Exam 2 Study Guide Thyroid Disorders Flashcards

1
Q

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

A

Intralingual

Lingual Thyroid Tissue

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2
Q

Excessive activation of the thyroid leads to…

A

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

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3
Q

Thyroid disease is most common in…

A

Females

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4
Q

What is “thyroid storm”?

A
Fever
Tachycardia
Sweating
Shaking
Agitation
Unconsciousness
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5
Q

What disease is affiliated with Hyperthyroidism?

A

Grave’s Disease (in 90% of cases)

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6
Q

What are causes of Grave’s disease?

A

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

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7
Q

What are the symptoms of Grave’s disease?

A

Hyperthyroidism
Exophthalmos
Thyroid gland hyperplasia

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8
Q

What is Plummer’s Disease?

A

A multi lobular goiter

5-10% of hyperthyroidism cases

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9
Q

What disease is affiliated with Hypothyroidism?

A

Hashimoto’s Disease

most common in females

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10
Q

Characteristics of a goiter…

A
  • Most common thyroid lesion
  • Rare with Hypothyroidism
  • Not a cancer
  • Iodine Deficiency
  • Diagnosed with fine needle aspiration (look for colloid)
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11
Q

What is the most common thyroid neoplasm?

A

Thyroid adenomas

*not malignant

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12
Q

Thyroid Carcinomas are typically…

A

Low risk and low metastasis

*Most common is Papillary carcinoma

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13
Q

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

A

Thyroid Nodules

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14
Q

What drugs are used to treat Hyperthyroidism?

A

Thiomides
Iodides-Lugo Solution
Beta Blockers
Radiation Iodine

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15
Q

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

A

propylythiouracil (PTU)

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

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16
Q

How doe Iodides-Lugol solution work?

A

Inhibit hormon release

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17
Q

How do beta blockers (propranolol) treat hyperthyroidism?

A

Inhibit the conversion of T4 to T3

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18
Q

How does Radiation iodine treat hyperthyroidism?

A

Destroys thyroid parenchyma

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19
Q

How do you treat Hypothyroidism?

A

Thyroid replacement

Synthroid or Levothroid

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20
Q

What is the function of the Parathyroid?

A
  • 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
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21
Q

Hyperparathyroidism causes what?

A

Hypercalcemia

*Primary and Secondary

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22
Q

What are the characteristics of Primary Hypercalcemia?

A
  • Common Endocrine Disorder (adenoma)
  • cause Arrhythmias
  • Elevated serum Ca++
  • Hypophosphatemic
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23
Q

What are symptoms of Primary Hypercalcemia?

A
Osteoporosis (fractures)
Constipation
Weakness
Anorexia
Stones
Ulcers
depression
coma
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24
Q

What is the treatment for Primary Hypercalcemia

A

Surgery

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25
Q

What is Secondary Hypercalcemia?

A

Intestinal malabsorption of Vitamin D or Calcium

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26
Q

What drugs are used to treat Osteoporosis?

A

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

27
Q

How does Denosumab (Xgeva) work?

A

antibody to the osteoclastic-stimulating protein (RANK)

-This drug blocks osteoclast number and activity

28
Q

How does Teraparatide (Forteo) work?

A

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

29
Q

How does estrogen (Modulators) work?

A

Prevent bone loss in early post-menopausal period

  • should be used in combination with progestin to protect against venous thrombi
30
Q

How do bisphosphonates work?

A

Suppress activity of osteoclasts and inhibit bone resorption

*BRONJ

31
Q

What are examples of Bisphosphonates?

A

Ibandronate (Boniva)

Alendronate (Fosamax)

32
Q

What drugs promote osteoporosis?

A

Glucocorticoids

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

33
Q

What are the symptoms of Hypoparathyroidism?

A

Hypocalcemia
Decreased PTH
Tetany
Dental changes in children

34
Q

What is the most common cause of Hypoparathyroidism?

