Thyroid and Parathyroid

Question 1

Thyroid Releasing Hormone TRH activates the release of what?

Answer 1

Thyroid Stimulating Hormone TSH

Question 2

(T/F) Excessive activation of thyroid causes hypermetabolic state causing protein anabolism and enhanced sympathetic nervous system activity

Answer 2

False. Catabolism

Question 3

(T/F) Thyroid disease very uncommon-strongly female expression

Answer 3

False. Common

Question 4

What is a “thyroid storm”

Answer 4

Fever, tachycardia, sweating, shaking, agitation, and unconsciousness

Question 5

Clinical findings of Hyperthyroidism

Answer 5

1. Nervousness
2. Hot and sweating (heat intolerant)
3. Weight loss
4. Muscle weakness/tremor
5. Palpitations/tachycardia
6. “thyroid storm”

Question 6

What percentage of females have Graves disease?

Answer 6

2%

Question 7

What percentage of hyperthroidism is Graves disease?

Answer 7

90%

Question 8

What causes Graves disease

Answer 8

Autoimmune-antibodies function as agonists to thyroid-related receptors-causing excessive thyroid receptor activation

Question 9

Symptoms of Graves disease

Answer 9

1. Hyperthyroidism
2. Exophthalamos
3. Enlarged thyroid gland (hyperplasia)

Question 10

Plummer’s disease

Answer 10

Multinodular goiter. 5-10% of the hyperthyroidism cases

Question 11

Hypothyroidism clinical findings

Answer 11

• Hypometabolic state
• Enlarged thyroid
• Low temperature
• Dry coarse skin and hair
• Sluggish
• Cold intolerance
• Modest weight gain
• Myxedema

Question 12

Hypothyroidism in children is called what?

Answer 12

Cretinism

Question 13

What is a good screen for Hypothyroidism?

Answer 13

High TSH

Question 14

Hashimoto’s disease is caused by what?

Answer 14

Autoimmune disease (females)

Question 15

(T/F) Hashimoto’s may start as hyperthyroidism followed by permanent hypothyroidism

Answer 15

True. The thyroid may enlarge and then atrophy over the years

Question 16

(T/F) Hashimoto’s is the most common form of hypothyroid deficiency

Answer 16

True

Question 17

What is the most common LESION of the thryoid

Answer 17

Goiter

Question 18

(T/F) A goiter is rarely associated with hypothyroidism

Answer 18

True

Question 19

What is usually associate with a goiter?

Answer 19

Deficiency of iodine

Question 20

Are thyroid adenomas malignant?

Answer 20

No. They are the most common thyroid neoplasm

Question 21

(T/F) Thyroid carcinomas hace a poor prognosis

Answer 21

False

Question 22

What is needed to diagnose a thyroid nodule?

Answer 22

Fine needle aspirate (more common in women than men)

Question 23

Thiomides (propylthiouracil-PTU):

Answer 23

Inhibit thyroid peroxidase reaction and block synthesis of hormone. Used to treat hyperthyroidism

Question 24

Lugol solution

Answer 24

Inhibit hormone release via high levels of iodine (used to treat hyperthyroidism)

Question 25

(T/F)Does propanolol inhibit conversion of T4 to T3?

Answer 25

True (used to treat hyperthyroidism)

Question 26

What does radiation iodine do?

Answer 26

Destroys thyroid parenchyma(used to treat hyperthyroidism)

Question 27

synthroid and levothroid

Answer 27

Treats hypothryriodism

Question 28

How is parathyroid hormone regulated?

Answer 28

By calcium levels in the blood. Low calcium means higher levels of PTH

Question 29

What four things does PTH regulate?

Answer 29

1. Activates osteoclasts 2. Increase tubular reabsorption of calcium 3. Activates vitamin D 4. Increases GI absorption

Question 30

Hypercalcemia is caused by what?

Answer 30

Hyperparathyroidism

Question 31

What usually causes hyperparathyroidism?

Answer 31

Adenomas

Question 32

What are symptoms of hyperparathyroidism?

Answer 32

None! But if they do, see the following: 1. Osteporosis 2. Constipation 3. Weakness 4. Anorexia 5. Stones 6. Peptic ulcers 7. Depression 8. Coma

Question 33

(T/F) Arrythmias can be caused by hyperparathyroidism?

Answer 33

True

Question 34

What is the treatment for hyperparathyroidism?

Answer 34

Surgery

Question 35

(T/F) Metastasis and carcinomas are common in the parathyroid?

Answer 35

False

Question 36

What causes secondary hyperparthyroidsim?

Answer 36

Malabsorption of vitamin D

Question 37

Denosumab (XGEVA

Answer 37

Antibody to the osteoclastic-stimulating protein (RANK)- this drug blocks osteoclast number and activity and treats osteoporosis

Question 38

Teraparatide (Forteo)

Answer 38

A recombinant form of parathormone (PTH) segment which selectively activates osteoblasts and stimulates new bone formation.

Question 39

Estrogens or estrogen modulators mechanism in terms of osteoporosis

Answer 39

Prevent bone loss in early postmenopausal period. The estrogens should be used in combination with progestin in postmenopausal women to protect against venous thrombi

Question 40

Ibandronate-Boniva

Answer 40

Suppress activity of osteoclasts and inhibit bone resorption; used to treat osteoporosis (BRONJ)

Question 41

Alendronate-Fosamax

Answer 41

Suppress activity of osteoclasts and inhibit bone resorption; used to treat osteoporosis (BRONJ)

Question 42

(T/F) Glucocorticoids are used to treat osteoporosis

Answer 42

False. 1. Antagonizes vit. D-stimulated intestinal Ca++ transport and stimulates renal secretion 2. Blocks OSTEOBLASTIC function

Question 43

(T/F) Hypoparathyroidism is rare and most often due to the accidental removal parathyroids at thyroid surgery

Answer 43

True

Question 44

Symptoms: | hypocalcemia, decreases PTH, tetany, dental changes in children

Answer 44

Hypoparathyroidism

Question 45

Calcitonin

Answer 45

1. Actions opposite of PTH: inhibits osteoclasic activity | 2. Useful for treatment of Paget’s disease