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Clinical Chemistry 2 - CEUMLS > Endocrinology Part 2 (Thyroid and Parathyroid) > Flashcards

Endocrinology Part 2 (Thyroid and Parathyroid) Flashcards

1
Q

Thyroid is butterfly-shaped due to?

A

bilobed structure

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2
Q

type of T3 that is biologically inactive

A

rT3 (reverse T3)

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3
Q

Location of iodine in T3

A

3, 5, 3’

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4
Q

Location of iodine in T4

A

3, 5, 3’, 5’

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5
Q

generation test that detects very minute amount of TSH

A

3rd gen

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6
Q

Due to parathyroid gland location, it is considered as?

A

smallest endocrine gland

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7
Q

Butterfly-shaped glands found in the lower anterior neck

A

thyroid gland

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8
Q

Tissue that connects 2 lobes of thyroid gland

A

isthmus

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9
Q

specific location of butterfly-shaped glands

A

lower anterior neck

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10
Q

functions of thyroid gland

A

Controls biosynthesis and release of TH from thyroglobulin

Regulates carbohydrates, proteins and lipid metabolism

Acts on CNS (by brain maturation and dev’t)

Stimulates the heart

Physical growth and development

Controls basal body temperature

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11
Q

how thyroid gland act on CNS

A

by brain maturation and development

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12
Q

body temp when there is ↑ TH

A

↑ body temp

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13
Q

oxygen consumption when ↑ TH

A

↑ O2 consumption / demand
(more cells consume O2)

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14
Q

hollow spheres of thyroid gland

A

colloid follicles

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15
Q

what type of tissue is follicle cells?

A

squamous epithelial cells, cuboidal cells

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16
Q

aka cuboidal cells

A

thyroid follicular cells

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17
Q

located within spherical structure

A

colloids

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18
Q

content of follicle cells, a gel-like matrix

A

colloids

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19
Q

has thyroglobulin within it

A

colloids

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20
Q

follicle cells are important for ______ synthesis

A

T3 and T4 synthesis

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21
Q

major component of thyroid colloids

A

thyroglobulin

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22
Q

important substance for TH synthesis

A

thyroglobulin

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23
Q

composition of thyroglobulin

A

2 tyrosine backbone

Each tyrosine backbone has 1 iodine binding site

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24
Q

how many iodine binding site is in each thyroglobulin

A

2

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25
Q

structures responsible for calcitonin production

A

parafollicular C cells

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26
Q

2 biologically active hormones

A

Triiodothyronine (T3)
Tetraiodothyronine/Thyroxine (T4)

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27
Q

more biologically active TH

A

Triiodothyronine (T3)

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28
Q

T3 pre-hormone

A

Tetraiodothyronine/Thyroxine (T4)

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29
Q

less biologically active (requires deiodination to become more biologically active)

A

Tetraiodothyronine/Thyroxine (T4)

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30
Q

enumerate steps for TH synthesis

A
  1. Iodide uptake
  2. Iodide → Iodine (oxidized)
  3. Iodine Uptake
  4. Iodination of tyrosine (thyroglobulin)
  5. Coupling reaction of iodinated tyrosine
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31
Q

what is acquired from diet that is necessary for TH synthesis

A

iodide

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32
Q

Iodide (I2) from diet will enter?

A

follicular cells (within follicular cells is colloid; colloid has thyroglobulin)

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33
Q

site of oxidation from iodide to iodine

A

colloid

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34
Q

process where iodine attaches to the tyrosine backbone of thyroglobulin

A

iodination of tyrosine (thyroglobulin)

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35
Q

1 iodine attached to thyroglobulin

A

monoiodothyronine

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36
Q

2 iodine attached to thyroglobulin

A

diiodothyronine

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37
Q

process of combination of two thyroglobulin with iodine

A

Coupling reaction of iodinated tyrosine

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38
Q

monoiodothyronine + diiodothyronine

A

triiodothyronine

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39
Q

diiodothyronine + diiodothyronine

A

tetraiodothyronine

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40
Q

important substance for TH synthesis

A

Iodine

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41
Q

Iodine deficiency indicates?

