Exam 2 Study Guide Thyroid Disorders Flashcards by Dane Goodwin

What are infrequent ectopic sites of the thyroid in the oral cavity?

Intralingual

Lingual Thyroid Tissue

How well did you know this?

Not at all

Perfectly

Excessive activation of the thyroid leads to…

a hypermetabolic state causing protein catabolism and enhanced sympathetic NS activity.

How well did you know this?

Not at all

Perfectly

Thyroid disease is most common in…

Females

How well did you know this?

Not at all

Perfectly

What is “thyroid storm”?

Fever
Tachycardia
Sweating
Shaking
Agitation
Unconsciousness

How well did you know this?

Not at all

Perfectly

What disease is affiliated with Hyperthyroidism?

Grave’s Disease (in 90% of cases)

How well did you know this?

Not at all

Perfectly

What are causes of Grave’s disease?

Autoimmune-antibodies function as agonists to thyroid-related receptors- causing excessive thyroid receptor activation.

How well did you know this?

Not at all

Perfectly

What are the symptoms of Grave’s disease?

Hyperthyroidism
Exophthalmos
Thyroid gland hyperplasia

How well did you know this?

Not at all

Perfectly

What is Plummer’s Disease?

A multi lobular goiter

5-10% of hyperthyroidism cases

How well did you know this?

Not at all

Perfectly

What disease is affiliated with Hypothyroidism?

Hashimoto’s Disease

most common in females

How well did you know this?

Not at all

Perfectly

Characteristics of a goiter…

Most common thyroid lesion
Rare with Hypothyroidism
Not a cancer
Iodine Deficiency
Diagnosed with fine needle aspiration (look for colloid)

How well did you know this?

Not at all

Perfectly

What is the most common thyroid neoplasm?

Thyroid adenomas

*not malignant

How well did you know this?

Not at all

Perfectly

Thyroid Carcinomas are typically…

Low risk and low metastasis

*Most common is Papillary carcinoma

How well did you know this?

Not at all

Perfectly

What are mostly benign and found in 6% of women and 2% of males?

Thyroid Nodules

How well did you know this?

Not at all

Perfectly

What drugs are used to treat Hyperthyroidism?

Thiomides
Iodides-Lugo Solution
Beta Blockers
Radiation Iodine

How well did you know this?

Not at all

Perfectly

What is an example of a thiomide and how dies it work?

propylythiouracil (PTU)

- inhibits the thyroid peroxidase reaction and blocks synthesis of the hormone.

How well did you know this?

Not at all

Perfectly

How doe Iodides-Lugol solution work?

Inhibit hormon release

How well did you know this?

Not at all

Perfectly

How do beta blockers (propranolol) treat hyperthyroidism?

Inhibit the conversion of T4 to T3

How well did you know this?

Not at all

Perfectly

How does Radiation iodine treat hyperthyroidism?

Destroys thyroid parenchyma

How well did you know this?

Not at all

Perfectly

How do you treat Hypothyroidism?

Thyroid replacement

Synthroid or Levothroid

How well did you know this?

Not at all

Perfectly

What is the function of the Parathyroid?

Secrete PTH regulated by free calcium in blood.
- Low Ca++ = increased PTH
PTH activates Osteoclasts and bone resorption to increase serum Ca++
also increases tubular reabsorption of calcium
Activates vitamin D
Increases GI absorption

How well did you know this?

Not at all

Perfectly

Hyperparathyroidism causes what?

Hypercalcemia

*Primary and Secondary

How well did you know this?

Not at all

Perfectly

What are the characteristics of Primary Hypercalcemia?

Common Endocrine Disorder (adenoma)
cause Arrhythmias
Elevated serum Ca++
Hypophosphatemic

How well did you know this?

Not at all

Perfectly

What are symptoms of Primary Hypercalcemia?

Osteoporosis (fractures)
Constipation
Weakness
Anorexia
Stones
Ulcers
depression
coma

How well did you know this?

Not at all

Perfectly

What is the treatment for Primary Hypercalcemia

Surgery

How well did you know this?

Not at all

Perfectly

What is Secondary Hypercalcemia?

Intestinal malabsorption of Vitamin D or Calcium

What drugs are used to treat Osteoporosis?

Denosumab (Xgeva) Teraparatide (Forteo) Estrogens and Estrogen Modulators Bisphosphonates

How does Denosumab (Xgeva) work?

antibody to the osteoclastic-stimulating protein (RANK) | -This drug blocks osteoclast number and activity

How does Teraparatide (Forteo) work?

a recombinant form of parathormone segment which selectively activates osteoblasts and stimulates new bone formation.

How does estrogen (Modulators) work?

