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Applied Biochemistry > Metabolic Disorders of the Thyroid and Adrenal Glands > Flashcards

Metabolic Disorders of the Thyroid and Adrenal Glands Flashcards

1
Q

metabolic syndrome

A

a cluster of metabolic risk factors; excessive abdominal fat, high blood pressure, high triglyceride and/or cholesterol levels, high blood sugar. These risk factors can result in serious disease, such as heart disease and type 2 diabetes

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2
Q

inborn errors of metabolism- rare disorders (hundreds are known, such as)

A

–Carbohydrate metabolism (ex: glycogen storage disease)
–Amino acid metabolism (ex: phenylketonuria)
–Organic acid metabolism (ex: alcaptonuria)
–Urea Cycle
–Fatty acid metabolism
–Porphyrin metabolism
–Purine Pyrimidine metabolism
–Steroid metabolism
–Mitochondrial function
–Peroxisomal function
–Lysosomal storage diseases
–Metal metabolism
–Congenital disorders of glycosylation
–Congenital disorders of creatine metabolism

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3
Q

diseases of the thyroid gland (3)

A

–Goiter (abnormally large thyroid)
–Graves disease (hyperthyroidism)
–Hashimoto’s disease (hypothyroidism)

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4
Q

diseases of the adrenal gland (2)

A

–Addison’s disease (aldosterone and cortisol insufficiency)

–Cushing’s syndrome (cortisol excess)

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5
Q

what is the largest endocrine gland in the body? weight?

A

thyroid

15-20 gm

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6
Q

what does the thyroid produce

A

thyroid hormones and calcitonin

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7
Q

location of the thyroid

A

it sits between anterior to the trachea

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8
Q

physical description of the thyroid

A

consists of two lobes and a central isthmus, which gives it a bow tie like shape

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9
Q

the thyroid is the only tissue in the body capable of

A

absorbing iodine

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10
Q

Iodine deficiency can lead to a variety of health and developmental consequences known as

A

iodine deficiency disorders (IDDs)

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11
Q

what is the most widely used strategy to control and eliminate IDDs?

A

universal salt iodization

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12
Q

universal salt iodization aims for consumption of adequately iodized salt in more than

A

90 per cent of households. However, this goal is a long way from being met

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13
Q

Iodine deficiency is especially damaging during

A

the early stages of pregnancy and in early childhood

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14
Q

In their most severe forms, IDDs can lead to (4)

A

cretinism, stillbirth and miscarriage; even mild deficiency can cause a significant loss of learning ability

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15
Q

Adequately iodized salt can protect children from

A

brain damage, but only three quarters of the world’s households are using it. In 2013, more than 35 million newborns were unprotected from the lifelong consequences of brain damage associated with iodine deficiency

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16
Q

one of the most common glandular disorders of the endocrine system

A

thyroid dysfunction

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17
Q

how much of the world lives in areas of iodine deficiency?

A

1/3

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18
Q

incidence of thyroid disorders

A

higher in females (9%) vs males (2%)

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19
Q

abnormal thyroid prevalence

A

about 15% of the population

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20
Q

most common findings of abnormal thyroid

A

thyroid nodules

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21
Q

what is the major form of thyroid hormone found in the blood?

A

thyroxine, T4

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22
Q

T4 is cleared into

A

3, 5, 3’ triiodothyronine (T3)

3, 3’, 5’ triiodothyronine (reverse T3)

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23
Q

metabolically active form of T3

A

3, 5, 3’ triiodothyronine (T3)

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24
Q

metabolically inactive form of T3

A

3, 3’, 5’ triiodothyronine (reverse T3)

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25
Q

T4 is the major form found in blood, because

A

it has a longer half-life than T3

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26
Q

T4 is converted to active T3 in target cells by the

A

deiodinase enzyme (or iodide peroxidase) Iodothyronine deiodinase.

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27
Q

three isoforms (Type 1, 2 and 3) of Iodothyronine deiodinase and these enzymes contains a

A

selenium metal ion (in the form of selenocystiene)

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28
Q

Selenium deficiency can lead to

A

decreased T3 levels

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29
Q

Synthesis of thyroid hormones involves the protein

A

thyroglobulin

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30
Q

TRH

A

thyrotropin releasing hormone

31
Q

TSH

A

thyroid stimulating hormone

32
Q

how is T4/T3 production regulated?