A

TH deficiency

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42
Q

removes 1 iodine atom from OUTER tyrosyl ring of T4 to produce T3 (biologically active form)

A

Monodeiodination

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43
Q

enzyme for the removal of 1 iodine atom from outer tyrosyl ring of T4 to produce T3

A

monodeiodinase

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44
Q

Combination of 2 thyroglobulin will form?

A

2 rings

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45
Q

Removal of iodine from outer ring produces?
Removal of iodine from inner ring produces?

A

T3

rT3 (reverse T3)

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46
Q

biologically inactive TH

A

rT3 (reverse T3)

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47
Q

regulation of TH follows this axis

A

hypothalamic pituitary thyroidal axis

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48
Q

secretes thyrotropin-releasing hormone (TRH)

A

hypothalamus

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49
Q

secretes thyroid-stimulating hormone (TSH)

A

pituitary gland

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50
Q

gland that produce TH (T3 & T4)

A

thyroid gland

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51
Q

after production of TH by thyroid gland? what is the next process?

A

TH (T3 & T4) acts on peripheral tissues with specific receptors

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52
Q

affected gland if a TH disorder is PRIMARY

A

thyroid

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53
Q

affected gland if a TH disorder is SECONDARY

A

pituitary

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54
Q

affected gland if a TH disorder is TERTIARY

A

hypothalamus

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55
Q

TH disorder classification if there is:

↑ TH
N/↓ TRH, TSH

A

primary hyperthyroidism

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56
Q

TH disorder classification if there is:

↓ TH
N/↑ TRH, TSH

A

primary hypothyroidism

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57
Q

TH disorder classification if there is:

↑ TSH, TH
N/↓ TRH

A

secondary hyperthyroidism

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58
Q

TH disorder classification if there is:

↓ TSH, TH
N/↑ TRH

A

secondary hypothyroidism

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59
Q

TH disorder classification if there is:

↑ TRH, TSH, TH

A

tertiary hyperthyroidism

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60
Q

TH disorder classification if there is:

↓ TRH, TSH, TH

A

tertiary hypothyroidism

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61
Q

hormone levels in primary hyperthyroidism

A

↑ TH
N/↓ TRH, TSH

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62
Q

hormone levels in primary hypothyroidism

A

↓ TH
N/↑ TRH, TSH

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63
Q

hormone levels in secondary hyperthyroidism

A

↑ TSH, TH
N/↓ TRH

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64
Q

hormone levels in secondary hypothyroidism

A

↓ TSH, TH
N/↑ TRH

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65
Q

hormone levels in tertiary hyperthyroidism

A

↑ TRH, TSH, TH

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66
Q

hormone levels in tertiary hypothyroidism

A

↓ TRH, TSH, TH

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67
Q

chemical name of T3

A

3, 5, 3’-triiodothyronine

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68
Q

Accounts for 20% of total TH synthesized

A

TRIIODOTHYRONINE (T3)

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69
Q

have the most active hormonal activity

A

TRIIODOTHYRONINE (T3)

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70
Q

Functions of T3

A
  • Metabolic rate of every cell of the body
  • Encourages cellular differentiation
  • Tissue growth and development
  • ↑ oxygen consumption
  • Calorie and Vitamin/Mineral metabolism
  • Indicator of hyperthyroidism recovery
  • Involve brain maturation
  • Cause ↑ heat production
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71
Q

Indicator of hyperthyroidism recovery

A

TRIIODOTHYRONINE (T3)

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72
Q

TH of heat intolerant individuals

A

increased (in cases of hyperthyroidism)

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73
Q

Reference Ranges of T3

A

Adult: 60-160 ug/dL

Children (1-14 y.o): 105 – 245 ng/dL

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74
Q

reason why there is increased values of T3 in children

A

T3 & T4 involvement in tissue growth and dev’t

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75
Q

chemical name of T4

A

3, 5, 3’, 5’ tetraiodothyronine

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76
Q

Accounts for 80% of total TH synthesized

A

TETRAIODOTHYRONINE (T4)

