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Yr 2 EOYS > MET EOYS5 > Flashcards

MET EOYS5 Flashcards

1
Q

How would hypothyrodism present with regards to T3/T4 and TSH levels? [2]
How would hyperthyrodism present with regards to T3/T4 and TSH levels? [2]

A

Hypothyroidism:
* Low T3/T4
* Low TSH

Hyperthyroidism
* High T3/T4
* Low TSH

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2
Q

Which of the following would you use to treat hypothyroidism?

Propylthiouracil
Levothyroxine
Iodine 131
Carbimazole
Iodine 123

A

Which of the following would you use to treat hypothyroidism?

Propylthiouracil
Levothyroxine
Iodine 131
Carbimazole
Iodine 123

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3
Q

Which of the following would you use to diagnose a toxic adenoma ?

Propylthiouracil
Levothyroxine
Iodine 131
Carbimazole
Iodine 123

A

Which of the following would you use to diagnose a toxic adenoma ?

Propylthiouracil
Levothyroxine
Iodine 131 - used to treat
Carbimazole
Iodine 123

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4
Q

Which of the following is the remnant of the umbilical vein?

A
B
C
D

A

Which of the following is the remnant of the umbilical vein?

A
B
C
D - ligament teres

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5
Q

Which of the following deiodinase enzymes makes more inactive from of thyroid hormone?

D1
D2
D3
D4

A

Which of the following deiodinase enzymes makes more inactive from of thyroid hormone?

D1 & D2 convert T4 to T3 and cause activation
D3 : ** **
D4

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6
Q

Pendred syndrome is a cause of hypothyroidism due to lack of which channel? [1]

A

PDS (pendred syndome - PDS)

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7
Q

What is the name for naturally form of active thyroid hormone?

Levothyroxine
Liothyronine
Thyrotrophin
Thyroxine

A

What is the name for naturally form of active thyroid hormone?

Levothyroxine
Liothyronine: T3
Thyrotrophin
Thyroxine

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8
Q

Which sign of ascites is present in this CT

Ascites
Caput medusae
Oesophageal varices
Spider naevi

A

Which sign of ascites is present in this CT

Ascites
Caput medusae
Oesophageal varices
Spider naevi

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9
Q

Which of the following occurs in graves disease

Increased insulin turnover; increased gluconeogenesis; increased insulin secretion
Increased insulin turnover; decreased gluconeogenesis; increased insulin secretion
Decreased insulin turnover; decreased gluconeogenesis; increased insulin secretion
Increased insulin turnover; increased gluconeogenesis; decreased insulin secretion

A

Which of the following occurs in graves disease

Increased insulin turnover; increased gluconeogenesis; increased insulin secretion
Increased insulin turnover; decreased gluconeogenesis; increased insulin secretion
Decreased insulin turnover; decreased gluconeogenesis; increased insulin secretion
Increased insulin turnover; increased gluconeogenesis; decreased insulin secretion

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10
Q

Which of the following can Graves Disease lead to?

Osteoarthritis
Osteomalacia
Osteoporosis
Pagets Disease

A

Which of the following can Graves Disease lead to?

Osteoarthritis
Osteomalacia
Osteoporosis
Pagets Disease

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11
Q

Which of the following types of anaemia is associated with Graves Disease?

IDA
B12 deficiency
Thalassemia
Haemolytic

A

Which of the following types of anaemia is associated with Graves Disease?

IDA
B12 deficiency / pernicious
Thalassemia
Haemolytic

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12
Q

Label A-C

A

A: Ligamentum venosum
B: Falciform ligament
C: Round ligament of the liver/ Ligamentum teres

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13
Q

Explain mech. of portal htn causing ascites

A
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14
Q

Why does jaundice occur if gall stone occurs in common bile duct?

A

Stone blocks bile leaving the gall bladder and the Liver.

So bilirubin in bile is not able to be broken down

accumulates in blood causing jaundice and biliary colic.

