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Endo/Repro Exam 1 > Hyper and Hypo-Thyroidism > Flashcards

Hyper and Hypo-Thyroidism Flashcards

1
Q

Three types of thyroid hormones?

A 
Thyroxine (T4)
Triiodothryonine (T3)
Reverse Triiodothryonine (rT3)
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2
Q

What thyroid hormone is produced the most?

A

T4 (90%)

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3
Q

What is the more potent thyroid hormone?

A

T3 (10x more)

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4
Q

In tissue, what turns T4 to T3?

A

5-deiodinase

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5
Q

Where are T3/T4 synthesized?

A

In the colloid of follicular cells

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6
Q

On what molecule are T3/T4 synthesized?

A

A large tyrosine-rich glycoprotein called thyroglobulin

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7
Q

How is iodide transported into the follicular cells?

A

Na/I cotransporter

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8
Q

What turns I- into I2?

A

Thyroid peroxidase

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9
Q

How is I2 conjugated onto tyrosine of thyroglobulin?

A

By thyroid peroxidase forming MIT and DIT

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10
Q

Thyroid peroxidase also couples MIT and DIT what do they form?

A

MIT + DIT = T3

DIT + DIT =T4

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11
Q

Where is iodinated thyroglobulin stored?

A

In the colloid of the follicular cells

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12
Q

What occurs to T4?

A

It is activated to more potent T3 in target cells

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13
Q

Where does T3 bind?

A

To both an extracellular and an intracellular receptor

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14
Q

5 physiologic effects of thyroid hormone?

A 
Growth
CNS development
Skeletal/Cardiac muscle
Central sympathetic nervous stimulation
Upregulates lipid, carbohydrate, oxidative metabolism, protein synthesis
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15
Q

What are the four thyroid replacement drugs?

A

Levothyroxine (drug of choice)
Liothyronine
Liotrix
Desiccated thyroid

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16
Q

What is Levothyroxine?

A

T4

17
Q

What is Liotrix?

A

T3 + T4

18
Q

What is Liothyronine?

A

T3

19
Q

What is desiccated thyroid?

A

Porcine thyroid

20
Q

What is a potential SE of desiccated thyroid?

A

Antibodies forming against the porcine

21
Q

What are the drug overdose SE of thyroid replacement drugs?

A

High sympathetic tone

22
Q

What test can Liothyronine used for?

A

TSH suppression test

23
Q

What are the 5 classes of anti-thyroid drugs?

A 
Radioactive iodides
Anion inhibitors
Beta blockers
Iodides
Thioamides
24
Q

What are the radioactive iodides?

A

131 I

25
Q

What are the anion inhibitors?

A

Perchlorate
Pertechnetate
Thiocyanate

26
Q

What are the Thioamides?

A

Methimazole

Propylthiouracil

27
Q

How do Thioamides work?

A

Inhibit synthesis but not release by inhibiting thyroid peroxidase

28
Q

When to use Thioamides?

A

Grave’s Disease in children
Propylthiouracil: 1st trimester
Methimazole: 2nd and 3rd trimester

29
Q

How do anion inhibitors work?

A

Competitively inhibit iodine uptake by follicular cells

30
Q

How do the Iodides work?

A

Inhibits thyroid hormone release

31
Q

Two possible effects from giving iodides?

A

Jod-Basedow Effect
Wolff-Chaikoff Effect
(opposites of each other)

32
Q

What occurs in the Jod-Basedow effect?

A

Severe hyperthyroidism when a TSH stimulated thyroid suddenly receives an increased in iodine (body didn’t have any Iodine and TSH was high so kick stated thyroid gland)

33
Q

What occurs in the Wolff-Chaikoff effect?

A

Temporary suppression of acute hyperthyroidism by increased iodine intake

34
Q

What does 131 I do?

A

Burns out half of the thyroid; long term treatment of hyperthyroidism

35
Q

What do you never treat hyperthyroidism with?

A

Only a beta blocker! (malpractice lawsuit)

36
Q

What are the signs of thyroid storm?

A

Fever
Sympathetic nervous system storm
Confusion/delirium
NVD

37
Q

Thyroid storm treatment?

A

IV beta blocker (propranolol)
IV Propylthiouracil
Iodides
Glucocorticoids (inhibit peripheral T4->T3)

38
Q

What are two iodides given?

A

Lugol’s solution

KI

Endo/Repro Exam 1 (17 decks)

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