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77
Q

T/F

↑ T4 ↑TSH (vice versa)

A

F
↑ T4 inhibit TSH

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78
Q

Reference Ranges of T4

A

Adult: 5.5 – 12.5 ug/dL
Neonates: 11.8 – 22.6 ug/dL

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79
Q

Different Forms of Iodine in the Body

A

tyrosine
thyroxine (T4)
triiodothyronine (T3)
reverse T3 [inactive]

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80
Q

THYROID BINDING PROTEINS

A

Thyroxine Binding Globulin
Thyroxine Binding Prealbumin
Albumin

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81
Q

major transporter for T3

A

Thyroxine Binding Globulin

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82
Q

bind 70-75% of T4

A

Thyroxine Binding Globulin

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83
Q

binds 15-20% of T4

A

Thyroxine Binding Prealbumin

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84
Q

T3 transport protein

A

Albumin

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85
Q

bind 10% of T4

A

Albumin

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86
Q

T/F

TH can be free or bound

A

T

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87
Q

percentage of protein-bound TH and free TH

A

99.9% – protein-bound TH
0.1% – free (unbound) TH

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88
Q

percentage of free T4 (FT4)

A

0.04%

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89
Q

percentage of free T3 (FT3)

A

0.4%

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90
Q

thyroid binding protein levels if ↑ estrogen

A

↑ TBP (allows free TH to bind, ↑ bound TH)

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91
Q

total TH refers to

A

T3 & T4

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92
Q

Most useful test for assessing thyroid function

A

Thyroid Stimulating Hormone/Thyrotropin (TSH)

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93
Q

Used to differentiate primary hypothyroidism from secondary hypothyroidism

A

Thyroid Stimulating Hormone/Thyrotropin (TSH)

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94
Q

Used to monitor and adjust thyroid hormone replacement therapy (3rd Gen)

A

Thyroid Stimulating Hormone/Thyrotropin (TSH)

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95
Q

generation test with 0.1 mU/L detection limit

A

Second Generation

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96
Q

generation test with 0.01 mU/L detection limit (more sensitive)

A

Third Generation

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97
Q

generation test for research purposes only (not for diagnosis)

A

Fourth Generation

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98
Q

what are measured in Serum T3 and T4

A

o Total T3 and T4
o Free T3 and T4 (FT3, FT4)

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99
Q

methods for Serum T3 and T4

A

o Radioimmunoassay
o Chemiluminometric assay
o Immunometric technique

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100
Q

Measures relationship between TSH & TRH secretions

A

Thyrotropin-Releasing Hormone (TRH)

101
Q

Used to confirm euthyroid Grave’s disease (type of hyperthyroidism)

A

Thyrotropin-Releasing Hormone (TRH)

102
Q

Thyrotropin-Releasing Hormone (TRH) is increased during? decreased during?

A

Increased: primary hypothyroidism
Decreased: hyperthyroidism

103
Q

Glycoprotein synthesized and secreted only by thyroid follicular cells

A

Thyroglobulin

104
Q

Proof of presence of thyroid tissues / thyroid follicular cells

A

Thyroglobulin

105
Q

Ideal tumor marker for thyroid cancer patients

A

Thyroglobulin

106
Q

Post-operative marker of thyroid cancer

A

Thyroglobulin

107
Q

Surgical removal of thyroid gland (2 lobes removed) leading to NO TGB in circulation

A

Bilateral thyroidectomy

108
Q

methods for thyroglobulin

A

Immunoassays

109
Q

Measures remaining free binding sites

A

T3 Resin Uptake

110
Q

Analyzes the capacity of TBG to bind TH

A

T3 Resin Uptake

111
Q

Indirect measurement of the number of free binding sites on the TBG molecules

A

T3 Resin Uptake

112
Q

thyroid binding site when ↓ TH (not saturated)

113
Q

thyroid binding site when ↑ TH (saturated)

114
Q

Indirectly assesses conc. of circulating FT4

A

Free Thyroxine Index (FT4I)

