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exam 2: thyroid and parathyroid hormones Flashcards

1
Q

93% of the active hormones secreted by thyroid gland is

A

T4- thyroxine

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2
Q

7% of active hormones secreted by thyroid gland is

A

T3- Triiodothyronine

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3
Q

which is more potent, T3 orT4?

A

T3

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4
Q

what do thyroid hormones impact?

they also have permission action on

A

metabolism and growth/development

permission action on: catecholamines: EPI and NE

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5
Q

what is required for thyroid hormone synthesis so thyroid follicular cells actively transport I- obtained from the diet?

A

Iodine I2 required

so actively transport I- (iodine)

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6
Q

______ is capable of producing intracellular I- concentrations that are 2-40 times greater as the concentration in plasma

A

Na+/I- symporter (NIS)

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7
Q

what must also exit the thyrocyte cells across the apical membrane to access the ______ where the initial steps of thyroid hormone synthesis occurs.
______ is a Cl-/I- exchanger

A

iodine must also exit to access collid

pendrin

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8
Q

essentially, to make thyroid hormone you need

A

iodine(I2) and tyrosine

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9
Q
  1. NIS moves I- into follicular cell
  2. Pendrin moves Cl- into follicular cell and I- out of cell to collid making it I2
  3. peroxidase complexes with Thyroglobin (Tg) to form T3 and T4
    -(T3 and T4 stored in collid until time to secrete into blood)
  4. T3 and T4 go back into follicular cell and secreted out into blood stream
A
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10
Q

T3 and T3 are produced in the ______ and complexed with _____ which complexed with peroxidase

A

thryroglobulin

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11
Q

protein that has a ton of tyrosine

A

thyroglobulin

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12
Q

steps of T3 and T4 secreted into blood

A
  1. collid is internalized by endocytosis (into follicular cell)
  2. vesicles fuse with lysosomes in the cell
  3. proteases cleave T3 and T4 from Tg
  4. T3 and T4 diffuse out of cell and into capillaries
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13
Q

99% of T3 and T4 bind with what for transport?

A

plasma proteins (albumin)

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14
Q

T4 can be converted to T3 by

A

iodinase/deiodinases

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15
Q

what is the most active form od thyroid hormone

A

T3

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16
Q

target cells make active T3 by using enzymes called:

which remove an iodine from T4

A

diodinases and iodinases

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17
Q

various conditions inhibit deiodinase activity:

A

selenium deficiency, burns, trauma, advanced cancer cirrhosis, chronic kidney disease, MI and febrile states, fasting, stress.

** could show signs of hypothyroidism

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18
Q

Thyroid hormones lead to production of

A

new proteins

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19
Q

the overall effect you have from thyroid hormone are:

A

-growth

-CNS development

-cardiovascular effects (permissive effects) (all increase)

-metabolism (glucose uptake, making glucose, protein synthesis, increase BMR) (all increase)

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20
Q

TH increases expression of Beta receptors and so thats going to let the sympathetic nervous system have a greater response at those receptors when the sympathetic nervous system is active

A
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21
Q

____actions occur sooner than ____ with the max activity ~2-3 days

A

T3 acts sooner than T4

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22
Q

control of thyroid hormone secretion (TH) is ______ FEEDBACK mainly at the level of:

A

negative feedback
mainly at the level of the anterior pituitary gland

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23
Q

____ is the main circulating form which is responsible for most of the negative feedback.

but it is converted into ____ when it reaches the hypothalamus and the anterior pituitary

A

T4

converted into T3

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24
Q

TSH secretion is _______.
output starts to rise at _______, peaks at ______, and then declines during _____

A

TSH secretion is pulsatile
output starts to rise at 9pm, peaks at midnight, and declines during day

