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Clinical Chemistry 2 > LECTURE 8 Thyroid Function > Flashcards

LECTURE 8 Thyroid Function Flashcards

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1
Q

T4 is also called _______ because 80 percent of of T3 comes from T4

A

Prohormone

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2
Q

What is the process where conversion of t4 to active t3

A

Monodeiodination

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3
Q

Maintains the plasma t3 concenctration

A

Type 1:5’-deiodinase

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4
Q

Maintains the local t3 concentrations in the tissue in which it is present

A

Type 2:5’-deiodinase

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5
Q

What is the product when inner ring of t4 undergoes monodeiodination

A

Reverse t3

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6
Q

What will form if the inner ring of T4 undergoes monodeionization

A

3,3’,5’-triiodotyronine

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7
Q

Mjor carrier protein of t3 and t4 in the circulation

A

Thyroxine-binding globulin

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8
Q

A water soluble hormone that is brought to the target cell via a protein carrier.

A

Thyroxine or t4

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9
Q

T/F. Both hormones enter the target cells but all t4 that enters is converted into t3

A

True

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10
Q

T or f. Only the t3 form of the hormones enters the nucleus and binds to nuclear receptor proteins

A

True

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11
Q

A group of interrelated neuroendocrine and endocrine organs that regulate and control the secretion of thyroid hormone

A

Hypothalamic-pituitary-thyroid axis

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12
Q

A tripeptide produced in the paraventricular nucleus of the hypothalamus and secreted into the venous system, which drains the pituitary

A

Thyroid releasing hormone

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13
Q

True or false. Trh attaches to receptor sites in the pituitary, where it causes increased production and secretion of TSH

A

True

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14
Q

A chief regulator of thyroid hormone synthesis

A

TSH

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15
Q

Increasing intracellular levels of cAMP has two main actions:

A

Trophic action

Production and secretion of thyroid hormone by the thyroid cells

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16
Q

What action where it increases the size of follicular cells and its number so that they csn trap mire iodine

A

Trophic action that is stimulated by the increasing levels of cAMP

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17
Q

What occurs when the rate of the process decreases as the ocncentraiton of the product increases, in this case thyroid hormone.

A

Negative feedback system

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18
Q

It is the extrinsic direct mechanism

A

Hyperparathyroidism access

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19
Q

Extrinsic indirect mechanism

A

Neurologic, metabolic snd pharmacological mechanism

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20
Q

Mechanism within thyroid cells, ensure that adequate amounts of intrathyroid hormones are also produced, and is dependent on the availability and effects of iodine

A

Intrinsic mechanism

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21
Q

Why does thyroid disease is predominant to females?

A

Due to effects of estrogen and androgen

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22
Q

T or false. Estrogen decreases TBG

A

False.

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23
Q

T or false. Androgen decreases TBG

A

True

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24
Q

Acts as a preformed matrix containing tyrosyl group; also a glycoprotein

A

Thyroglobulin

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25
Q

How does the MIT and DIT forms

A

Iodination of tyrosine residues in thyroglobulin

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26
Q

Where does the conversion of t4 to t3 takes place

A

Peripheral tissues

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27
Q

It is biologically inert and functions as storage sites of circulating hormones

A

Protein bound hormones

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28
Q

Exert biologically active effects

A

Free hormones

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29
Q

Determine if it is T3 or T4

  1. 3,5,3’-Triiodothyronine
  2. Principal secretory product
  3. Major fraction of organic iodine in the circulation
  4. Prohormone
  5. Increase levels is first abnormality seen in cases of hyperthyroidism
  6. Increase levles causes inhibition of TSH secretion
A
  1. T3
  2. T4
  3. T4
  4. T4
  5. T3
  6. T4
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30
Q

Lagging of upper eyelid on downward rotation pf the eye

A

Von graefe’s sign

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31
Q

It is one of the significant symptom of hyperthyroidism which it icmrease leukocyte imfiltration in the eyelids causing protruding of the eyes

A

Exophthalmos

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32
Q

What is the cause of protrudinng of the eyes.

A

Increase leukocyte infiltration

33
Q

Used to describe state of thyroid that a patient with thyroyoxicosis may experience that requires emergrncy treatment

A

Thyroid storm

34
Q

Type of hyperthyroidism that the problem is intrinsic to the thyroid gland itself.

A

Primary hyperthyroidism

35
Q

Type of hyperthyroidism wherein the problem is in the pituitary gland

A

Secondary hyperthyroidism

36
Q

What are the diseases in the primary hyperthyroidism?

A

Toxic multinodular goiter
Thyroid carcinoma
Thyroid adenoma
Struma ovarii

37
Q

T or false. Grave’s disease cannot cross the placenta and does not affect the fetus during pregnancy.