115
Q

a test that is not measured; requires computation

A

Free Thyroxine Index (FT4I)

116
Q

formula for Free Thyroxine Index

A

FT41 = total T4 x T3 resin uptake

117
Q

test that utilizes antibodies for screening

A

Thyroid Antibody Screen

118
Q

antibodies used in Thyroid Antibody Screen

A

Anti-TSH receptor (TSH receptor antibody)
Antithyroglobulin
Anti-thyroid peroxidase (anti-TPO)

119
Q

antibody associated with Grave’s disease

A

Anti-TSH receptor (TSH receptor antibody)

120
Q

antibody associated with some if not all autoimmune hypothyroidism

A

Antithyroglobulin

121
Q

antibody associated with Hashimoto’s thyroiditis

A

Anti-thyroid peroxidase (anti-TPO)

122
Q

Measures pituitary TSH stores

A

TRH Stimulation Test

123
Q

Conclusive test for hyperthyroidism

A

TRH Stimulation Test

124
Q

process of TRH Stimulation Test

A

o Collect blood
o Inject 500 ug TRH (intravenous) – stimulate pituitary gland to secrete TSH
o Collect blood
o RESULT:
* Normal: ↑ TSH
* Hyperthyroidism: no ↑ (same level)

125
Q

intravenous TRH injected during stimulation test will stimulate this gland? what is the hormone secreted by that gland?

A

pituitary gland
TSH

126
Q

reason why hyperthyroidism has no increase (same level) during TRH stimulation test

A

pituitary is not stimulated by TRH injection (ex: if secondary), pituitary gland is already producing its own TSH regardless of TRH stimulation; same rate of production

127
Q

Measures thyroid gland ability to trap iodine

A

Radioactive Iodine Uptake (RAIU)

128
Q

Test where thyroid gland absorbs/uptake radioactive iodine

A

Radioactive Iodine Uptake (RAIU)

129
Q

Uptake of iodine by thyroid gland is stimulated by

130
Q

↑ iodine uptake signifies?

A

metabolically active gland (produces TH)

131
Q

↓ iodine uptake signifies?

A

metabolically inactive gland (no TH production)

132
Q

type of nodules with ↑ RAIU

A

Hot nodules

133
Q

type of nodule found in thyroid gland

A

hot nodules

134
Q

type of nodule that takes up large amt. of injected radioactive iodine

A

hot nodules

135
Q

type of nodule that is less likely cancerous

A

hot nodules

136
Q

type of nodules with ↓ / No RAIU

A

Cold/Indeterminate/Intermediate

137
Q

type of nodules that is cancerous

A

Cold/Indeterminate/Intermediate

138
Q

↑ RAIU, undetectable TSH indicates?

A

autonomous thyroid gland activity; takes iodine even TSH absence

139
Q

used for thyroid anatomy assessment

A

Thyroid Ultrasound

140
Q

used for characterization of palpable abnormalities

A

Thyroid Ultrasound

141
Q

during thyroid ultrasound, thyroid nodule size that can be seen

A

Thyroid nodules (<1cm) - NORMAL

142
Q

Most accurate tool in thyroid nodule evaluation

A

Thyroid needle biopsy/fine needle aspiration biopsy (FNAB)

143
Q

First test to be performed for thyroid abnormalities

A

Thyroid needle biopsy/fine needle aspiration biopsy (FNAB)

144
Q

used for identification and treatment of thyroid malignancy

A

Thyroid needle biopsy/fine needle aspiration biopsy (FNAB)

145
Q

FNAB is assisted by either of these 2 methods

A

Nodule palpation
Ultrasound

146
Q

TH deficiency

A

HYPOTHYROIDISM

147
Q

hypothyroidism usually refer to this disorder classification

A

primary hypothyroidism

148
Q

Hypothyroidism symptoms

A

o Thyroid gland enlargement/goiter
o Fatigue
o Impairment of mental process
o Loss of appetite
o Myxedema (↓ cardiac output)
o Cold intolerance
o Weight gain

149
Q

Thyroid gland enlargement/goiter in hypothyroidism is due to?