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25
what are the effects of thyroid hormone on metabolism:
increase to everything: +BMR +protein synthesis +lipolysis (stimulates FAT metabolism) (increase lipid mobilization^ and oxidation of FA) +glycolysis +glucose absorption +gluconeogenesis (stimulates carbohydrate metabolism) +O2 consumption
26
effects of thyroid hormone on metabolism 5 main points:
+BMR +Oxygen consumption +carbohydrate metabolism +protein catabolism and synthesis +fat metabolism
27
what are the 3 points referring to the stimulate of carbohydrate metabolism with effects of TH on metabolism
causes uptake of glucose by cells, enchances glycolysis and gluconeogenesis, and increases rate of CHO (carbohydrate) absorption from GI tract
28
3 points referring to stimulates of FAT metabolism with effect of TH on metabolism
increase lipid mobilization (lipolysis) and oxidation of FA by cells, required to convert beta carotene to Vitamin A wound healing(hyperthyroid patients have yellowish skin), and decreases circulating cholesterol levels (hypothyoidism associated with hyperlipidemia)
29
without TH secretion, BMR
falls to about 50% of normal
30
effects of TH on metabolism stimulates more ______ of protein than it does ____ of protein
stimulates more break down of protein (catabolism) than synthesis of protein
31
what is needed for normal development of the NS
Thyroid hormone
32
impacts reflex time: -what can cause prolonged reflex time?
TH hypothyroidism
33
what 3 things can occur from an increase of TH
1. muscle tremors due to increased reactivity of neuronal synapses 2. feeling of tiredness but difficulty sleeping 3. anxiety, worry and paranoia
34
what are the effects of TH with the cardiovasucular system?
1. increased expression of B-adrenergic receptors (EPI and NE) 2. increased blood flow, heart rate, and heart contractibility
35
what are the effects of TH in the endocrine system?
1. activation of bone formation, causes a need for increased PTH secretion, which means would increase blood Ca2+
36
effects of TH with GI tract:
1. increase appetite and food intake 2. increased rate of secretion and motility of GI tract
37
which has constipation and which has diarrhea?
constipation: hypothyroidism diarrhea: hyperthyroidism
38
enlarged thyroid that DOES NOT indicate functional status
goiter
39
what is goiter all seen in?
hypothyroidism hyperhtyroidism, euthyroidism
40
goiter caused by excess amounts of TSH secretion. high TSH stimulates thyroid to secrete large amounts of ______________ into follicles, resulting in gland enlargement
stimulates thyroid to secrete large amounts of thyroglobulin colloid into follicles
41
most common form of hypethyroidism
grave's disease
42
hyperthyroidism can also occur due to a thyroid:
adenoma
43
grave's disease is an autoimmune disease where antibodies to TSH receptor called _____________ stimulate the thyroid gland to excess
TSI thyroid-stimulating immunoglobulins
44
what is goiter caused by
excess TSH (from anterior pituitary gland)
45
what has a long half life than TSH
TSI antibodies have prolonged stimulating effects on thyroid gland
46
high levels of thyroid hormone secretion caused by TSI supress:
anterior pituitary TSH secretion (negative feedback)
47
some symptoms of grave's disease aka hyperthyroidism
bilateral exophthalmos, goiter, increased appetite but weight loss, tremor, muscle wasting, edema in skin at ankles
48
treatment of hyperthyroidism (grave's disease)
1. radioactive I thyroid ablation or antithyroid drugs (dont need surgery) 2. propanolol (B blockers) (for adrenergic sympts.) 3. L-thyroxine (T4) to prevent hypothyroidism who had surgery
49
what are oral symptoms of hyperthyroidism:
1. burning mouth syndrome (neuropathic pain) 2. gum disease 3. excessive salivation 4. weakening of mandible 5. increased caries risk
50
elevated thyroid hormone with stressful events (trauma, surgery, severe emotional distress) or serious illness
thyroid storm (thyrotoxicosis)
51
what are the symptoms of thyroid storm (thyrotoxicosis)
fever, tachycardia, elevated BP, nausea, vomiting, diarrhea, breathing problems
52
in patients with hyperthyroidism (have more beta receptors) or those that exhibit signs/symptoms of it (with thyroid storm), administration of _______ is contraindicated and elective dental care should be deferred (dont use)
epinephrine
53
autoimmune reaction against thyroid gland destroys gland rather than stimulating it
hypothyroidism aka Hashimoto's Thyroiditis
54
most common cause of hypothyroidism
hashimoto's thyroiditis
55
in hypothyroidism aka Hashimotos, most patients first exhibit autoimmune __________ aka thyroid inflammation. inflammation leads to _______ of thyroid resulting in decreased secretion of TH
thyroiditis fibrosis of thyroid
56
what is the treatment for hypothyroidism
T4- L-thyroxine
57
other than Hasimotos's, hypthyroidism can also occur from
low iodine
58
in hypothyroid states: goiter: no goiter:
goiter: iodine deficiency and high levels of TSH no goiter: TSH deficiency and no iodine deficiency
59
hypothyroidism symptoms:
- impaired memory, large tongue, weight gain, pallor, slow pulse (decreased number of beta receptors=less sympathetic nervous system response) loss of lateral eyebrows coarse, dry and brittle hair
60
is hypothyroidism due to iodine deficiency a primary or secondary endocrine disorder?
primary = goiter= increase in TSH
61
hypothyroidism due to TSH deficiency?
secondary endocrine disorder bc effecting anterior pituitary = no goiter= decrease in TSH
62
what is seen in severely hypothyroid patients
myxdema
63
increased quantities of hyaluronic acid and chondroitin sulfate bound with protein plus water accumulate in skin
myxedema -puffy eyelids, waxy dry pale wrinkly skin
64
thyroid hormones required for postnatal brain maturation -results from: *congenital absence of thyroid gland *iodine deficient diet (most common cause)
cretinism
65
what causes physcial and mental retardation of neonates
cretinism (iodine deficiency or lacking thyroid gland)
66
in cretinism, _______ growth is more inhibited than soft tissue growth (obese, stocky and short with large protruding tongue_
skeletal growth
67
hypothyroidism oral manifestations
macroglossia dysgeusia delayed tooth eruption poor wound healing (need vitamin A) increased periodontal disease salivary gland enlargement
68

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