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Biochem exam 2 > Metabolic Disorders of the Thyroid and Adrenal Glands > Flashcards

Metabolic Disorders of the Thyroid and Adrenal Glands Flashcards

1
Q

what is the largest endocrine gland in the body?

A

thyroid gland

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2
Q

functional unit of thyroid gland

A

follicle

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3
Q

follicle base

A

touches the bloodstream

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4
Q

follicle apex

A

touches the colloid

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5
Q

thyroid gland produces and secretes…

A

thyroid hormones

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6
Q

thyroid gland uptakes and stores…

A

iodine

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7
Q

what is necessary for thyroid hormone production?

A

iodine

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8
Q

lack of iodine=

A

iodine deficiency disorders (IDDs)

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9
Q

excess of iodine=

A

hyperthyroidism

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10
Q

sources of iodine

A

food (primary source)
medications: amiodarone

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11
Q

thyroid hormones are found…

A

in entire body

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12
Q

most abundant thyroid hormone

A

T4- thyroxine
*prehormone

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13
Q

most active thyroid hormone

A

T3- triiodothryonine

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14
Q

inactive thyroid hormone

A

rT3- reverse T3

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15
Q

thyroid releasing hormone

A

secreted by hypothalamus
important in regulation of thyroid hormones

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16
Q

thyroid-stimulating hormone

A

secreted in pituitary gland
important in regulation of thyroid hormones

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17
Q

thyroglobulin

A

protein involved in synthesis

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18
Q

thyroid peroxidase

A

involved in production of thyroid hormones

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19
Q

where is T4 converted into T3 or rT3?

A

liver & kidney

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20
Q

what converts T4 to T3?

A

iodothyronine deiodinase enzyme or iodide peroxidase
*contain selenium

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21
Q

selenium deficiency can lead to…

A

decreased T3 levels

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22
Q

thyroid hormone biosynthesis

A
  1. active uptake of IODINE for Na; stimulated by TSH; @ base of follicle
  2. oxidized to ACTIVE iodine (by thyroid peroxidase)
  3. active iodine moves across apex into colloid
  4. forms into thyroglobulin to form MIT and DIT
  5. T3 and T4 formed
  6. T3 and T4 moved back into follicle for storage along with thyroglobulin
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23
Q

MIT + DIT forms

A

T3

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24
Q

DIT + DIT forms

A

T4

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25
Q

what couples the reaction combining MIT and DIT?

A

thyroid peroxidase

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26
Q

thyroid hormones stored in cell until…

A

thyroglobulin is taken back up (taken together)

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27
Q

TSH moves what into the cell?

A

thyroglobulin

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28
Q

how are T3 and T4 released into the bloodstream?

A

proteolysis of thyroglobulin complex

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29
Q

cellular action of thyroid hormones

A

-target cells throughout entire body
-T3 and T4 bind to nuclear receptors w/in cell nucleus and regulate gene expression
-stimulate metabolic rate

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30
Q

how do thyroid hormones stimulate metabolic rate?

A

-increasing number & size of mitochondria
-increasing Na/K ATPase concentration
-increasing Na and K membrane permeability

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31
Q

what is unique about thyroid hormones?

A

bind w/in the nucleus
*most others bind in the cytoplasm

32
Q

how are thyroid hormones regulated?

A

negative feedback loop

33
Q

what happens if there is too much T3 or T4?

A

inhibits TRH (which in turn does not produce TSH)
OR
inhibits TSH
both stop production of T3 and T4

34
Q

hyperthyroidism

A

high T3 and T4 levels
low TSH levels
increased metabolic rate

35
Q

hypothyroidism

A

low T3 and T4 levels
high TSH levels
decreased metabolic rate

36
Q

thyroid function tests used to detect

A

TSH levels
T4 levels (free and total)
T3 levels (free and total)
*primarily focus on free levels b/c that is what is available to move into cells

37
Q

factors that affected thyroid function tests

A

-diurnal variation (should take tests at same time of day to avoid this)
-temperature
-medications (steroids, estrogens)
-acute illness or stress

38
Q

steroids ____ thyroid secretions

A

inhibit

39
Q

estrogens ____ thyroid secretions

A

increase

40
Q

thyroid gland disorders have higher incidence in…

A

females

41
Q

common symptoms of hyperthryoidism

A

*increase metabolic rate
-goiter
-general: excitation, tremor
-tachycardia
-weight loss
-intolerance to heat

42
Q

oral manifestations of hyperthyroidism

A

-increased risk for caries & periodontal disease
-burning mouth syndrome
-enlargement of thyroid tissue
-maxillary and mandibular osteoporosis
-severe dry mouth

43
Q

causes of hyperthyroidism

A

-Grave’s disease (autoimmune disorder)
-thyroiditis (recent infection); temporary
-medications

44
Q

amiodarone

A

can cause hypo- and hyperthyroidism

has iodine in chemical structure –> can be uptaken by thyroid and influence thyroid hormone levels

