Endo 3 - Thyroid

Question 1

Thyroid axis

Answer 1

TRH =>+ TSH =>+ T4, T3

Question 2

T4, T3 inhibits what?

Answer 2

TRH and TSH release

Question 3

anatomy at risk during thyroid surgery

Answer 3

parathyroid glands and recurrent laryngeal

Question 4

cells adjacent to thyroid follicle

Answer 4

C cells - calcintonin

Question 5

source of iodine for humans

Answer 5

diet

Question 6

minimum level of iodine to avoid hypothyroidism

Answer 6

100 ug/d

Question 7

iodine is ingested and then (1) by thyroid and then (2) to iodine by (3)

Answer 7

1) trapped
2) oxidized
3) thyroid peroxidase

Question 8

Thyroid makes (1) and secretes it into colloid, (2) is added to (3) in (1) to make (4)

Answer 8

1) thyroglobulin
2) iodine
3) tyrosine
4) T3, T4

Question 9

how do thyroid hormones circulate?

Answer 9

bound to proteins

Question 10

T/F T3/T4 must be nonbound to be taken up by tissue

Answer 10

T (<.5% actually free)

Question 11

T4 = (1)% and T3 = (2)%

Answer 11

1) 85

2) 15

Question 12

target of thyroid hormone

Answer 12

thyroid receptor on DNA => increased transcription

Question 13

T/F T3 decreases some things in your body

Answer 13

F

Question 14

useful chemistry tests for hypothyroidism

Answer 14

TSH and free T4 (T3 not as good of a test)

Question 15

mild hypothyroidism (high TSH, regular T4) is how prevalent? %

Answer 15

5-15%

Question 16

goiter is likely during primary or secondary hypothyroidism

Answer 16

primary

Question 17

tx of hypothyroidism

Answer 17

T4, goal = normal TSH and free T4

Question 18

too much T3 T4 =

Answer 18

thyrotoxicosis

Question 19

symptoms of T3/T4 excess

Answer 19

weight loss, vasodilation, warm skin, more appetite, bone turnover

Question 20

two types of thyrotoxicosis

Answer 20

hyperthyroidism and thyroiditis

Question 21

chance of a fib in thyrotoxicosis

Answer 21

10%

Question 22

causes of thyrotoxicosis

Answer 22

graves, tsh receptor mutation, viral/immune, iodine, exogenous, excess tsh (rare)

Question 23

hyperthyroid = high/low iodine uptake?

Answer 23

higher iodine uptake

Question 24

cause of thyroid eye disease

Answer 24

buildup of mucopolysaccharides and lymphocytes

Question 25

symptoms of thyroid eye disease

Answer 25

double vision, eye congestion

Question 26

tx of hyperthyroidism

Answer 26

radioactive iodine (70%), anti-thyroid (29%), surgery (1%)

Question 27

anti-thyroid drugs

Answer 27

methimazole and propylthiouracil

Question 28

black box warning of PTU

Answer 28

hepatotoxicity but used in pregnancy

Question 29

rare blood complication of antithyroid drugs

Answer 29

agranulocytosis

Question 30

thyroid hormone levels in thyroiditis initially

Answer 30

very high due to dump of TH (thyrotoxic)

Question 31

causes of thyroiditis

Answer 31

autoimmune, viral, radiation, drugs

Question 32

radioiodine uptake high or low in thyroiditis

Answer 32

low

Question 33

high iodine levels in patients affects radioiodine uptake levels how?

Answer 33

decreases uptake due to competition from other sources

Question 34

thyroid states associated with goiter

Answer 34

hyperthyroidism, primary hypothyroidism (High TSH), euthyroid

Question 35

how does a euthyroid work in goiter?

Answer 35

thyroid is defective but AP secretes more TSH = normal T3/T4

Question 36

HR in thyrotoxicosis`

Answer 36

elevated

Question 37

T/F you can see edema in both hypo and hyperthyroidism

Answer 37

Ta