Diseases and what to expect clinically

Question 1

Hypothyroidism

Answer 1

Metabolism SLOWS DOWN

lethargy, fatigue, weakness, dyspnea on exertion, cold intolerance (feel cold all the time)

just remember SLOWS DOWN

Question 2

Hyperlipidemia is associated with what disease?

Answer 2

Hypothyroidism

higher cholesterol and LDL cholesterol, but the mechanism for hypothyroidism is A DECREASE IN LDL RECEPTOR DENSITY

T3 upregulates LDL gene activation

clearance of LDL and cholesterol slows down

Question 3

Hyperthyroidism

Answer 3

Metabolism SPEEDS UP

heat intolerant, hyperactivity, weight loss, increased appetite, diarrhea, hyperreflexia

Question 4

Goiter caused by what

Answer 4

High TSH, but inability to produce T3/T4

Due to iodine deficiency

Graves

Question 5

Primary disease of Hypo and Hyperthyroidism and T3/T4 and TSH?

Answer 5

Hypo: High TSH, low T3/T4

Hyper: Low TSH, high T3/T4

Question 6

Grave’s disease?

what’s causing it

what levels are TSH

most common clinical sign?

what test is good to use

Answer 6

Hyperthyroidism

autoimmune. thyroid stimulating antibodies are producing a bunch of stuff to mimic TSH but it’s not TSH.

TSH are low

Presence of exophthalmos (bulging of eyes)

thyroid stimulating immunoglobulins

Question 7

PTU (propylthiouracil)

Answer 7

inhibits TPO and inhibits the conversion of T4 to T3

Question 8

Iodine deficiency.. what do you think of?

Answer 8

Goiter… Hypothyroidism

Question 9

Iodine excess?

Answer 9

wolff-chaikoff effect –> inhibits organification.

so this will lead to hypothyroidism due to the wolff-chaikoff effect

Question 10

Congenital Hypothyroidism?

Answer 10

TH is required for normal bone growth/CNS maturation

Cretinism, caused by iodine deficiency, thyroid dysgenesis, abnormal TPO.

Question 11

Hashimoto’s thyroiditis?

Answer 11

most common cause of hypothyroidism that is non-iodine related from diet

autoimmune.. T cells attack the thyroid causing B cell activation

HLA-DR5

Question 12

Other than glucose, what also triggers the release of insulin?

Answer 12

Amino Acids

Question 13

Insulin release is inhibited by epinephrine how?

which is dominant.

Answer 13

if it binds to the alpha 2 receptors. (dominant)

if it binds to the beta 2 receptors, insulin is upregulated

Question 14

Effects of Insulin:

Answer 14

increase uptake

glycogen synthesis

inhibits GNG

Fatty acid synthesis

Protein synthesis

lowers potassium

think WEIGHT GAIN

Question 15

Glucagon on the liver (not on muscle)?

Answer 15

glycogen breakdown

GNG

increases amino acid uptake in the liver for production of glucose through GNG!!!

activates lipolysis via hormone sensitive lipase!

Question 16

Anterior Pituitary Hormones that are cyclic AMP type?

what about from the parathyroid gland?

Hypothalamus?

Answer 16

FSH, LH, ACTH, TSH

PTH, Calcitonin

CRH, GHRH

Question 17

Of the Hypothalamus and pituitary gland, what runs off of an IP3 type of system?

Answer 17

GnRH, TRH in the hypothalamus

Oxytocin and ADH from the posterior pituitary