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Reproduction, Development and Aging > The Thyroid > Flashcards

The Thyroid Flashcards

1
Q

Medullary thyroid cancer in an aggressive cancer which secretes a large amount of ________ which is used as a tumour marker.

High levels of this hormone, secreted by ________ cells in the thyroid, results in a _______ prognosis

A

Medullary thyroid cancer in an aggressive cancer which secretes a large amount of Calcitonin which is used as a tumour marker.

High levels of this hormone, secreted by parafollicular cells in the thyroid, results in a poor prognosis.

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2
Q

What is the general function of the thyroid? (basic)

1.

2.

A

What is the general function of the thyroid?

  1. Regulation of the overall rate of metabolism, including Oxygen utilisation.
  2. Instrumental in growth and development, particularly in the CNS
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3
Q

Thyrotoxicosis and thyroid cancer can be effectively treated by ________. Side effects include ________.

A

Thyrotoxicosis and thyroid cancer can be effectively treated by Radioactive Iodine (gets taken up by thyroid cells and destroyed by radiation). Side effects include dry eyes/mouth.

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4
Q

What is the disease progression for a patient with thyroiditis?

A

In thyroiditis the pre-formed hormone is dumped from the lumen with the thyroglobulin. The patient presents thyrotoxic (hyperthyroidism) with elevated thyroglobulin, then has a HYPOthyroid phase before recovering.

Surreptitious ingestion of thyroxine (thyroid hormone) results in a thyrotixic patient without a raised thryroglobulin level.

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5
Q

Is the circulating level of thyroglobulin high or low in differentiated thyroid cancer?

A

High.

Thyroglobulin is a precursor for thyroid hormones.

Elevated levels indicate thyroiditis or papillary/follicular (differentiated) thyroid cancer.

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6
Q

90% of the thyroid hormone produced in the thyroid gland is _______ with the rest being ______, the active hormone.

The inactive hormone is converted in the ______ and _______ into the active form. Very little of the active form is circulating.

A

90% of the thyroid hormone produced in the thyroid gland is T4 with the rest being T3, the active hormone.

The inactive hormone is converted in the liver and kidney into the active form. Very little of the active form is circulating.

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7
Q

What can happen to thyroid hormone levels in acute illness?

1.

2.

3.

A

What can happen to thyroid hormone levels in acute illness?

  1. Conversion of T4 —> T3 is reduced
  2. Hypothyroid-like state with a healthy thyroid with normal TSH levels, just T3 (active hormone) is reduced.
  3. Reverse T3 is high.
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8
Q

When would you give Carbimazole, and what enzyme does it affect?

Bonus Point for the contraindication!

A

Carbimazole blocks a peroxidase enzyme and so is used to treat THYROTOXICOSIS.

Contra-indication: Thyroiditis-induced thyrotoxicosis.

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9
Q

In thyroid hormone resistance syndrome, patients have a mutation leading to pituitary ______ to T3. Therefore _____ rises, and so both T4 and T3 levels rise.

Do patients present with hypothyroid or hyperthyroid symptoms?

A

In thyroid hormone resistance syndrome, patients have a mutation leading to pituitary insenstivity to T3. Therefore TSH rises, and so both T4 and T3 levels rise.

Patients can present with hypo or hyperthyroid features in different tissues but usually have a GOITRE.

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10
Q

Increased TSH leads to _______.

(symptom)

A

Increased TSH leads to Goitre.

(symptom)

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11
Q

What are the cause and symptoms of Graves’ disease?

A

Cause: Autoantibodies to TSH receptors causing ongoing stimulation and raised T3 and t4, low TSH, and TSI (Thyroid Stimulating Immunoglobins) in blood.

Symptoms: Goitre, Bruits over thyroid, general symptoms of hyperthyroidism.

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12
Q

A mutated/constitutively activated TSH receptor in the thyroid can lead to the formation of _________ in the thyroid and results in ________.

A

A mutated/constitutively activated TSH receptor in the thyroid can lead to the formation of an adenoma in the thyroid and results in thyrotoxicosis.

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13
Q

Is medullary thyroid cancer a differentiated thyroid cancer?

A

No.

Differentiated cancers are papillary and follicular. [Tumour marker is increased THYROGLOBULIN]

Medullary cancer is an aggressive cancer [Tumour marker is increased CALCITONIN]

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14
Q

Why is it important for pregnant women to take iodine supplements?

A

Cretinism.

They can give birth to little cretins if they have maternal hypothyroidism.

Low Iodine results in hypothyroidism as it leads to decreased production of T3 and T4.

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15
Q

What are Thyroxine and Triiodothyronine?

A

T4 and T3.

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16
Q

Iodine Transport and hormone release (oh what fun)

  1. Taken up from capillaries in the thyroid by _______.
  2. Oxidised to ________
  3. Incorporated into ________ molecules in ________ cells.
  4. Incorporated into thyroglobulin.
  5. At lumenal interface it forms _____ and _____.
  6. Stored in lumen as iodonated _______.
  7. T4 and T3 released into lumen when stimulated by ______, the _______ (from 6) is endocytosed by follicular cells.
A

Iodine Transport and hormone release (oh what fun)

  1. Taken up from capillaries in the thyroid by Sodium-Iodine symporter.
  2. Oxidised to iodide.
  3. Incorporated into tyrosine molecules in follicular cells.
  4. Incorporated into thyroglobulin.
  5. At lumenal interface it forms MIT and DIT.
  6. Stored in lumen as iodonated thyroglobulin.
  7. T4 and T3 released into lumen when stimulated by TSH, the thyroglobulin (from 6) is endocytosed by follicular cells.
17
Q

What is Hashimoto’s Disease?

(4 points)

A

- Hashimoto’s Disease is an autoimmune condition

- T Cells invade thyroid and gradually destroy it

- Hypothyroidism symptoms

- Decreased T3 and T4, Increased TSH

18
Q

Hypothyroidism Symptoms:

1.

2.

3.

4.

5.

6.

Treatment:

A

Hypothyroidism Symptoms:

  1. Weight Gain
  2. Cold
  3. Hair loss and dry skin
  4. Constipation
  5. Tired
  6. Oedema

Treatment: Give Thyroxine

19
Q

What are the signs and symptoms of Thyrotoxicosis/Hyperthyroidism/Overactive Thyroid?

Signs

Symptoms

A

What are the signs and symptoms of Thyrotoxicosis/Hyperthyroidism/Overactive Thyroid?

Signs

Symptoms

Nervousness, Increased sweating

Bruit over thyroid, tachycardia

Weight loss, no reduction in appetite

Goitre

Heat sensitivity

Skin Changes

Tachycardia

Tremor

Weakness

Eye signs

20
Q
A

Reproduction, Development and Aging (5 decks)

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