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Biochem > Metabolic Disorders of the Thyroid and Adrenal Glands > Flashcards

Metabolic Disorders of the Thyroid and Adrenal Glands Flashcards

1
Q

what is metabolic syndrome

A

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

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2
Q

what are the diseases of the thyroid gladn

A

goiter, graves disease and hashimoto’s disease

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3
Q

what is goiter

A

abnormally large thyroid

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4
Q

what is graves disease

A

autoimmune disorder resulting in overproduction of thyroid hormones

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5
Q

what is hasmimotos disease

A

autoimmune disease (T-cell mediated) in which your immune system attacks the thyroid resulting in hypothyroidism
- The attack on thyroid follicular cells leads to apoptosis
- no thyroid follicular cells available to make T3 and T4

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6
Q

what are the diseases of the adrenal glands

A

addisons disease and cushings syndrome

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7
Q

what is addisons disease

A

underproduction of aldosterone and cortisol

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8
Q

what is cushings syndrome

A

cortisol overproduction

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9
Q

what does the thyroid gland produce

A

thyroid hormones and calcitonin

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10
Q

describe the anatomy of the thyroid gland and location

A

consists of 2 lobes and a central isthmus which gives it a bow tie like shape and sits anterior to the trachea

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11
Q

what element does the thyroid gland absorb

A

iodine

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12
Q

who is at higher risk for thyroid disorders

A

females

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13
Q

how much of the population have abnormal thyroid anatomy

A

15% of population

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14
Q

what is one of the most common findings of abnormal thyroid anatomy

A

thyroid nodules

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15
Q

what is the chemical name for T4

A

L-thyroxine

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16
Q

what is the chemical name for the metabolically active form of T3

A

3,5,3’ triiodothyronine

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17
Q

what is the chemical name for the metabolically inactive form of T3

A

3,3’,5’ triodothyronine

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18
Q

what is the major form of thyroid hormones in the blood

A

T4

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19
Q

which thyroid hormone has a longer half life

A

T4

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20
Q

how is T4 converted into T3 and where

A

in target cells by iodothyronine deiodinase

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21
Q

what do the 3 isoforms of iodothyronine deiodinase contain

A

a selenium metal ion

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22
Q

what can selenium deficiency lead to

A

decreased T3 levels

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23
Q

what does the synthesis of thyroid hormones involve

A

the protein thyroglobulin

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24
Q

describe how T4/T3 production is regulated by the thyroid

A

hypothalamus produces TRH which acts on the pituitary gland to produce TSH which acts on the thyroid gland to release T4 and T3 to target tissues. T3 and T4 act back on the pituitary gland and hypothalamus in a negative feedback loop

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25
Q

describe thyroid hormone biosynthesis

A

-iodine enters thyroid follicular cell by the iodine/Na symporter
-this initiates thyroglobulin secretion to be exported into the follicle colloid
- iodine is transported across the cell to the follicle colloid
- in the follicle colloid thyroglobulin undergoes iodination and conjugation
- it is endocytoses back into the thyroid follicular cell where it undergoes proteolysis to make thyroxine and triiodothyronine and T3 and T4 are released into the blood

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26
Q

what are some common symptoms of hyperthyroidism

A
  • heart problems- arrhythmia or A-fib
  • osteoporosis- too much thyroxine interferes with process of bone formation and calcium handling
    -eye problems- graves opthalmopathy
  • red swollen skin- increased sensitivity to heat
  • thyrotoxic crisis- sudden intensification of symptoms
  • abnormal thermal regulation- night sweats
  • brittle hair
27
Q

what percentage of graves patients develop opthalmopathy

A

30%

28
Q

what is the mechanism of action of graves disease

A

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

29
Q

what are common symptoms of hypothyroidism

A

-fatigue
-sensitivity to cold
- constipation
-dry skin
- weight gain
- puffy face
-hoarseness
-muscle weakness, aches, tenderness and stiffness
-thinning hair

30
Q

who is more likely to develop hashimotos disease

A

women are 8x more likely

31
Q

what are the risk factors for hashimotos disease

A

addisons disease, celiac disease, pernicious anemia, sjogren’s syndrome, type 1 diabetes, vitiligo