Prevent bone loss in early post-menopausal period * should be used in combination with progestin to protect against venous thrombi

How do bisphosphonates work?

Suppress activity of osteoclasts and inhibit bone resorption *BRONJ

What are examples of Bisphosphonates?

Ibandronate (Boniva) | Alendronate (Fosamax)

What drugs promote osteoporosis?

Glucocorticoids -antagonizes Vit. D stimulated intestinal Ca++ transport and stimulates renal secretion (Blocks osteoblasts)

What are the symptoms of Hypoparathyroidism?

Hypocalcemia Decreased PTH Tetany Dental changes in children

What is the most common cause of Hypoparathyroidism?

Accidental removal at thyroid surgery.

What are secondary hormonal regulators of Bone Mineral Homeostasis?

Calcitonin * acts opposite of PTH by inhibiting osteoclastic activity. * can use to treat Paget's Disease

What is the Pituitary gland?

Brains endocrine gland, secretes through blood-brain barrier.

What to directions does the pituitary gland secrete?

Anterior - Portal circulation from hypothalamus | Posterior - axons go into systemic circulation

What is GIH known as?

Somatostatin

What are the 3 secretions from the pituitary and what can cause them to be disturbed?

``` Prolactin (Reproductive function) Growth Hormone (Gigantism, Acromegaly) Corticotropin (Affect ACTH causing Cushing's Disease) ``` *Adenomas

Which disease results in increased growth hormone before puberty?

Gigantism *Acromegaly after puberty

What is the most common cause for Hypopituitarism?

Consecratory pituitary adenomas * loss of sex characteristics (sterility) * Retards child growth * Hypothyroidism

What is the function of the adrenal glands?

Medulla makes and releases catecholamines | Cortex makes Steroids ( mineralocorticoids, glucocorticoids, and sex steroids)

What are the features of Primary Acute Cortical Insufficiency?

``` Weakness Nausea Hyponatremia Hypotension Skin Pigmentation ``` *Addison Disease

What are the features of Secondary adrenocortical Insufficiency?

Due to hypothalamic or pituitary problem - hypoglycemia - No hyper pigmentation - Aldosterone Normal

What is adrenal crisis?

Sudden for increase of steroid output *can be caused by massive adrenal hemorrhage

What are the two disorders associated with Hypercortisolism?

Cushing Disease | Secondary Adrenocortisol Insufficiency

What are the features of Cushing Disease?

Adrenal Hyperplasia Adrenal then shrinks due to feedback Low ACTH, High Cortisol Adrenals Act autonomously

What are the symptoms of Cushing Disease?

``` Moon Face Osteoporosis Buffalo Hump Obesity Thin Skin Amenorrhea Poor wound healing ``` *basically someone in chronic corticosteroid treatment

What is Secondary Aderoncortsol Insufficiency?

- The result of extended use of exogenous steroids (Prednisone) - Normal adrenal function is suppressed, but then tx is abruptly stopped causing a hypocortisolic reaction.

What is Hyperaldosteronism (Conn Syndrome)?

- Na+ retention and K+ excretion | - Supression of renin-angiotensin system

What are the 3 Adrenal Cortical Tumors?

Adenomas (Common -usually non-functional) Carcinomas (rare) Pheochromocytoma (adrenal medullary tumor)

What are characteristics of Pheochromocytoma?

Usually benign Increases secretion of Catecholamines Clinically looks like increased sympathetic function -Hypertension and flushing

Cortisol is synthesized from...

Cholesterol

What is the primary use of Glucocorticoids?

Rapid and dramatic anti-inflammatory effects - Suppress leukocytes and cytokines/chemokines - Topical inhibits histamine relate and skin thinning

What are short to medium acting Glucocorticoids?

Hydrocortisone, Cortisone, Prednisone

What is a long acting Glucocorticoid?

Dexamthazone

Glucocorticoids are used for

Allergic reactions Inflammatory bowel disease Acute Respiratory Distress Disorder Dermatitis

What is the treatment for Addison's Disease?

Since the adrenal glands produce too little cortisol and aldosterone Hydrocortisone combined with salt-retaining hormone will treat it.

What causes Cushings Disease?

Chronic high levels of Cortisol - usually due to ACTH-secreting tumor

What Drugs can be used for Cushings Disease?

Ketoconazole Metyrapone *treats osteoporosis and Paget's Disease

What does Ketoconazole do?

Inhibits adrenal steroid synthesis

What does Metyrapone do?

selective inhibitor of cortisol/corticosterone synthesis.

What is Paget's Disease (Osteitis Deformans)

Excessive bone removal followed by excessive bone formation = weakened bone and fractures. *may be triggered by virus

Paget's disease would see high what in the serum?

Alkaline Phosphates