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15
Q

What symptoms would occur here? [3]

A

biliary colic, jaundice and pancreatitis

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16
Q

Portosystemic Anastomoses at the Esophagus is made from? [2]

A

splenic (HPV) and azygous veins (IVC)

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17
Q

Caput meduase is caused by htn in anastomoses in which two veins?

A

Paraumbilical veins (ligamentum teres recanalised)

Intercostal and inferior epigastric veins

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18
Q

Label A-F

A

A: splenic artery
B: gastroduodenal artery
C: hepatic artery proper
D: SMA
E: SMV
F: Hepatic portal vein

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19
Q

Label A-C

A

A: Coronary Ligament
B: Right Triangular Ligament
C: Left triangular Ligament

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20
Q

What is the chemical name for active form of thyroid hormone?

What is the chemical name for inactive form of thyroid hormone?

A

Liothyronine (T3)
Thyroxine (T4)

21
Q

Branchial pouch embryology:

Pouch = endodermal outpouching of pharynx

Which pouch made the inferior parathryoid and thymus? [1]
Which pouch made the superior parathryoid and ultimobranchial body? [1]

A

Pouch 3 - inferior parathyroid and thymus
Pouch 4 - superior parathyroid and ultimobranchial body
Ultimobranchial body - C-cells

22
Q

Where does the thryoid originate? [1]

What duct does it move down to get to perm position? [1]

A

Thyroid originates from foramen cecum

Travels along thyroglossal duct. to cricoid cartilage

Normally thyroglossal duct disappears but in some it can remain: contains thyroid tissue

23
Q

How is T3 transported around the body? [3]

A

Predominately via Thyroid Binding Globulin

Also by albumin and transthyretin

24
Q

Why are pregnant people in a hypothryoid state?

A

In pregnancy: the level of oestrogen increases: increases sialylation of TBG (increases the half life) so it is cleared slowly from plasma: less free thyroid hormone

25
Q

T4 -> T3 (activation) of free TH:

What are the effect of Deiodinase enzymes:

D1 & D2? [1]
D3 [1]

Why is this important?

A

D1 & 2: convert T4 -> T3 - activation

D3: D3 -> inactivates T4 to rT3

Important because another level of control - expression of deiodonase enzymes:

these enzymes will be up/down regulated at certain times to increase/decrease metabolism.

26
Q

Hyperthyroidism:

[] insulin turnover
[] gluconeogenesis
[] insulin secretion

A

Increased insulin turnover
Increased gluconeogenesis
Reduced insulin secretion

27
Q

Hyperthyroidism:

Effect on Nervous System? [3]

Effect on skin [3]

Effect on eyes? [1]

A

Hyperthyroidism:

Effect on Nervous System? [3]
* Increased risk of seizures
* Nervousness/tremor.
* Hyperphagia - increased hunger

Effect on skin [3]
* Warm and moist - due to vasodilation + heat loss.
* ‘Plumber’s’ nails. Or soft and crumbling nails - acropachy
* Pretibial myxoedema inflammation over the tibia.

Effect on eyes? [1]
* Eyelid retraction and eyelid drag.

Pretibial myxoedema i
28
Q

Hyperthyroidism

Effect on GI tract? [4]

Effect on bones? [3]

Haematological effect [2]

Effect on reproductive system [3]

A

Hyperthyroidism

Effect on GI tract? [4]
* Increased appetite
* Weight loss
* Increased gut motility
* Increased liver enzymes - transaminitis.

Effect on bones? [3]
* * Accelerated osteoclast activity - to provide substrates for metabolism.
* Hypercalcemia
* Osteoporosis - in the long term.

Haematological effect [2]
* Pernicious anaemia - coincidental, autoimmune.
* B12 deficiency

Effect on reproductive system [2]
* Periods stop (oligomenorrhoea)
* Gynecomastia (man boobs)
* Erectile dysfunction.

29
Q

What are 3 risk factors for graves disease? [3]

A

HLA status - TH17 led autoimmune response
Trigger: infection, neck trauma, stress
Female stress - 1-2% of women. Because connected to X- chromosome.

