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My Endocrine flashcards > Thyroid > Flashcards

Thyroid Flashcards

1
Q

what levels of the spine correlate to the thyroid?

A

C5 - T1

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2
Q

what is the additional artery which may supply the thyroid?

A

thyroid ima

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3
Q

what is the parasympathetic innervation of the thydoid?

A

vagus

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4
Q

what is the symp innervation of the thyroid?

A

sup / mid / inferior ganglia of the symp trunk

runs with the s / m / i arteries

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5
Q

describe the follicle

A

The follicles are lined with follicular cells and are filled with a fluid known as colloid that contains the prohormone thyroglobulin (which is like an attatchment site for different hormones / tyrosine)

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6
Q

there is iodine uptake to follicular cells. what happens next?

A

iodine attached to tyrosine residues on thyroglobulin to form (MIT) & (DIT). from this, T3 and T4 are formed.

T3 and T4 are stored in the colloid thyroglobulin until needed!

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7
Q

plasma protiens: what % of T3 / T4 binds to…

  • albumin?
  • thyroxine binding pre-alb?
  • thyroxine binding globulin?
A

5% to albumin
20% to thyroxine binding pre-albumin
70% - most bind to thyroxine binding globulin

5% is free and active, unlike the rest of us xx

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8
Q

what is the effect of thyroid hormones on the sympathetic nervous system?

A

thyroid hormones lead to an increase in the number of receptors for adrenaline / noradrenaline, so ENHANCES the effect of sympathetic mediators.

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9
Q

How do you treat symptoms caused by the thyroid hormone effect on the sympathetic nervous system?

A

increased HR and force of contraction (due to more noradrenaline receptors cropping up) can be reversed using PROPANOLOL.

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10
Q

What environmental factor can increase thyroid hormone release in babies?

A

cold temperatures

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11
Q

does stress inhibit or enhance thyroid hormone release?

A

inhibits release

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12
Q

2 Delodinase enzymes deactive thyroid hormones. where is
D1?
D3?

A

d1 - liver and kidneys

d2 - everywhere - heart and skeletal muscle, CNS, fat , thyroid, and pituitary

d3 - fetal tissue, placenta and brain (not pituitary)

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13
Q

what is the mechanism of inactivation of D1 and D3?

A

T4 –> reverse T3 !!

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14
Q

what does D2 do and where?

A

D2 activates T4–> T3!!

heart, skeletal muscle, CNS, fat , thyroid, and pituitary

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15
Q

what is the effect on TSH if T3 and T4 are low?

A

TSH would be high

this doesn’t cause goitre.

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16
Q

what is the autoimmune mechanism of graves?

A

there is lots of TSI - thyroid stimulating immunoglobulin

this acts in the same way as TSH, and is unregulated by negative feedback with T3/4

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17
Q

joseph’s thyroid hasn’t bothered to descent and you can see it beside his tonsils. what is this called?

A

a lingual thyroid

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18
Q

what does thyroxine bind to and where? whats the effect?

A

what - Thyroid response elements
where - target genes all around the body
effect - increased BMR through transcription changes

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19
Q

2 drugs that commonly cause hypothyroidism associated thyroiditis?

A

amiodarone - v common

also lithium

20
Q

does de Quervains subacute thyroiditis cause pain?

A

no

21
Q

what thyroid condition is predisposed by Turners and Down’s syndrome?

A

Hashimoto’s hypothyroidism

22
Q

anti- thyroglobulin and anti - thyroperoxidase (tpo) is high — what could this show?

A

Hashimoto’s (autoimmune antibodies)

23
Q

does iodine deficiency cause diffuse or nodular goitre?

A

both ! ha ha !

24
Q

treatment of thyroid cancer

A
  1. thyroidectomy
  2. radiotherapy ablation
  3. thyroid replacement forever
25
Q

describe the most common thyroid cancer

A

1 = Papillary (75-85%)

Multi-nodular
Spread via lymph nodes

26
Q

describe 2nd most common thyroid cancer

A

2 = Follicular (from thyroid epithelium)

Single Nodule
Haematogenous spread

27
Q

what thyroid cancer has the worst prognosis?

A

ANAPLASTIC
Rapidly expanding undifferentiated tumour
Normally mets by diagnosis
Associated with p53

28
Q

what thyroid cancer arises in parafollicular cells?

A

Medullary - C cell from parafollicular
Single nodule
Airway compromised

29
Q

4 month old Jenna has a big swelling behind her left ear that is transilluminate. what is it?

A

Cystic Hygroma
Benign swelling full of lymph
Occurs in babies < 1
Can cause pressure symptoms

30
Q

where to branchial cysts occur?

A

upper anterior triangle of children

failed fusion of 2nd and 3rd branchial arches

31
Q

what are dermoid cysts?

A

soft benign teratomas of dermatology structures - soft and can occur in the midline of the neck

32
Q

what midline neck cyst would move with the tongue?

A

Thyroglossal cyst

Contain lymph which may get infected

33
Q

Hypothyroid women need more replacement when they get pregnant (mimic physiological increase) – how do you test that they are getting enough??

A

test TSH - should be inhibited, so low

should be < 3 Mu / L

34
Q

recommended dose of thyroxine in hypothyroid woman??

  • once you suspect pregnancy
  • throughout pregnancy
A
  • up to 25mg - ASAP

- up to 150mg by 20 weeks

35
Q

what hormone supports egg development / release, and is biochemically similar to thyroxine??

A

hCG

36
Q

what can cause hyperthyroidism in weeks 0-20 of pregnancy specifically??

A

hCG associated hyperthytoidism

37
Q

treatment of hyperthyroidism in pregnancy (2 drugs, when?)

A

1st tri = propylthyriouacil

3rd = Carbimazole

38
Q

what is neonatal transcient hypothyroidism caused by???

A

TRAbs crossing the placent (thyroid receptors antibodies)

39
Q

hypothyroidism in pregnancy can be life threatening to the mum and baby – true or false??

A

TRUE
mum = pre-eclampsia, premature labour, haemorrhage

baby = abortion, low IQ

40
Q

how could babies “acquire” thyroid disease? (3)

A

infection
autoimmune disease
iodine deficiency

41
Q

what 3 things can lead to primary congenital thyroid disease? (in contrast to secondary / tertiary congenital thyroid disease)

A

Primary = a problem within the thyroid itself
dysplastic thyroid
sublingual thyroid - developed in wrong place
metabolism error

42
Q

how is congenital thyroid disease in babies picked up??

A

POSITIVE DAY 5 GUTHRIE TEST - HIGH TSH AND LOW T4

43
Q

consequence of failing to notice congenital thyroid disease?

A

cretinism develops by 3 months

44
Q

classic presentation of a congenital thyroid disease baby? (3)

A
  • delayed jaundice
  • constipation
  • gaining weight despite poor feeding!!
45
Q

what is seen on histology of de Quervains subacute thyroiditis?

A

granulatous inflammation / giant cell

46
Q

what is seen on histology of Reidel’s subacute thyroiditis?

A

dense fibrosis

47
Q

what it the difference between primary and secondary congenital thyroid disease?

A

primary - a problem within the thyroid eg. metabolism error

secondary - a problem in the thyroid stimulating sequence eg, hypopituitarism

My Endocrine flashcards (8 decks)

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