A

↑ TSH (stimulates cell growth)

150
Q

Impairment of mental process in hypothyroidism is due to?

A

slowed down CNS activity

151
Q

Loss of appetite in hypothyroidism is due to?

A

multiple organ defect

152
Q

How is TH associated with Myxedema (↓ cardiac output) in hypothyroidism?

A

TH regulates heart rate

153
Q

mechanism of having cold intolerance in hypothyroidism

A

↓ TH : ↓ body temp

154
Q

mechanism of weight gain in hypothyroidism

A

Slow macromolecule metabolism

155
Q

Inadequate secretion of TH by thyroid gland

A

Primary Hypothyroidism

156
Q

causes of Primary Hypothyroidism

A

o Lack of dietary iodine
o Thyroid tissue destruction (inability to produce TH)
o Autoantibodies

157
Q

Laboratory Results of primary hypothyroidism

A

Decreased: T3, T4, FT3, FT4, FT41, T3 uptake
Increased: TSH, TRH

158
Q

conditions associated with primary hypothyroidism

A

Hashimoto’s Thyroiditis
Congenital Hypothyroidism/Cretinism
Myxedema (low cardiac output)

159
Q

aka Hashimoto’s Thyroiditis

A

Chronic Lymphocytic Thyroiditis

(massive infiltration of thyroid gland by lymphocytes)

160
Q

Most common form of primary hypothyroidism; autoantibodies bind to cell membrane causing cell lysis and inflammatory reactions

A

Hashimoto’s Thyroiditis

161
Q

manifestation of Hashimoto’s Thyroiditis

162
Q

Laboratory Results of Hashimoto’s Thyroiditis

A

Decreased: T3, T4, FT3, FT4, FT41, T3 uptake
Increased: TSH, TRH
Anti-TPO positive

163
Q

aka Congenital Hypothyroidism

164
Q

Defect in development or function of thyroid gland

A

Congenital Hypothyroidism/Cretinism

165
Q

symptoms of Congenital Hypothyroidism/Cretinism

A

Retarded physical and mental development

166
Q

most common feature of Congenital Hypothyroidism/Cretinism

167
Q

result if congenital hypothyroidism/cretinism is left untreated within 3 months

A

Irreversible neurologic & mental deficiency

168
Q

Laboratory results of congenital hypothyroidism/cretinism

A

Decreased: T3, T4
Increased: TSH

169
Q

Peculiar nonpitting swelling [no indentation after pressure] of skin

A

Myxedema (low cardiac output)

170
Q

Sever form of myxedema

A

Myxedema coma

171
Q

Clinical features of myxedema

A

o Puffy face
o Weight gain, slow speech, eyebrows thinned, dry and yellow skin, anemia

172
Q

Decrease TSH production leading to ↓ serum levels of TH

A

Secondary Hypothyroidism

173
Q

Laboratory results of Secondary Hypothyroidism

A

Decreased: T3, T4, FT3, FT4, FT41, T3 uptake, TSH
Increased: TRH

174
Q

lack of TRH production (caused by hypothalamic failure)

A

Tertiary Hypothyroidism

175
Q

Laboratory results of tertiary hypothyroidism

A

all TH Decreased: T3, T4, FT3, FT4, FT41, T3 uptake, TSH, TRH

176
Q

Asymptomatic form of hypothyroidism

A

Subclinical Hypothyroidism

177
Q

Lab results of Subclinical Hypothyroidism

A

Normal: FT3, FT4
Slightly increased: TSH

178
Q

aka HYPERTHYROIDISM

A

THYROTOXICOSIS

179
Q

T/F
↑ TH is NOT toxic to all cells

A

F
↑ TH = toxic to all cells

180
Q

Caused by excessive TH in circulation

A

HYPERTHYROIDISM / THYROTOXICOSIS

181
Q

Causes overactive cells

A

HYPERTHYROIDISM / THYROTOXICOSIS

182
Q

symptoms of hyperthyroidism / thyrotoxicosis

A

o Weight loss
o Loss of muscle mass
o Hyperactivity yet quick fatigability
o Insomnia
o Increased sweating
o Nervousness
o Palpitations
o Goiter
o Exophthalmia (bulging of eyes)