45
Q

Grave’s disease

A

autoimmune disorder where antibodies are produced that stimulate TSH
*not regulated by negative feedback loop so will cause increased levels of T3 and T4

46
Q

hyperthyroidism treatment

A

-antithyroid drugs (inhibits thyroid peroxidase)
-iodine (uses negative feedback loop)
-radioiodine (produces hypothyroidism)
-surgery (removal of thyroid gland)

47
Q

dental complications of radioiodine therapy

A

-dry mouth
-increased risk of caries
-permanent taste loss
-increase salivary gland malignancies

48
Q

common symptoms of hypothyroidism

A

*reduces metabolic rate
-goiter
-general: fatigue, lethargy
-bradycardia
-weight gain
-intolerance to cold

49
Q

oral manifestations of hypothyroidism

A

-salivary gland enlargement
-macroglossia (enlarged tongue)
-glossitis (painful tongue)
-dysgeusia (altered taste)
-thick lips
-mouth breathing
-delayed bone reabsorption

50
Q

causes of hypothyroidism

A

-Hashimoto’s disease (autoimmune disorder)
-pituitary or hypothalamic disease
-medications
-thyroid removal

51
Q

Hashimoto’s disease

A

autoimmune disorder
T-cell mediated disorder where immune system attacks and destroys the thyroid
*thyroid peroxidase antibodies & thyroglobulin antibodies detected in blood

52
Q

hypothyroidism treatment

A

thyroid replacement

-levothyroxine (synthetic T4)
-liothyronine (synthetic T3)
-armour thyroid (combination of synthetic T3 and T4)

53
Q

thyroid cancer

A

-2-4x more likely in women
-develops around 45-50 years old
-growth of cells w/in the thyroid
-may involve esophagus, trachea, or laryngeal nerve

symptoms include
-asymptomatic
-hoarse voice
-difficulty breathing or swallowing

54
Q

what type of hormones are made by the cortex of adrenal glands?

A

-mineralocorticoids
-glucocorticoids
-adrenal androgens

55
Q

what type of hormone is made by the medulla?

A

catecholamines

56
Q

zona glomerulosa

A

-outermost layer of adrenal cortex

-synthesizes aldosterone

57
Q

zona fasciculata

A

-middle layer of adrenal cortex

-synthesizes cortisol

58
Q

zona reticularis

A

-deepest layer of adrenela cortex

-synthesizes dehydroepiandrosterone (DHEA) and testosterone

59
Q

medulla

A

-core part of adrenal gland

-synthesizes epinephrine and norepinephrine

60
Q

adrenal hormone synthesis

A
  1. cholesterol absorbed from diet or synthesis in the body
  2. cholesterol hydrolysis
  3. cholesterol converted to pregnenolone which is moved into mitochondria
  4. pregnenolone then moved to ER and converted to progesterone
  5. progesterone converted to other steroids
61
Q

how are adrenal hormones regulated?

A

negative feedback loop
-ACTH action inhibited

62
Q

glucocorticoids action within the cell

A
  1. cortisol crosses and binds to receptors in cytoplasm
  2. Hsp releases allowing hormones to move to nucleus
  3. bind to glucocorticoid response element (GRE) w/in DNA
  4. can increase or decrease gene transcription
63
Q

glucocorticoids (cortisol) hormone actions

A

*metabolic in the liver
*catabolic in muscles and fat
-increase blood glucose
-maintain BP
-mood changes
-increased glomerular flow
-anti-inflammatory

64
Q

mineralocorticoid (aldosterone) hormone actions

A

sodium & water retention

65
Q

androgens (DHEA and testosterone) hormone action

A

limited effects

66
Q

catecholamines (epinephrine and norepinephrine) hormone actions

A

maintain BP and heart rate

67
Q

Cushing’s disease

A

-excess cortisol
-increased production of: androgens, mineralocorticoids, and glucocorticoids

68
Q

Addison’s disease

A

-cortisol deficiency
-decreased production of: androgens, mineralocorticoids, and glucocorticoids

69
Q

does Cushing’s or Addison’s disease have more effects?

A

Cushing’s disease

70
Q

general clinical manifestations of Cushing’s disease

A

-weight gain
-myopathy

71
Q

general clinical manifestations of Addison’s disease

A

-weight loss
-weakness

72
Q

oral manifestations of Cushing’s disease

A

delayed healing

73
Q

oral manifestations of Addison’s disease

A

hyperpigmentation of oral mucosa

74
Q

measuring adrenal gland function

A

-cortisol levels
-ACTH stimulation test
-adrenal gland imaging

75
Q

treatment of Cushing’s disease

A

-surgical removal of adrenal glands
-removal of excess glucocorticoid

76
Q

treatment of Addison’s disease

A

steroid replacement

Biochem exam 2 (9 decks)

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