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Block 8 Ellen > The thyroid in health and disease > Flashcards

The thyroid in health and disease Flashcards

1
Q

What are the follicles in the thyroid filled with

A

colloid

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2
Q

what epithelial is in the thyroid

A

cuboidal epithelial cells

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3
Q

what is special about the thyroid

A

stores and secretes hormones

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4
Q

what do the parafollicular cells produce

A

Calcitonin

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5
Q

what do the follicular cells produce

A

T3 and T4

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6
Q

what controls the release of thyroid hormones

A

Hypothalamo-pituitary axis

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7
Q

HPA for thyroid =

A

releases TRH from hypothalamus
Anterior pituitary releases TSH
TSH stimulates the thyroid to release T3 and T4
T3 and T4 negative feedback

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8
Q

TRH=

A

thyrotropin releasing hormone

from the hypothalamus

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9
Q

TSH=

A

Thyroid stimulating hormone

released from the anterior pituitary

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10
Q

T3=

A

Triodothyronine

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11
Q

T4=

A

Thyroxin

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12
Q

T3 is made up of

A

2 tyrosine with 3 iodine

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13
Q

T4 is made up of

A

2 tyrosine with 4 iodine

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14
Q

overall function of thyroid hormone (3)

A

increase metabolic rate
positive inotropic and chronotropic
growth and development

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15
Q

bc Thyroid hormone increases metabolism and heat production what is it

A

calorigenic

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16
Q

how does thyroid hormone increase growth in children

A

stimulates GH secretion and promotes GH effects

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17
Q

lack of growth hormone=

A

growth retardation

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18
Q

in foetal and postnatal life thyroid hormone deficiency =

A

mental retardation

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19
Q

where does synthesis of thyroid hormone take place

A

in the follicles on the thyroglobulin molecule

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20
Q

what ion is needed in producing thyroid hormone

A

iodine

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21
Q

1st step in thyroid hormone production

A

iodine atoms are actively transported across follicular cells and trapped in the colloid

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22
Q

what happens to iodine in the colloid

A

it is oxidised to iodine I2 by thyroid peroxidase

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23
Q

what enzyme oxidises iodine

A

thyroid peroxidase

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24
Q

what does I2 attach to in the thyroglobulin molecule

A

tyrosine

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25
Q

1 iodine + tyrosine=

A

MIT (monoiodotyrosine)

26
Q

2 iodine + tyrosine=

A

DIT (di-iodotyrosine)

27
Q

how do MIT and DIT combine

A

via thyroid peroxidase enzyme

28
Q

T3 combo=

A

MIT+ DIT

29
Q

T4 combo=

A

DIT + DIT

30
Q

what happens to any MIT/DIT that hasn’t formed T3/T4

A

recycled back into process

31
Q

where is all the bodies t4 produced

A

thyroid gland

32
Q

where is the main source of T3

A

deiodination of T4 in liver and kidneys

33
Q

Actions of TSH (4)

A
  • causes active uptake of iodine
  • stimulates other reactions involved in thyroid hormone synthesis
  • stimulates the uptake of colloid
  • induces growth of the thyroid
34
Q

majority of T3 and T4 bound to

A

TBG (thyroid binding globulin)

35
Q

thyroid hormone mechanism of action

A

bind to transmembrane receptor and directly alter gene expression in cells that regulate metabollic rate

36
Q

3 hypothyroid diseases

A

primary
secondary
tertiary

37
Q

2 types of primary hypothyroidism

A

congenital

acquired

38
Q

congenital hypothyroidism is usually due to

A

absence of thyroid or ectopic thyroid

39
Q

acquired hypothyroidism is due to (2)

A

iodine deficiency

autoimmune

40
Q

levels in primary hypothyroidism

A

High TSH
High TRH
low T4/T3

41
Q

symptoms of hypothyroidism

A

fatigue
cold intolerance
depression
Myxedema (retention of water)

42
Q

Hashimoto’s disease=

A

autoimmune thyroiditis

43
Q

most common cause of hypothyroidism=

A

hashimoto’s disease (autoimmune)

44
Q

what is hashimoto’s disease associated with

A

thyroid peroxidase and thyroglobulin antibodies

45
Q

what happens on the thyroglobulin molecule

A

MIT and DIT are combined to make T3 and T4

46
Q

levels in secondary hypothyroidism

A

Decreased TSH

Decreased T3/ T4

47
Q

example of a secondary hypothyroidism

A

pituitary tumour

48
Q

2 main causes of hyperthyroidism

A

autoimmune

toxic nodular goitre

49
Q

what happens in autoimmune hyperthyroidism

A

produce antibodies similar shape to TSH

50
Q

what do antibodies similar to TSH cause

A

turns on T3 and T4 production process uncontrollably

51
Q

primary hyperparathyroid levels=

A

very little TSH, very high T3 and T4

52
Q

symptoms of hyperthyroidism (5)

A 
weight loss
lack of energy 
heat intolerance
Anxiety
increase appetite
53
Q

Giotre=

A

enlarged thyroid

54
Q

graves disease=

A

hyperthyrodism

55
Q

treatment for hyperthyroidism

A

medical
radioactive iodine
surgical

56
Q

drug treatment for hyperthyroidism

A

Thionamindes

Beta blockers

57
Q

e.g 2 thionamindes

A

Carbimazole

Propylthiouracil

58
Q

what do Thioamindes do

A

inhibit iodide oxidation by thyroid peroxidase

59
Q

beta blockers

A

alleviate sympathetic manifestations rapidly

60
Q

what is the surgical procedure for hyperthyroidism

A

thyroidiectomy

Block 8 Ellen (14 decks)

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