30
Q

What causes Toxic Multinodular Goitre? [1]

A

Somatic TSHR mutation: Thyroid always on

31
Q

What is toxic adenoma? [1]

How can you diagnose? [1]

How do you treat? [1]

A

One nodule of T (where the tumour is) becomes hyperactive and the rest of the gland becomes inactive.

Diagnosed by ingesting iodine 123 and using gamma camera imaging - will see one area lit up by gamma emitting iodine- 123.

Can treat with iodine-131 - emits b-particles to destroy overactive nodules - used in toxic adenoma and thyroid cancer.

32
Q

What findings would you find for thyrotoxicosis:
- T4 / T3 [1]
- TSH [1]

What treatment would you find for thyrotoxicosis [3]

A

Findings:
* Elevated T4 and T3
* Suppressed TSH
* Technetium or iodine uptake scans

Treatment:
* Thionamide drugs: Propylthiouracil; Carbimazole
* Radioactive Iodine I-131
* Thyroidectomy

33
Q

Hypothyroidism effects on:

Skin [2]
CV [4]
GI tract [3]

A

Skin [1]
* myxoedema
* Accumulation of hyaluronic action -> yellowing. Hair falls our and becomes thin.

CV [4]
* Stroke volume reduces
* Cold/reduced circulation
* Sinus bradykinin.
* J-waves on ECG due to hypothermia.
* LDL cholesterol rises.

GI tract [3]
* Reduced appetite
* Constipation
* Weight increases (fat - due to reduced metabolic rate - and fluid retention).

34
Q

Causes of hypothyroidism? [4]

A

Hashimoto’s disease
Endemic goitre (Iodine deficiency)
Lithium (toxic to thyroid)
Pendred’s syndrome (lack of PDS: improper synthesis of TH)

35
Q

What causes cretinism?

A

Large goitres:

Low levels iodine in diet + low levels of iodine produced in thyroid -> increasing TSH production -> stimulates growth of thyroid gland

Causes mental retardation

36
Q

Diagnosis [2] and Treatment of HypoT? [1]

A

Diagnosis of hypothyroidism:
* High levels of TSH and low T4 in blood - biochemistry tests

Treatment:
* Levothyroxine - only treatment used In UK

37
Q

[] is the first line anti-thyroid drug
[] is the second line anti-thyroid drug.

A

Carbimazole is the first line anti-thyroid drug
Propylthiouracil is the second line anti-thyroid drug.

38
Q

Label A-D

A

A: Falciform ligament
B: fundus of gall bladder
C: stomach
D: Ligamentum teres

39
Q

Label A-F

A

A: IVC
B: Cystic duct
C: Cystic artery
D: Ligamentum teres
E: Ligamentum venosum

40
Q

Label A & B [2]

A

A: Quadrate lobe
B: Caudate lobe

41
Q

Which of the following are the:

SMA [1]
Middle colic artery [1]
Right colic artery [1]
SMV [1]
Jejunal arteries [1]

A

11 Superior mesenteric
artery
2 Middle colic artery
3 Right colic artery
10 Superior mesenteric vein
13 Jejunal arteries

42
Q

Name this pathology [1]

A

Ascites. Axial CT scan of the abdomen shows low density ascitic fluid surrounding the liver, spleen and stomach.

43
Q

Label 1, 2, 3, 7, 8, 9 & 10

A

1 Left hepatic duct
2 Right hepatic duct
3 Cystic duct
7 Common hepatic duct
8 Common bile duct
9 Pancreatic duct
10 Greater duodenal papilla

44
Q

Which thyroid pathology is depicted here? [1]

A

Hashimotos thyroiditis

45
Q

Which thyroid pathology is depicted here? [1]

A

Graves disease

46
Q

What is the name for this symptom of Graves disease? [1]

What is this symptom usually associated with? [1]

A

Acropachy

in association with thyroid ophthalmopathy

47
Q

Name three reasons for hyperthyroidism [2]

A

Toxic multinodular
goitre
Graves Disease
Toxic adenoma

48
Q

Pendreds symptom is a cause of hypothyroidism. Which transporter is lacking in this disease? [1]

A

Lack of PDS

Yr 2 EOYS (58 decks)

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