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GIGU > SAQ 6 > Flashcards

SAQ 6 Flashcards

1
Q

the thyroid gland is Composed of _______, which are hollow spheres filled
with thyroid colloid that contains
thyroglobulin.

there are two types:

  1. ________________
  2. _______________
A

follicles

Two types of cells: follicular and parafollicular
cells

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2
Q

Before being stored in the colloid of follicles, T3 & T4 are attached to ______molecules, forming ____________ complexes

A

globulin

thyroglobulin

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3
Q

Upon release, T3 & T4 detach from globulin and enter the bloodstream; Once in the blood, T3 &T4 attach to _______ _______
and travel as a_______-_______ complex

A

plasma globulins

hormone-globulin

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4
Q

the Thyroid gland contains numerous follicles that Release several hormones such as _______ (T4) and _______________(T3)

A

thyroxine

triiodothyronine

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5
Q

Thyroid hormones end up attached to

thyroid binding globulins (TBG) such as: ________ or ________

A

transthyretin

albumin

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6
Q

________hormone helps regulate the metabolic rate of all cells and cell growth and tissue differentiation

A

Thyroid

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7
Q

_________ is Produced in the thyroid gland by the parafollicular cells

A

Calcitonin

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8
Q

___________ Influences the processing of calcium by bone cells by ________ blood calcium levels and promoting _________ of hard bone matrix

A

calcitonin

decreasing

conservation

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9
Q

_________ ________ acts as antagonist to calcitonin in maintaining calcium homeostasis

A

Parathyroid hormone

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10
Q

specific binding protein is ________ _______ _______ while non specific binding proteins are _________ and ___________

A

thyroxine Binding globulin (TBG)

Albumin

Transthyretin (prealbumin)

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11
Q

list the 3 regulatory factors that stimulate secretion of thyroid hormone:

A
  • TSH
  • Thyroid-stimulating immunoglobulin
  • Increased TBG levels (e.g., pregnancy)
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12
Q

list 3 regulatory factors that inhibit secretion of thyroid hormone:

A

• Iodine deficiency
• Deiodinase deficiency
•Excessive iodide intake (Wolff-Chaikoff
effect)
• Perchlorate; thiocynate(inhibit Na-I cotransport)
•Propylthiouracil (inhibits peroxidase enzyme)
•Decreased TBG levels (e.g.,liver disease)

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13
Q

hyperthyroidism= hyperthyroid(clinical state)

hypothyroidism= hypothyroid (clinical state)

estrogens/ pregnancy = __________ (clinical state)

liver disease, glucocorticoids and androgens = __________(clinical state)

A

Euthyroid

Euthyroid

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14
Q

if there’s an increase in carbohydrate metabolism then t3 and t4 _________, glycogenesis ________, and glycolosis _________

A

Increases

Increases

Increases

** if there’s a decrease in metabolism all are decreased as well

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15
Q

if there’s an increase in protein metabolism then there’s going to be an ________ in t3 and t4, a ________ in proteolysis and a _______ in muscle wasting.

A

increase

increase

increase

** if there’s a decrease in metabolism all are decreased as well

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16
Q

if there’s an increase in lipid metabolism then theres going to be an _______ in t3 and t4, an _____ in lipogenesis, and _______ in lipolysis and a ________ in serum cholesterol

A

increase

increase

increase

decrease

** if there’s a decrease in metabolism all are opposite

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17
Q

there are three causes of thyrotoxicosis (Graves disease):

1) Primary hyperthroidism
2) Thyrotoxicosis without hyperthyroidism
3) Secondary hyperthyroidism

most common form of thyrotoxicosis?

A

Graves’ disease

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18
Q

there are three causes of thyrotoxicosis (Graves disease):

1) Primary hyperthroidism
2) Thyrotoxicosis without hyperthyroidism
3) Secondary hyperthyroidism

give me two details about number 2:

A

-Thyroiditis

–Iatrogenic

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19
Q

there are three causes of thyrotoxicosis(Graves disease):

1) Primary hyperthroidism
2) Thyrotoxicosis without hyperthyroidism
3) Secondary hyperthyroidism

what causes # 3?

A

–TSH-secreting pitutary adenoma

– Hypothalamic disease

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20
Q

List at least 3 symptoms associated with Thyrotoxicosis (Graves disease)

A
  • Hyperactivity, irritability,dysphoria
  • Heat intolerance & sweating
  • Palpitations
  • Fatigue & weakness
  • Weight loss & increased appetite
  • Diarrhea
  • Oligomenorrhea
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21
Q

List at least 3 signs associated with Thyrotoxicosis (Graves disease)

A
  • Tachycardia, atrial fibrillation
  • Tremor
  • Goiter
  • Warm moist skin
  • Muscle weakness
  • proximal myopathy
  • Gynecomastia
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22
Q

what are some primary causes of hypothyroidism?

