto’s disease?

A

hypothyroidism.

49
Q

What happens with hyperthyroidism?

A

Increased activity.

50
Q

What happens to the Basal metabolic rate with hyperthyroidism?

A

It can rise to 60-100% above normal.

51
Q

What happens to wight and appetite with hyperthyroidism?

A

Major clinical weight loss and ravenous appetite.

52
Q

What type of treatment is given for hyperthyroidism?

A

suppressive thyrostatic medicatin and surgery, or radioisotope therapy.

53
Q

What will all approaches to treat hyperthyroidism have as a possible side effect?

A

May cause under activity of thyroid gland. So thyroid hormones will be supplemented.

54
Q

What do Beta-blockers do for treatment of hyperthyroidism?

A

They only mask the common symptoms like palpitations, trembling and anxiety.

55
Q

What is the radioactive iodine given to destroy the hyperactive thyroid gland?

A

Iodine-131