Endocrine 2 Flashcards

1
Q

Where are thyroid hormones stored?

A

Extracellularly for 2-3 months

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2
Q

Hypothalamus secretes ___ which stimulates pituitary gland to secrete ___ which stimulates thyroid to secrete ___ and ____

A

TRH
TSH
T3/T4 can now turn off hypothalamus and pituitary

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3
Q

percentages in pop with hypo or hyper thyroidism

A

80% have hypo. T3 and T4 are low. TSH is high.

20% have hyper T3 and T4 are high. TSH is low.

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4
Q

1 cause of hypothyroidism in US and world.

A

US: Hashimotos 90-97%
World: Insufficient iodine intake

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5
Q

Hypothyroidism ocular symptoms

A

1/3 of eyebrows missing (queen Ann’s sign)
Superior limbit keratoconj
Exophthalmos

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6
Q

Symptoms of hashimotos

A

Myxedema- deposition of mucopolysaccharides. Causes edema.

Lethargy, cold intolerance, decrease ap, weight gain.

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7
Q

Tx hashimotos with

A

levothyroxine / synthroid

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8
Q

Main cause of hyperthryoidism

A

Graves autoimmune disease. 60-80%

Others: Goiter, excess iodine.

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9
Q

What autoimmune disease is most commonly associated with TED

A

Graves

50% of graves pt’s develop TED

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10
Q

Thyroid eye disease

A

Lymphocytic infiltration of orbital soft tissue.

Fibroblasts deposit mucopolysacharids and cause edema (myxedema) = enlarged EOMs.

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11
Q

Most common cause of proptosis/diplopia in adults

A

TED.
Myxedema causing swelling/enlarged EOMs.
Could be unilateral or bilateral

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12
Q

___% of graves pt’s develop TED

__% of TED patients have graves

A

50

85

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13
Q

Is TED severity related to severity of systemic disease?

A

No

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14
Q

Contraindications if pt has TED

A

smoking!

4x increased risk of TED

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15
Q

Early and late signs of TED

A

Early- eyelid retraction (90%)

Late- exophthalmos (60%) and EOM restriction/diplopa (40%)

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16
Q

TPO/thyroperioxidase

A

Enzyme that synthesizes T3/T4. May see TPO antibodies in both hashimotos and graves, although more common in hashimotos. (95%)

17
Q

Which thyroid disease would you see a TSH receptor antibody?

A

Graves (90%)

18
Q

Response to low serum calcium levels

A

Parathyroid secretes PTH to raise Calcium levels in the blood by increasing osteoclast activity and increasing calcium reabsorption

19
Q

Response to high serum calcium levels

A

Parafollicular cells in thyroid secrete calcitonin to lower serum calcium levels.
Calcitonin tones ur bones!

20
Q

75% of hypoparathyroidism is due to

A

Neck surgery

21
Q

Result of hypoparathyroidism

A

Hypocalcemia, increased phosphorus levels.
(PTH usually increases serum calcium levels. Without, will result in low calcium)

Causes muscle cramps and paresthesia.
Ocular: Cataracts

Decreased PTH, decreased calcium, increased phos

22
Q

85% of hyperparathyroidism is due to

A

Parathyroid adenoma.

23
Q

Result of hyperparathyroidism

A
Excess PTH secreted, resulting in an increased level of calcium in the blood. 
95% only involve 1 of 4 glands
Symptoms- 50-80% are asymptomatic 
Osteoporosis 
Kidney stones 

Will see increase in PTH, increase in calcium and decrease in phos

Ocular: Band keratopathy due to calcium build up
Conj concretions in palpebral conj

24
Q

Ocular results of hypo and hyperparathyroidism

A

Hypoparathyroidism- Decrease PTH = decrease calcium levels. Cataracts.

Hyperparathyroidism- Increase PTH= increase calcium levels. Band keratopathy and palpebral conj concretions.
*Most people are asymptomatic tho

25
Vitamin D deficiency can result in what based off age
Rickets in children Osteomalacia in adults (Softening and weakening of bones)
26
Pineal gland location
Posterior midbrain in the brainstem | produces melatonin
27
Parinaud syndrome
Pineal gland tumor. Upward gaze deficit - sunset Dx with MRI Due to pinealoma or hydrocephalus Signs: Lid retraction, papilledema, nystagmus.
28
Causes of parinaud syndrome/Dorsal midbrain syndrome.
Due to pinealoma or hydrocephalus (accumulation of CSF in the brain)
29
Thyroid gland targets which cells in the body
All
30
Thyroid gland regulates
The basal metabolic rate. | O2, body temp, gastric motility, HR
31
Why do you get a goiter with hypo and hyperthyroidism?
Hypo- body trying to stimulate it | Hyper- due to overaction
32
How to treat hyperthyroidism
Radioactive iodine= TOC
33
Most common cause and symptoms of hypoparathyroidism and hyper
Hypo- neck surgery (80%), muscle cramps, numb limbs, brittle nails/hair. Hyper-Parathyroid adenoma, asymptomatic