32
Q

what do patients develop as hashimotos syndrome progresses

A

goiter

33
Q

what are some oral manifestations of hypothyroidism

A

-salivary gland enlargement
- compromised periodontal health
-delayed eruption
-enamel hypoplasia in both dentitions
- thick lips
-mouth breathing

34
Q

what are some oral manifestations of hyperthyroidism

A

-increased susceptibility to caries
- increased susceptibility to periodontal disease
-enlargement of extraglandular thyroid tissue

35
Q

what happens in thyroid follicular cell cancer

A

-point mutations on the TSH receptor or G-proteins associated with the receptor lead to hyperproliferation of thyroid cells
-growth factor receptors can be mutated that also affect thyroid cell proliferation

36
Q

what are the dental complications of radioiodine therapy

A

-dry mouth
-increased risk of caries due to change in oral microbiome

37
Q

what time of the day is hormone production the highest

A

during sleeping

38
Q

what is perchlorate and what does it do

A

chemical originally developed for rocketfuel and explosives but is now in ground water and food supplies in US.
- blocks the thyroid glands ability to absorb and utilize dietary iodine

39
Q

how do you do an iodine deficiency test on yourself

A

-use tincture of iodine and paint a patch on your arm
- inspect area in less than 8 hours. if color is done you have iodine deficiency
- in 24 hours if all color is gone you also likely need iodine

40
Q

where are the adrenal glands located

A

on top of kidneys

41
Q

what are the two parts of the adrenal galnds

A

the cortex and the medulla

42
Q

what does the cortex of the adrenal glands produce

A

mineralocorticoids, glucocorticoids, and adrenal androgens

43
Q

what does the medulla of the adrenal glands produce

A

catecholamines

44
Q

what stimulates CRH release from the hypothalamus

A

low plasma cortisol levels, hypoglycemia, pyrogen, and stress

45
Q

what suppresses CRH release from the hypothalamus

A

high plasma glucocorticoid levels

46
Q

how are the adrenal glands regulated

A

CRH is released from the hypothalamus which acts on the anterior pituitary to release ACTH which acts on the adrenal gland to release their products

47
Q

what is the main mineralocorticoid

A

aldosterone

48
Q

what is the main glucocorticoid

A

cortisol

49
Q

what are the main 2 adrenal androgens

A

DHEA and testosterone

50
Q

what are the main catecholamines

A

adrenaline (epinephrine) and noradrenaline (norepinephrine)

51
Q

what are the genomic actions of glucocorticoids

A

GC binds to receptor, receptor dimerizes and moves into the nucleus to upregulate through transactivation
- if receptor does not dimerize the receptor inhibits transcription (transrepression)

52
Q

what is hyperaldosteronism

A

increased aldosterone which controls BP and body fat and K+ levels

53
Q

what is pheochromocytoma

A

high levels of adrenaline

54
Q

what are some of the adverse reactions to glucocorticoid use

A
  • infections
    -myopathia
  • osteoporosis
    -pysch issues
  • weight gain
  • skin thinning
  • glaucoma
  • cardio vascular
55
Q

what are the symptoms of cushings syndrom

A

-fatty tissue deposition -> “moon face”
- osteoporosis -> pathological fractures of the mandible, maxilla, or alveolar bone
-delayed healing of fractures and also of tissue injuries

56
Q

what are the symptoms of addisons disease

A
  • bronzing, hyperpigmentation of the skin
  • oral mucosal melanosis- buccal mucosa, tongue
  • melanotic macules in the oral mucosa
57
Q

what produces TSH and what is its functin

A
  • produced by thyrotope cells in the anterior pituitary gland
  • it regulates endocrine function of the thyroid gland
58
Q

what produces TRH and what is its function

A
  • produced by hypothalamus
  • stimulates release of TSH and prolactin from the anterior pituitary
59
Q

what is thyroid peroxidase

A

enzyme found in the thyroid that activates iodine for incpororation into tyrosine residues in thyroglobulin to produce T3 or T4

60
Q

what is xerostomia

A

dry mouth

61
Q

what is macroglossia

A

enlarged or swollen tongue

62
Q

what is dysgeusia

A

distorted sense of taste

63
Q

what is a treatment option for hyperthyroidism

A

radioiodine therapy

Biochem (34 decks)

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