Thyroid and Parathyroid Flashcards
Thyroid Releasing Hormone TRH activates the release of what?
Thyroid Stimulating Hormone TSH
(T/F) Excessive activation of thyroid causes hypermetabolic state causing protein anabolism and enhanced sympathetic nervous system activity
False. Catabolism
(T/F) Thyroid disease very uncommon-strongly female expression
False. Common
What is a “thyroid storm”
Fever, tachycardia, sweating, shaking, agitation, and unconsciousness
Clinical findings of Hyperthyroidism
- Nervousness
- Hot and sweating (heat intolerant)
- Weight loss
- Muscle weakness/tremor
- Palpitations/tachycardia
- “thyroid storm”
What percentage of females have Graves disease?
2%
What percentage of hyperthroidism is Graves disease?
90%
What causes Graves disease
Autoimmune-antibodies function as agonists to thyroid-related receptors-causing excessive thyroid receptor activation
Symptoms of Graves disease
- Hyperthyroidism
- Exophthalamos
- Enlarged thyroid gland (hyperplasia)
Plummer’s disease
Multinodular goiter. 5-10% of the hyperthyroidism cases
Hypothyroidism clinical findings
- Hypometabolic state
- Enlarged thyroid
- Low temperature
- Dry coarse skin and hair
- Sluggish
- Cold intolerance
- Modest weight gain
- Myxedema
Hypothyroidism in children is called what?
Cretinism
What is a good screen for Hypothyroidism?
High TSH
Hashimoto’s disease is caused by what?
Autoimmune disease (females)
(T/F) Hashimoto’s may start as hyperthyroidism followed by permanent hypothyroidism
True. The thyroid may enlarge and then atrophy over the years
(T/F) Hashimoto’s is the most common form of hypothyroid deficiency
True
What is the most common LESION of the thryoid
Goiter
(T/F) A goiter is rarely associated with hypothyroidism
True
What is usually associate with a goiter?
Deficiency of iodine
Are thyroid adenomas malignant?
No. They are the most common thyroid neoplasm
(T/F) Thyroid carcinomas hace a poor prognosis
False
What is needed to diagnose a thyroid nodule?
Fine needle aspirate (more common in women than men)
Thiomides (propylthiouracil-PTU):
Inhibit thyroid peroxidase reaction and block synthesis of hormone. Used to treat hyperthyroidism
Lugol solution
Inhibit hormone release via high levels of iodine (used to treat hyperthyroidism)
(T/F)Does propanolol inhibit conversion of T4 to T3?
True (used to treat hyperthyroidism)
What does radiation iodine do?
Destroys thyroid parenchyma(used to treat hyperthyroidism)
synthroid and levothroid
Treats hypothryriodism
How is parathyroid hormone regulated?
By calcium levels in the blood. Low calcium means higher levels of PTH
What four things does PTH regulate?
- Activates osteoclasts
- Increase tubular reabsorption of calcium
- Activates vitamin D
- Increases GI absorption
Hypercalcemia is caused by what?
Hyperparathyroidism
What usually causes hyperparathyroidism?
Adenomas
What are symptoms of hyperparathyroidism?
None! But if they do, see the following:
- Osteporosis
- Constipation
- Weakness
- Anorexia
- Stones
- Peptic ulcers
- Depression
- Coma
(T/F) Arrythmias can be caused by hyperparathyroidism?
True
What is the treatment for hyperparathyroidism?
Surgery
(T/F) Metastasis and carcinomas are common in the parathyroid?
False
What causes secondary hyperparthyroidsim?
Malabsorption of vitamin D
Denosumab (XGEVA
Antibody to the osteoclastic-stimulating protein (RANK)- this drug blocks osteoclast number and activity and treats osteoporosis
Teraparatide (Forteo)
A recombinant form of parathormone (PTH) segment which selectively activates osteoblasts and stimulates new bone formation.
Estrogens or estrogen modulators mechanism in terms of osteoporosis
Prevent bone loss in early postmenopausal period. The estrogens should be used in combination with progestin in postmenopausal women to protect against venous thrombi
Ibandronate-Boniva
Suppress activity of osteoclasts and inhibit bone resorption; used to treat osteoporosis (BRONJ)
Alendronate-Fosamax
Suppress activity of osteoclasts and inhibit bone resorption; used to treat osteoporosis (BRONJ)
(T/F) Glucocorticoids are used to treat osteoporosis
False.
- Antagonizes vit. D-stimulated intestinal Ca++ transport and stimulates renal secretion
- Blocks OSTEOBLASTIC function
(T/F) Hypoparathyroidism is rare and most often due to the accidental removal parathyroids at thyroid surgery
True
Symptoms:
hypocalcemia, decreases PTH, tetany, dental changes in children
Hypoparathyroidism
Calcitonin
- Actions opposite of PTH: inhibits osteoclasic activity
2. Useful for treatment of Paget’s disease