183
Q

weight loss during hyperthyroidism is due to

A

Rapid macromolecule metabolism

184
Q

hyperactivity yet quick fatigability during hyperthyroidism is due to

A

↑ O2 demand

185
Q

insomnia during hyperthyroidism is due to

A

↑ CNS activity

186
Q

increased sweating during hyperthyroidism is due to

A

↑ body temp

187
Q

nervousness during hyperthyroidism is due to

A

↑ CNS activity

188
Q

palpitations during hyperthyroidism is due to

A

↑ cardiac output

189
Q

goiter during hyperthyroidism is due to

190
Q

T/F

Both hypothyroidism and hyperthyroidism manifest goiter

A

T

hyperthyroidism: due to ↑ TH
hypothyroidism: due to ↑ TSH

191
Q

Dangerously HIGH TH levels leading to STROKE

A

Thyroid Storm

192
Q

Dangerously HIGH TH levels leads to STROKE due to

A

↑ CNS output
↑ Body temperature
↑ Cardiac output

193
Q

Group of syndromes caused by ↑ free TH in circulation

A

Thyrotoxicosis

194
Q

FT3 level in T3 Thyrotoxicosis / Plummer’s Disease

195
Q

aka T3 Thyrotoxicosis

A

Plummer’s Disease

196
Q

FT4 level in T3 Thyrotoxicosis / Plummer’s Disease

197
Q

TSH level in T3 Thyrotoxicosis / Plummer’s Disease

198
Q

FT3 level in T4 Thyrotoxicosis

199
Q

FT4 level in T4 Thyrotoxicosis

200
Q

TSH level in T4 Thyrotoxicosis

201
Q

a primary hyperthyroidism; autoimmune disorder

A

Grave’s Disease

202
Q

Prevalence of Grave’s dse

A

5-6x more in female than male

203
Q

Clinical features of Grave’s dse

A

Exophthalmos (bulging of eye)
Pretibial myxedema

204
Q

Laboratory Results of Grave’s dse

A

Increased: T3, T4, FT41, T3 uptake
Normal/Decreased: TSH
Anti-TSH receptor positive

205
Q

condition where thyroid turns into woody or stony-hard mass (calcification of thyroid gland)

A

Reidel’s Thyroiditis

206
Q

hyperthyroidism with no clinical symptoms

A

Subclinical Hyperthyroidism

207
Q

Lab result of Subclinical Hyperthyroidism

A

Normal: FT3, FT4
Decreased: TSH

208
Q

aka De Quervain Thyroiditis

A

Subacute granulomatous thyroiditis
Subacute nonsuppurative thyroiditis

209
Q

results to painful/inflammed TH gland

A

De Quervain Thyroiditis/
Subacute granulomatous thyroiditis/
Subacute nonsuppurative thyroiditis

210
Q

Lab result of De Quervain Thyroiditis

A

↑ ESR & thyroglobulin
Anti-TPO negative

211
Q

Produced by parafollicular C cells of thyroid gland

A

CALCITONIN

212
Q

Participated in calcium homeostasis by responding to hypercalcemia

A

CALCITONIN

213
Q

Indirectly regulate phosphate by stimulating renal reabsorption of phosphorus (↑ PO4-)

A

CALCITONIN

214
Q

Calcitonin is (hypercalcemic, hypocalcemic) and (hyperphosphatemic, hypophosphatemic)

A

hypocalcemic, hyperphosphatemic

215
Q

actions of calcitonin as hypocalcemic agent

A

o Stimulates renal excretion of Ca2+
o Depresses release of Ca2+ from bone (↓ bone resorption)
o Inhibits bone-dissolving activity of osteoclasts (bone macrophage)

