Firecracker Endo III Flashcards
Drugs that can cause hypothyroidism
Lithium
Amiodarone
Sulfonamides
5 causes of hypothyroidism
- Hashimoto
- Iodine deficiency
- Surgery/radiation
- Drugs
- Subacute lymphocytic thyroiditis
What is tertiary hyperparathyroidism?
Long standing hyperparathyroidism: progresses into autonomous hypersecretion of PTH even after correction of chronic hypocalcemia
patients with Hashimoto thyroiditis are at increased risk of developing which malignancy?
B-cell non-Hodgkin lymphomas, especially extra nodal marginal zone lymphomas of MALT
↑ urinary cAMP
reflects PTH action at the proximal tubule
What is the most common cause of thyroid pain?
DeQuervain
Medullary CA of thyroid is associated with which two MEN syndromes?
MEN 2A
MEN 2B
- lymphocytic infiltrate
- multinucleate giant cells surrounding fragments of colloid
DeQuervain histology
Fibrous tissue replaces thyroid parenchyma, with fibrosis extending beyond the thyroid capsule into surrounding tissue.
Reidel thyroiditis
Parathyroid hyperplasia is commonly associated with what 2 MEN syndromes?
MEN 1 and MEN 2A
May induce remission of hyperthyroidism by blocking new thyroid hormone production via inhibition of the organification and coupling steps of thyroid hormone synthesis.
Thioamides (PTU or methimazole)
- PTU (not methimazole) also inhibits peripheral conversion of T4 to T3.
What are four common causes of hypomagnesemia?
diarrhea, aminoglycosides, diuretics, and alcohol abuse.
Besides serum TSH, total T4, free T4, and 123I uptake, what other lab findings are associated with thyrotoxicosis? (Try to name 3)
- hypercalcemia
- hyperglycemia
- hypocholesterolemia
What effect does PTH have on bones?
PTH binds osteoblasts → secrete M-CSF and RANK-L –> osteoCLASTs break down bone to release calcium.
goiter causes
graves and iodine deficiency
- Fever
- Painful thyroid
- Painful cervical LAD
acute thyroiditis
- Fine tremor (eg, of the hands)
- Anxiety
- Insomnia
- Emotional lability
- Inability to concentrate
- Brisk DTRs (deep tendon reflexes)
neurological effects of hyperthyroidism
hyperparathryoidism –> hypercalcemia –> bones, stones, groans, and moans =
Oseitis fibrosa cystica calcium nephrolithiassis GI distress psych disturbances (depression) (also HF and arrhythmias)
How does follicular thyroid carcinoma spread?
Hematogenously
Ergocalciferol
vitamin D2
cholecalciferol
vitamin D3
- Slow DTRs with prolonged relaxation phase
- Fatigue
- Lethargy
- Mental slowness
- Mental retardation (perinatal)
hypothyroidism
What is the most common cause of hyperparathyroidism?
Single benign adenoma
What is the mechanism of action of β-blockers in treatment of hyperthyroidism?
control symptoms of ↑ SNS tone
- brain trauma
- surgery
- pituitary tumor
- histiocytosis X
cause central diabetes insipidus
- chronic renal failure
- malabsorption syndromes
- rickets
- psuedohypoparathryoidism
4 causes of secondary hyperparathyroidism
FSH, LH, ACTH, TSH, CRH, hCG, ADH (V2 receptor), MSH, PTH, calcitonin, GHRH, and glucagon use what signaling mechanism?
adenylate cyclase -cAMP signaling mechanism
what is stimulated by mild decreases in Mg2+ but inhibited by severe decreases in Mg2+?
PTH
drugs that inhibit thyroid peroxidase (TPO)
propylthiouracil and methimazole.
What catalyzes the formation of vitamin D3 from 7-dehydrocholesterol?
sunlight!
Can you name 3 immunologic mechanisms which may cause thyroid cell death in patients with Hashimoto thyroiditis?
- CD8+
- cytokines
- ADCC
Hürthle cells
hashimoto
Hürthle cells
hashimoto
How does Thyroid Releasing Hormone affect prolactin secretion?
stimulates it!
How does Thyroid Releasing Hormone affect prolactin secretion?
stimulates it!
What is the function of calcitonin?
decrease bone resorption of calcium (i.e. put calcium on bones)
What is the function of calcitonin?
decrease bone resorption of calcium (i.e. put calcium on bones)
High levels of I- inhibit thyroid hormone synthesis by blocking the organification step.
Wolff-Chaikoff effect
High levels of I- inhibit thyroid hormone synthesis by blocking the organification step.
Wolff-Chaikoff effect
In the hypothalamic-pituitary system, which two hormones does somatostatin inhibit?
GH + TSH
In the hypothalamic-pituitary system, which two hormones does somatostatin inhibit?
GH + TSH
Name a viral cause of hemorrhagic cystitis.
adenovirus
Name a viral cause of hemorrhagic cystitis.
adenovirus
Associated with HLA-DR3 and HLA-B8
Graves
Associated with HLA-DR3 and HLA-B8
Graves