A

False. Kay it is IgG

38
Q

Antibody responsible for grave’s disease. It mimics the TSH and causes the thyroid to increase the synthesis and release of t4

A

Thyroid stimulating immunoglobulin

39
Q

An antibody responsible for grave’s disease are formerly called

A

Long acting thyroid stimulator

40
Q

Has an alpha subunit that is similar to TSH. however it is a weak stimulator but can still cause hyperstimulation of the thyroid

A

HSG

41
Q

HSG is secreted by

A

Choriocarcinoma

42
Q

True or false. Hyperthroidism: diffuse goiter, pretibial swelling, exophthalmos

A

True

43
Q

The problem is intrinsic to the thyroid gland that can cause increase or excess thyroid hormones in the circulation

A

Primary thyroid disease

44
Q

Second common cause of hyperthyroidism

A

Primary thyroid disease

45
Q

Which is false about primary thyroid disease

A. Involves hypersection of thyroid hormones from one or more nodules within the thyroid gland
B. Autonomous activity of nodules causes supression of pituitary TSH
C. the problem is in the pituitary gland
D. Graves disease
E. Toxic nodular goiter
F. Plummer’s disease

A

C and D

46
Q

It is not a single disorder but term used to described a group of inflammatory disease that affect the thyroid gland

A

Thyroiditis

47
Q

Uncommon inflammatory disease that result from an infection of the thyroid gland by gram positive microorganism

A

Acute thyroiditis

48
Q

What are the microorganism is associated with acute thyroiditis

A

Staphylococcus aureus, Staphylococcus preumoniae, Staphylococcus pyogenes

49
Q

Identify disease wherein there is neutrophilic leukocyte, elevated sedimentation rate, normal thyroid function

A

Acute thyroiditis

50
Q

What is the confirmatory test for thyroiditis caused by gram positive microorganism

A

Needle aspiration

Culture revealing a pathogenic organism

51
Q

Inflammatory disorders that us most likely due to virus

A

Subacute thyroiditis

52
Q

T or f. Secondary thyroiditis results from ruptured follicles and leakage of large amounts of stored hormones in to the circulation

A

False. Subacute thyroiditis

53
Q

What lab findings that causes thyroiditis due to virus

A

Elevated serum thyroglobulin

54
Q

What thyroid disease that is based on the ff. laboratory results.

High sensitive TSH levels and high free t4

A

Secondary hyperthyroidism

55
Q

Low sensitive TSH Levels but free t4 and free t3 are normal

A

Subclinical hyperthyroidism

56
Q

Low sensitive TSH levels, free t4 normal, high free t3

A

T3 thyrotoxicosis

57
Q

Sensitive TSH is greatly suppressed or low but free t4 is high

A

Primary hyperthyroidism

58
Q

Positive thyroid antibodies

A

Grave’s disease

59
Q

Nagative for thyroid antibodies

A

Toxic adenoma or multinodular goiter

60
Q

Develops whenever insufficient amounts of thyroid hormone are available to tissues

A

Hypothyroidism

61
Q

Causes of hyperthyroidism where in the problem is in the thyroid gland, presemce of parenchymal disease, therapeutic ablation, thyroid dysgenesis, thyroid imfiltration

A

Primary thyroid dysfunction

62
Q

Cause of hypothyroidism that occurs after surgery and 131 therapy

A

Therapeutic ablation

63
Q

Causes of hyperthyroidism wherein aplasia and dysplasia is significant

A

Thyroid dysgenesis

64
Q

What cause of hypothyroidism wherein there is TSH deficiency

A

Pituitary hypothyroidism

65
Q

Deficiency in TRH amd it has problem with hypothalamus

A

Hypothala,ic hypothyroidism

66
Q

Syndrome found in patients with severe hypothyroidism

A

Myxedema

67
Q

Severe manifestation of long standing hypothyroidism

A

Myxedema coma

68
Q

Symptoms result from a genrAl slowing down of metabolic processes

A

Overt hypothyroidism

69
Q

Cretenism in infants is caused by

A

Congenital Hypothyroidism

70
Q

Screning forcdetection of neonatal hypothyroidism and is also considered as most sensitive for diagnosis

A

Elevated TSH

71
Q

Identify if it is hashimoto’s thyroidism or Grave’s disease or both

  1. 10:1
  2. Cellular and antibody mediated destruction of thyroid tissue
  3. Amtibody mimics TSH
  4. HLA B8
  5. high TSH
  6. Low TSH
A
  1. Hypo
  2. hypo
  3. Hyper
  4. Both
  5. Hypo
  6. Hyper
72
Q

What specimen is used to detect hypothyroidism in newborn screening

A

Whole blood

73
Q

It is usaloy affect young patients especially women, characterized by a firm, solitary nodule that is clearly different from the rest of the gland,

A

Papillary carcinoma

74
Q

More invasive than papillary carcinoma, can spread to the lymph nodes of blood vessels with metastases to bone

A

Follicular carcinoma

75
Q

Arises from psrafollicular cells of thyroid or c cells and produce excess calcitonin

A

Medullary carcinoma

76
Q

This group of tumors includes small cells, giant cells and spindle carcinomas, usually occur in patients with long history of goiter

A

Undifferentiated thyroid carcinoma

77
Q

Low TSH, low free t4 and blunt response to TRH stimulation test

A

Secondary hypothyroidism

78
Q

Can be used for detection of hyper or hypo thyroidism in patients who are taking drugs

A

sTSH

Clinical Chemistry 2 (3 decks)

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