216
Q

LABORATORY ANALYSES OF CALCITONIN

A

Serum Calcitonin
Pentagastrin Stimulation Test

217
Q

Serum Calcitonin analysis is a marker for

A

Medullary thyroid carcinoma (MTC)

218
Q

required period and repetition of serum calcitonin measurement

A

before & 6 mos after thyroid surgery

219
Q

test used for MTC diagnosis

A

Pentagastrin Stimulation Test

220
Q

Smallest endocrine gland

A

PARATHYROID GLAND

221
Q

Bilaterally located in the posterior portion of thyroid gland

A

PARATHYROID GLAND

222
Q

T/F
Most people have 4 PTH gland, some 2 or 8

223
Q

Modulation of parathyroid gland

A

Free-Standing Endocrine Gland System

(regulation influenced by substance it regulates)

224
Q

Regulates Blood Calcium and phosphate (sensitive to Ca2+, PO4- level changes; immediate production)

225
Q

PTH metabolism of both calcium and phosphorus is done by these (2)

A

kidney
bone

226
Q

PTH is (hypercalcemic, hypocalcemic) and (hyperphosphatemic, hypophosphatemic)

A

hypercalcemic, hypophosphatemic

227
Q

Stimulates conversion of Vit D  activated Vit D3

228
Q

how PTH act as hypercalcemic agent

A

In Bone: ↑ bone resorption of Ca2+ into plasma
In Kidney: ↑ renal reabsorption of Ca2+

229
Q

it stimulates bone resorption

A

osteoclast (bone macrophage)

230
Q

LABORATORY ANALYSES OF PTH

A

PTH C-TERMINAL ANALYSIS
PTH N-TERMINAL ANALYSIS

231
Q

Examines intact/whole PTH molecule

A

PTH C-TERMINAL ANALYSIS

232
Q

Lab analysis specific for detecting hyperparathyroidism

A

PTH C-TERMINAL ANALYSIS

233
Q

Measures both the whole (intact) PTH molecule and amino-terminal fragments in the serum

A

PTH N-TERMINAL ANALYSIS

234
Q

Inability to maintain Ca2+ in blood without Ca2+ supplementation
~ ↓ PTH, ↓ Ca2+

A

HYPOPARATHYROIDISM

235
Q

feature of hypoparathyroidism? how to assess?

A

tetany

Chvostek’s sign – facial contraction (tap)
Trousseau’s sign – carpal spasm

236
Q

causes of hypoparathyroidism

A

Post-surgical cases: accidental injury to parathyroid gland
Autoimmune parathyroid destruction

237
Q

condition with ↓ PTH (hyposecretion due to parathyroid gland defect)

A

Primary Hypoparathyroidism

238
Q

condition with ↓ serum Ca2+, ↑ Phosphorus

A

Idiopathic Hypoparathyroidism

239
Q

condition having lack of responsiveness of PTH by renal system (kidney) – ↓ PTH

A

Pseudohypoparathyroidism

240
Q

All classifications of HYPERPARATHYROIDISM are always accompanied by

A

phosphaturia, presence of PO4- crystals in urine

241
Q

Most common cause of hypercalcemia

A

Primary hyperparathyroidism

242
Q

This condition occur due to parathyroid adenoma

A

Primary hyperparathyroidism

243
Q

Lab result of Primary hyperparathyroidism

A

Increased: PTH, Ionized Ca2+
*Ca2+ also increased since it is hypercalcemic

244
Q

Develops in response to hypocalcemia

A

Secondary hyperparathyroidism

245
Q

causes of Secondary hyperparathyroidism

A

Vitamin D deficiency
Chronic renal failure

246
Q

Lab result of Secondary hyperparathyroidism

A

Increased: PTH
Decreased: Ionized Ca2+

247
Q

Occurs with secondary hyperthyroidism

A

Tertiary hyperparathyroidism

248
Q

condition with Ca2+ phosphates precipitate (crystals) in soft tissues

A

Tertiary hyperparathyroidism

249
Q

Lab Result of Tertiary hyperparathyroidism

A

Phosphates level: N/↑

Clinical Chemistry 2 - CEUMLS (9 decks)

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