A

negative feedback regulation look at the levels of the pituitary and hypothalamus

33
Q

production of T4/T3

A

hypothalamus released TRH which stimulates the pituitary gland to release TSH which stimulates the thyroid gland to produce and secrete T3 and T4 which is converted to T3 in peripheral tissues

34
Q

Hyperthyroidism often

A

mimics other diseases

35
Q

hyperthyroidism can greatly accelerate your body’s

A

metabolism

36
Q

common symptoms of hyperthyroidism include (5)

A

–Heart problems: arrhythmia or atrial fibrillation
–Osteoporosis: too much thyroxine interferes with process of bone formation and calcium handling
–Eye problems: Graves ophthalmopathy
–Red swollen skin: increased sensitivity to heat
–Thyrotoxic crisis: sudden intensification of symptoms
–Abnormal thermal regulation: night “sweats”
–Brittle hair

37
Q

Graves Disease

A

Autoimmune disorder resulting in overproduction of thyroid hormones

38
Q

~30% of patients develop

A

Graves’ ophthalmopathy

39
Q

The autoimmune reaction is due to

A

an antibody that binds to the thyrotropin receptor, which stimulates the thyroid to overproduce thyroid hormones

40
Q

In rare circumstances patients can develop a

A

thyroid storm or thyrotoxic crisis. This is a life-threatening condition and must be treated immediately

41
Q

who is most likely to get hypothyroidism?

A

More common in women over age 60, but anyone, including infants can develop hypothyroidism

42
Q

common symptoms of hypothyroidism (8)

A 
–Fatigue–Sensitivity to cold
–Constipation
–Dry skin
–Weight gain
–Puffy face
–Hoarseness
–Muscle weakness, aches, tenderness and stiffness
–Thinning hair
43
Q

Hashimoto Syndrome

A

Autoimmune disease (T-cell mediated) in which your immune system attacks the thyroid

44
Q

Hashimoto Syndrome results in

A

hypothyroidism

45
Q

Hashimoto Syndrome affects about

A

5 in 100 people in the US

46
Q

who is most likely to develop Hashimoto Syndrome

A

Women are ~8X more likely to develop than men

47
Q

Several diseases are risk factors, such as (6)

A

Addison’s disease, celiac disease, pernicious anemia, Sjogren’s syndrome, type 1 diabetes, vitiligo

48
Q

patients with Hashimoto Syndrome often develop a — as the disease progresses

A

goiter

49
Q

dental complications of radioiodine therapy (2)

A
  • Xerostomia or dry mouth

* Increased risk of caries due to changes in oral microbiome

50
Q

radioiodine therapy is a treatment of

A

thyroid cancer because the thyroid is the only organ that produces iodine

51
Q

The danger of low dietary iodine is further compounded by your body’s decreased ability to utilize it, the result of contamination by a ubiquitous environmental toxin called

A

perchlorate

52
Q

what is perchlorate used for?

A

Originally developed for explosives and rocket fuel, perchlorate now pervades ground water and food supplies throughout the US. It’s even used as a flavor-enhancer in certain foods.

53
Q

how does perchlorate act?

A

blocks the thyroid gland’s ability to absorb and utilize dietary iodine, an effect that is of concern when iodine intake drops off.

54
Q

5 steps to do an iodine deficiency test on yourself

A
  1. Use tincture of iodine (the orange variety) to paint a 2-3-inch square patch on the inside of your forearm, the inside of a thigh, or your abdomen.
  2. Inspect the painted area in less than 8 hours. If all the color is gone, then you definitely have an iodine deficiency.
  3. If after 24 h, all the color is gone, you also likely need iodine.
  4. If the color simply remains on your arm and begins to slowly fade in color after 24 h, you have reached iodine sufficiency.
  5. You can repeat the test in a month or so after supplementing with iodine to see how you’re doing.
55
Q

where are adrenal glands located?

A

on top of the kidneys

56
Q

two parts of the adrenal glands?

A

cortex and medulla

57
Q

what does the cortex produce? (3)

A

mineralocorticoids
glucocorticoids
adrenal androgens

58
Q

what does the medulla produce?

A

catecholamines

59
Q

main mineralocorticoid

A

aldosterone

60
Q

main glucocorticoid

A

cortisol

61
Q

main adrenal androgens (2)

A

DHEA

testosterone

62
Q

main catecholamines (2)

A

adrenaline (epinephrine)

noradrenaline (norepinephrine)

63
Q

examples of diseases of adrenal gland dysfunction in humans (4)

A

Cushing disease
addisons disease
hyperaldosteronism
pheochromocytoma

64
Q

Cushing disease

A

adrenal overproduction of cortisol

65
Q

Addisons diease

A

adrenal underproduction of cortisol

66
Q

hyperaldosteronism

A

increase aldosterone, which control blood pressure and body stat and potassium levels

67
Q

phenochromocytoma

A

high levels of adrenaline

68
Q

cushings syndrome oral signs (3)

A

fatty tissue deposition (moon face)
osteoporosis (pathological fractures of the mandible, maxilla, or alveolar bone
delayed healing of fractures and also soft tissue injuries

69
Q

Addisons disease (oral signs) (2)

A

bronzing hyperpigmentation of the skin

oral mucosal melanosis (buccal muscosa, tongue)

70
Q

Addisons disease causes an increased production of melanin, results in

A

melanotic macules in the oral mucosa

71
Q

the thyroid gland produces (2)

A

T3 and T4

72
Q

what are T3 and T4 produced from?

A

iodination of thyroglobulin

73
Q

thyroglobulin is degraded to release (2)

A

T3 and T4

74
Q

major circulating form

A

T4

Applied Biochemistry (52 decks)

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