A

Accidental removal at thyroid surgery.

35
Q

What are secondary hormonal regulators of Bone Mineral Homeostasis?

A

Calcitonin

  • acts opposite of PTH by inhibiting osteoclastic activity.
  • can use to treat Paget’s Disease
36
Q

What is the Pituitary gland?

A

Brains endocrine gland, secretes through blood-brain barrier.

37
Q

What to directions does the pituitary gland secrete?

A

Anterior - Portal circulation from hypothalamus

Posterior - axons go into systemic circulation

38
Q

What is GIH known as?

A

Somatostatin

39
Q

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

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

*Adenomas

40
Q

Which disease results in increased growth hormone before puberty?

A

Gigantism

*Acromegaly after puberty

41
Q

What is the most common cause for Hypopituitarism?

A

Consecratory pituitary adenomas

  • loss of sex characteristics (sterility)
  • Retards child growth
  • Hypothyroidism
42
Q

What is the function of the adrenal glands?

A

Medulla makes and releases catecholamines

Cortex makes Steroids ( mineralocorticoids, glucocorticoids, and sex steroids)

43
Q

What are the features of Primary Acute Cortical Insufficiency?

A
Weakness
Nausea
Hyponatremia
Hypotension
Skin Pigmentation

*Addison Disease

44
Q

What are the features of Secondary adrenocortical Insufficiency?

A

Due to hypothalamic or pituitary problem

  • hypoglycemia
  • No hyper pigmentation
  • Aldosterone Normal
45
Q

What is adrenal crisis?

A

Sudden for increase of steroid output

*can be caused by massive adrenal hemorrhage

46
Q

What are the two disorders associated with Hypercortisolism?

A

Cushing Disease

Secondary Adrenocortisol Insufficiency

47
Q

What are the features of Cushing Disease?

A

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

48
Q

What are the symptoms of Cushing Disease?

A
Moon Face
Osteoporosis
Buffalo Hump
Obesity
Thin Skin
Amenorrhea 
Poor wound healing

*basically someone in chronic corticosteroid treatment

49
Q

What is Secondary Aderoncortsol Insufficiency?

A
  • The result of extended use of exogenous steroids (Prednisone)
  • Normal adrenal function is suppressed, but then tx is abruptly stopped causing a hypocortisolic reaction.
50
Q

What is Hyperaldosteronism (Conn Syndrome)?

A
  • Na+ retention and K+ excretion

- Supression of renin-angiotensin system

51
Q

What are the 3 Adrenal Cortical Tumors?

A

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

52
Q

What are characteristics of Pheochromocytoma?

A

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

53
Q

Cortisol is synthesized from…

A

Cholesterol

54
Q

What is the primary use of Glucocorticoids?

A

Rapid and dramatic anti-inflammatory effects

  • Suppress leukocytes and cytokines/chemokines
  • Topical inhibits histamine relate and skin thinning
55
Q

What are short to medium acting Glucocorticoids?

A

Hydrocortisone, Cortisone, Prednisone

56
Q

What is a long acting Glucocorticoid?

A

Dexamthazone

57
Q

Glucocorticoids are used for

A

Allergic reactions
Inflammatory bowel disease
Acute Respiratory Distress Disorder
Dermatitis

58
Q

What is the treatment for Addison’s Disease?

A

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

59
Q

What causes Cushings Disease?

A

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

60
Q

What Drugs can be used for Cushings Disease?

A

Ketoconazole
Metyrapone

*treats osteoporosis and Paget’s Disease

61
Q

What does Ketoconazole do?

A

Inhibits adrenal steroid synthesis

62
Q

What does Metyrapone do?

A

selective inhibitor of cortisol/corticosterone synthesis.

63
Q

What is Paget’s Disease (Osteitis Deformans)

A

Excessive bone removal followed by excessive bone formation = weakened bone and fractures.

*may be triggered by virus

64
Q

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

A

Alkaline Phosphates