Autoimmune = ____________________

Drugs = _____________________

Diffuse nontoxic goiter = ________________

A
  • Hashimoto’s thyroiditis (goiter) →atrophic thyroiditis
  • iodine excess, antithyroid drugs
  • iodine deficiency (endemic goiter), environmental goitrogens
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23
Q

what are the 2 secondary causes of hypothyroidism (Myxedema)?

A
  • Hypopituitarism

- Hypothalamic disease

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24
Q

what does the acronym SLUGGISH mean in relation to signs and symptoms of hypothyroidism (Hashimoto’s disease)?

A 
Sluggish:
S= Sleepiness, fatigue, tiredness
L= Loss of memory
U= Unusually dry skin
G= Goiter
G= Gradual personality change
I= Increase in body weight
S= Sensitivity to cold
H= Hair loss, sparseness of hair
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25
Q

list at least 3 symptoms of hypothyroidism:

A
  • Weakness, tiredness
  • Dry skin
  • Feeling cold
  • Hair loss
  • Difficulty concentrating & poor memory
  • Constipation
  • Weight gain & poor appetite
  • Dyspnea
  • Hoarse voice
26
Q

list at least 3 signs of hypothyroidism:

A
  • Dry coarse skin, cool extremities
  • Puffy face, hands, & feet (myxedema)
  • Diffuse alopecia
  • Bradycardia
  • Peripheral edema
  • Delayed tendon reflex relaxation
  • Carpal tunnel syndrome
27
Q

what are the 3 main controlling substances or calcium in the blood

A

*PTH
•Vitamin D
•Calcitonin

28
Q

PTH is produced by ______ cells of the parathyroid

A

chief

29
Q

thyroid hormone is made in the thyroid gland’s __________ cells

A

follicular

30
Q

Vitamin D Actions
•Intestine
–______ Ca2+ absorption
– increase phosphate absorption

•Bone
–Increase mineralization (indirect effect)
– increase bone resorption (direct effect)

•Kidney
–increase Ca2+ reabsorption (weak effect)
–_____ phosphate reabsorption (weak effect)

A

increase

increase

31
Q 
PTH Actions
•Bone
–receptors on osteoblasts & osteocytes
–increase osteocytic osteolysis
–increase resorption ( osteoclasts)
•Kidney
–increase Ca2+ reabsorption
– \_\_\_\_\_\_\_\_ phosphate reabsorption
– \_\_\_\_\_\_\_\_ Na+ reabsorption (weak effect)
–increase 1,25-(OH) 2-D3

• Intestine
–increase Ca2+ absorption
–increrase phosphate absorption

A

decrease

decrease

32
Q

Calcitonin
•receptors on ________

•osteoclasts : ↓ activity; ↓ number

•minor role in _____ regulation of plasma [Ca
2+]

•no role in ______ regulation of plasma [Ca
2+]
–thyroidectomy
–C-cell tumors

A

osteoclasts

acute

chronic

33
Q

in rickets there is a defiecency in vitamin __

rickets can be treated by vitamin ___, ________, ________ and 1,25 -D3(calcitriol)

A

D

d2

sunlight

calcium

34
Q 
in osteoperosis there is:
•Aging which provides a:
•decrease estrogen
•decrease testosterone
•decrease GH
•\_\_\_\_\_\_ Glucocorticoids
•Immobilization
A

increase

35
Q

treatment of osteoperosis includes:

\_\_\_\_\_\_\_\_ Therapy; with substances like:
–\_\_\_\_\_\_\_\_\_\_\_\_\_\_
–estrogen
–SERMs (raloxifene, tamoxifen)
–\_\_\_\_\_\_\_

and Anabolic Therapy– with _____

A

Antiresorptive

bisphosphonates

calcitonin

PTH

36
Q

Humoral Hypercalcemia causes some tumors to secrete ___-_____ ______ and Blood profile is similar to primary hyperparathyroidism; but _____ level is low

A

PTH -related peptide (PTH-rp)

PTH

37
Q

Treatment of humoral hypercalcemia actively uses _______ to inhibit renal Ca
2+ reabsorption & increase Ca2+ excretion.
treatments also use _______ which inhibits bone resorption

A

Furosemide

Etidronate

38
Q

Adrenal cortex is Composed of three distinct layers and is Derived from __________.

