L5 Thyroid Gland Flashcards

1
Q

Describe the structure of the thyroid gland.

A
  • Overlies the trachea
  • 2 large asymmetrical lobes connected by an isthmus
  • 4 parathyroid glands found posteriorly (control plasma calcium)
  • Rich blood supply
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which organs regulate the thyroid gland?

A

The hypothalamus and pituitary gland.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the overall function of thyroid hormones?

A

Controls metabolism, growth and development.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the histology of the thyroid gland.

A
  • Functional unit of gland = follicle
  • Each follicle is composed of a layer of follicular cells surrounding a colloid filled cavity
  • Separations made by follicular epithelium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 2 main thyroid hormones?

A
  • Triiodothyronine (T3)

- Thyroxine (T4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe triiodothyronine.

A

T3:

  • 5ug produced per day
  • Much greater biological activity than T4
  • Contains 3 atoms of iodide per molecule
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe thyroxine.

A

T4:

  • 80ug produced per day
  • Contains 4 atoms of iodide per molecule
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Both T3 and T4 are in a protein bound form in plasma, what are these proteins?

A

Carrier-proteins:

  • Thyroxine-binding globulin
  • Albumin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe thyroid hormone synthesis.

A
  • Tyrosines provided by thyroglobulin are secreted into the lumen of follciles as colloid
  • Iodine is pumped into the follicular cells and binds to the tyrosine
  • Lyososomal enzymes remove the rest of the thyroglobulin molecule so only the iodinated tyrosine remians
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What causes T4 or T3 to be produced?

A

Iodine is consumed in the diet and enters cells as diiodotyrosine or monoidotyrosine depending on how many iodines are bound.
2 diiodytorisne = T4
1 diiodotryosine + 1 monoidotyrosine = T3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which thyroid hormone is functional?

A

Triiodothyronine (T3) is functional.

T4 must be converted to T3 in peripheral tissues e.g. liver and kidneys by enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the process of T3 binding to cells.

A
  • Cells uptake T3
  • There are nuclear receptors called thryoid responsive elements (TRE) which bind the hormone
  • Causes transcription of specific genes
  • Causes a cellular effect which leads to a whole body effect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the 4 principal actions of triiodothyronine?

A
  • Metabolism: increased mobilisation and utilisation of glucose, fat and proteins
  • Heat production: calorigenic effects to regulate temperature
  • Growth and development (e.g. CNS development)
  • Cardiovascular function: increases cardiac output, heart rate and contractility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Explain the hypothalamic-pituitary-thyroid axis (HPT).

A
  • Hypothalamus produces thyrotropin releasing hormone (TRH)
  • Stimualtes anterior pituitary to secrete thyroid stimulating hormone (TSH)
  • TSH acts on the thyroid gland to produce T3 and T4

It is a negative feedback loop.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the causes of hypothyroidism?

A
  • Iodine deficiency (aka endemic goitre): enlarged thyroid gland due to trophic effects of TSH, insufficient T3 and T4, abnormally high TSH.
    Treated with iodine supplements and levothyroixne.
  • Hashimoto’s thyroiditis (autoimmune disease): body produces antibodies against TSH receptors in thyroid gland, prevents T3 and T4 production, causes thyroid gland destruction.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the symptoms of hypothyroidism?

A
  • Sensitivity to cold
  • Impaired memory
  • Weight gain
  • Myxoedema (puffy eyes)
  • Slow pulse
  • Reduced cardiac output
  • Reduced metabolic rate
17
Q

How is hypothyroidism diagnosed and treated?

A
  • Low plasma levels of T3 and T4, high TRH, high TSH

- Levothyroxine (dose determined through blood monitoring)

18
Q

What is cretinism?

A
  • Congenital hypothyroidism
  • 1 in 4000 births
  • Children are mentally retarded, have short, disproportionate bodies, thick tongue and neck
  • Diagnosed through heel prick
  • Treated with levothyroxine
19
Q

What are the symptoms of hyperthyroidism?

A
  • Weight loss
  • Excessive sweating
  • Palpitations and irregular heartbeat
  • Anxiety
  • Increased metabolic rate and heart rate
  • Hypertension
20
Q

How is hyperthyroidism diagnosed and treated?

A
  • Low TSH levels
  • High T4 levels
  • Treated with surgical removal of all or part of the gland
  • or ingestion of radioactive iodine to selectively destroy most active thyroid cells
  • or drugs which interfere with gland’s ability to produce T3/T4 e.g. methimazole, carbimazole
21
Q

Which autoimmune disease causes hyperthyroidism?

A

Grave’s disease:

- The body produces a thyroid-stimulating antibody that activates the TSH receptor and induces T3/T4 release

22
Q

What are the oral manifestations of hypothyrodism?

A
  • Macroglossia
  • Dysgeusia
  • Delayed tooth eruption
  • Poor periodontal healing
23
Q

What are the oral manifestations of hyperthyroidism?

A
  • Increased susceptibility to caries and periodontal disease
  • Accelerated tooth eruption
  • Maxillary and mandibular osteoporosis
  • Burning mouth syndrome