T1 L7 Thyroid hormones and physiology Flashcards

1
Q

Describe the tissue of the thyroid gland

A

Composed of follicles consisting of monolayer of epithelial cells enclosing a large core of viscous homogenous colloid

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2
Q

What does the colloid do?

A

Thyroid hormones are stored here

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3
Q

What are the 3 primary hormones secreted by the thyroid gland?

A

T3
T4
Calcitonin

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4
Q

What does T3 stand for?

A

Triiodothyronine

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5
Q

What does T4 stand for?

A

Tetraiodothyronine

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6
Q

What is calcitonin involved in?

A

Calcium homeostasis

Secreted independently of other thyroid hormones

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7
Q

Where does iodine come from?

A

The diet

Vegetables and meat providing the animals have been fed on vegetables containing iodine

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8
Q

What can affect thyroid function?

A

Pollution
Contamination
Iodine deficiency
Iron deficiency

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9
Q

What degrades MIT & DIT to free the iodide?

A

Halogenases

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10
Q

What happens when T3 and T4 leave the follicular cells?

A

Enter blood stream and are distributed to target tissues

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11
Q

What percentage of thyroid hormone leaving the thyroid gland is T4?

A

95%

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12
Q

Why can’t we be certain that T3 and T4 inhibit TRH release in humans?

A

We can’t measure TRH in humans

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13
Q

What happens if you are iodine deficient?

A

1) Thyroid hormone decreases
2) Lose negative feedback
3) Increased TSH
4) Enlarged thyroid gland

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14
Q

How are thyroid hormones carried round the body?

A

Bound to plasma proteins and transported in the blood

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15
Q

Describe the binding of T4

A

75% to thyronine-binding globulin (TBG)
15-20% to thyroxine
5-10% to albumin

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16
Q

What happens after a thyroid hormone has interacted with its intracellular receptor?

A

Influence gene transcription to influence protein synthesis

17
Q

What is the main effect of thyroid hormones?

A

Increase basal metabolic rate

18
Q

How do thyroid hormones increase the basal metabolic rate?

A

Increase in carbohydrate metabolism
Increase in synthesis, mobilisation and degradation of lipids
Increase in protein synthesis

19
Q

How is carbohydrate metabolism increased by thyroid hormones?

A

Glycogenesis and glucose uptake by muscle and adipose cells
Potentiation of effects of insulin
Potentiation of effects of catecholamines
Increase in glucose absorption by GI tract

20
Q

What organs does thyroid hormone not increase the basal metabolic rate of?

A
Brain
Uterus
Testes
Spleen
Thyroid gland
Anterior pituitary gland
21
Q

What happens to the growth of an individual who is thyroid hormone deficient?

A

They won’t grow and will continue looking like a child after puberty

22
Q

What happens to the growth of an individual who is growth hormone deficient?

A

They won’t grow but they will undergo normal changes of ageing so they look like a short adult

23
Q

What is levothyroxine used for?

A

Treat thyroid deficiency

Suppress TSH secretion in treatment of some thyroid tumours

24
Q

How is levothyroxine administered?

A

Mouth

Injection

25
What are the adverse effects of levothyroxine?
``` palpitations arrhythmias diarrhoea insomnia tremor weight loss ```
26
What drugs affect thyroid function?
``` Carbimazole and methimazole Propythiouracil Potassium perchlorate Radioactive iodine Lithium Iodides ```
27
What drugs can induce goitre?
Lithium | Iodides
28
What does potassium perchlorate do?
Competes with iodide for active iodide uptake pump
29
Describe prophylactic administration of iodine
Injection or incorporation into table salt or flour Reduced incidence of endemic goitre Carries risk of Jod-Basedown phenomena
30
What is carbimazole used for?
Hyperthyroidism
31
What are the adverse effects of carbimazole?
Rashes and pruritus Neutropenia Agranulocytosis Teratogenic
32
How is carbimazole a pro drug?
After absorption it is converted into active form methimazole which prevents peroxidase iodinating the tyrosine residues on thyroglobulin which reduces production of thyroid hormones T3 and T4
33
What is propylthlouracil used for?
Hyperthyroidism including Graves disease | Drug of choice in first trimester
34
What are the adverse effects of propylthouracil?
Rashes and pruritus agranulocytosis Serious liver injury