A

mesoderm

39
Q

the Adrenal medulla is Composed of neurosecretory tissue Derived from __________

A

neuroectoderm

40
Q

name the three adrenocortical hormones:

A
  1. cortisol
  2. aldosterone
  3. androgens
41
Q

the synthesis of amine hormones in the adrenal medulla follows the course: ________ –> L-Dopa –> Dopamine–> ___________ –> epinepherine

A

tyrosine

norepinephrine

42
Q

Biosynthesis of adrenocortical hormones starts with _________.
- corticosterone becomes ________ through _______ synthase which is activated by angiotensin 2

A

cholesterol

aldosterone

aldosterone

43
Q

specific transport proteins carry individual hormones. CBG and transcortin transport ______and aldosterone while TBG and SHBG transport thyroxine, ___________, testosterone and estrogen

A

cortisol

triiodothyronine

44
Q

Zona glomerulosa depends on ______ for the first step in biosynthesis, but otherwise controlled separately via renin-angiotensin-aldosterone system

A

ACTH

45
Q

the regulation of glucocorticoid and androgen secretion is regulated by the __________ - _______ axis. the hypothalamus releases _____ to the anterior pituitary which releases ACTH to the _____ _____ which in turn releases _______ to regulate hypothal. and Ant. pituitary.

A

hypothalamic- pituitary

CRH

adrenal cortex

cortisol

46
Q

Dexamethasone suppression test can distinguish between an _____-secreting tumor and an ______ ______ tumor.

A

ACTH

adrenal cortical

47
Q

if a healthy person is given a Dexamethasone in a low dose cortisone production will decrease. if the cortsol level remains high it leads to hypercorticoidism. then to further differintiate,the patient is given a low dose of DXM, in an ACTH secreting adenoma cortisol would _____ but given a high dose of DXM cortisol levels would _______. in an adrenal cortex tumor a low dose of DXM would ______ cortisol but a high dose would also also _______ cortisol levels. this is how to differentiate between ACTH secreting adenomas and adrenal cortex tumors.

A

increase

decrease

increase

increase

48
Q

list a few stimulatory factors of glucocorticoid and androgen secretion:

A
  • Decreased blood cortisol levels
  • Stress; hypoglycemia; surgery; trauma
  • Psychiatric disturbances
  • a-adrenergic agonists
  • b-adrenergic antagonists
49
Q

list a few inhibitory factors of glucocorticoid and androgen secretion:

A
  • Increased blood cortisol levels
  • Opioids
  • Somatostatin
50
Q

list 3 actions of glucocorticoids:

A
  1. Increase GFR
  2. Decrease REM sleep
  3. Increase lipolysis
51
Q
  • Plasma K – greatly increases _________secretion
  • Angiotensin II – greatly _________ aldosterone secretion
  • Plasma Na – very slightly _______ aldosterone secretion
  • ACTH – necessary for aldosterone secretion but has little effect in rate of secretion
A

aldosterone

increases

decreases

52
Q

mineralocorticoids increase ____, increase ___ and increases ___ which casues alkalosis

A

NA+

K+

H+

53
Q

Actions of Adrenal Androgens
•Females: stimulate growth of ______ and _____ hair; stimulate libido
•Males: same as ________, though weak

A

axillary

pubic

testosterone

54
Q

give me 3 causes of cushings SYNDROME;

A
  1. acth hypersecretion
  2. benign adrenal adenomas
  3. small cell lung carcinoma
55
Q

what are the top 3 symptoms in cushings syndrome/ disease?

A
  1. central obesity
  2. increased body weight
  3. fatigability and weakness
56
Q

Addison’s and causes of adrenal insufficiency are _______ of the gland (possibly by ________), metabolic issues or secondary adrenal insufficiency (hypothalamic- pituitary disease or the supression of HPA)

A

destruction

tuberculosis

57
Q

give me the top 3 symptoms seen in addison’s disease:

A
  1. weakness
  2. pigmentation of the skin
  3. weight loss
58
Q

Conn’s syndrome aka primary aldosteronism is an apparent ___________ excess that increases ECF volume and ________, as well as ________ and metabolic alkalosis

A

mineralocorticoid

hypertension

hypokalemia

slide 42

59
Q

in Congenital Adrenal Hyperplasia there is a deficiency in either 21β- Hydroxylase or 11β- Hydroxylase which cause issues in ____________ production

A

Corticosterone

60
Q

17a-Hydroxylase Deficiency is a less common congenital condition where neither ____________ nor adrenal androgens are produced, it leads to hypoglycemia. Overproduction of 11-deoxycorticosterone and
corticosterone–_____________ activity is also present which cause hypertension, Hypokalemia and Metabolic alkalosis.

A

glucocorticoids

mineralocorticoid

GIGU (6 decks)

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