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Physio > Thyroid and parathyroid hormones > Flashcards

Thyroid and parathyroid hormones Flashcards

1
Q

93% of active hormone secreted by the thyroid gland is __

A

thyroxine (T4)

more made (both have 4 letters)

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2
Q

what transporter increases I- intracellcular concentration?

A

Na+/I- symporter (NIS)

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3
Q

7% of active hormone secreted by the thyroid gland is __

A

triiodothyronine (T3)

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4
Q

what do thyroid hormones impact?

A

-metabolism
-growth
-permissive for catecholamines

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5
Q

is T3 or T4 more potent?

A

T3

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6
Q

parafollicular cell secretes __

A

calcitonin

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7
Q

calcitonin is released when

A

Ca is high

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8
Q

T3 and T4 secretion into blood-
2. vesicles fuse with __ in the cell

A

lysosomes

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9
Q

thyroid follicular cells actively transport __ obtained from the __

A

iodide (I-), diet

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10
Q

what is required for thyroid synthesis?

A

iodine (I2)

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11
Q

thyroglobulin stored in __ of follicle

A

colloid

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12
Q

what is pendrin? (where initial steps of thyroid hormone take place)

A

Cl-/ I- exchanger

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13
Q

T3 and T4 secretion into blood-
1. colloid is internalized by __

A

endocytosis

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14
Q

iodide must exit across the __ membrane to access the colloid

A

apical

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15
Q

T3 and T4 are produced in the __ and complexed with __

A

colloid, thyroglobulin

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16
Q

T3 and T4 secretion into blood-
3. protease cleave __ from TG

A

T3, T4

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17
Q

T3 and T4 secretion into blood-
4. T3 and T4 diffuse out of the cell and into __

A

capillaries

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18
Q

what is a reservoir of thyroid hormones?

A

colloid

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19
Q

_______ forms T3 and T4 compounds with thyroglobulin

A

peroridase

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20
Q

T3 and T4 need __ proteins for transport

A

binding

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21
Q

due to how tightly is binds, what has a longer half life?

A

T4

long life (both have 4 letters)

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22
Q

what do cells use to make active T3 that remove iodine from T4?

A

deiodinases/ iodinases

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23
Q

how many deiodinases are there?

A

3 (D1,D2,D3)

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24
Q

what do deiodinases contain that is essential for their enzymatic activity?

A

selenocysteine (replaces sulfur with selenium)

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25
Q

conditions that inhibit deiodinase activity could show signs of __

A

hypothyroidism

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26
Q

which out of T3 or T4 action is sooner?

A

T3

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27
Q

T4 has a __ onset and __ duration of action

A

slower, long

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28
Q

thyroid hormone __ is the main circulating form

A

T4

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29
Q

what converts T4 to T3

A

iodinase

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30
Q

what is responsible for most of thyroid hormone negative feedback?

A

T4

gets converted to T3 at the target tissue

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31
Q

TSH secretion is __

A

pulsatile

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32
Q

T3 and T4 are _________ to cardiovascular

A

permissive

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33
Q

TSH secretion peaks at __

A

12 AM

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34
Q

TSH secretion rise around __

A

9 PM

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35
Q

TSH secretion declines during the __

A

day

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36
Q

thyroid hormone stimulates __ by most metabolically active tissues

A

oxygen consumption

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37
Q

thyroid hormone increases __

A

basal metabolic rate (BMR)

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38
Q

thyroid hormone causes uptake of __ by cells

A

glucose

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39
Q

thyroid hormone stimulates __ and __metabolism

A

carbohydrate, fat

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40
Q

thyroid hormone enhances __ and gluconeogenesis

A

glycolysis

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41
Q

thyroid hormone stimulates protein __ and synthesis

A

catabolism

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42
Q

thyroid hormone increases rate of CHO absorption from __

A

GI tract

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43
Q

thyroid hormone increases lipid __ and __ of fatty acids by cells

A

mobilization, oxidation

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44
Q

thyroid hormone required to covert beta carotene to __

A

Vit. A (hypothyroid patients with yellow skin)

wound healing

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45
Q

thyroid hormone decreases circulating __ levels

A

cholesterol (hypothyroidism associated with hyperlipidemia)

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46
Q

thyroid hormone in the nervous system control

A

-Needed for development
-reflex time

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47
Q

hyperthyroidism in the nervous system causes

A

-muscle tremors
-tiredness but can’t sleep
-anxiety, worry, paranoia

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48
Q

thyroid hormones in the endocrine system affects the __

A

activation of bone formation

cause need for PTH (increases Blood Ca

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49
Q

thyroid hormones in the cardiovascular system increase __

A

-B- adrenergic receptors
-blood flow, HR,

permissive

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50
Q

thyroid hormones in the gastrointestinal system affects

A

-appetite
-rate and secretion of GI tract

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51
Q

Goiter is an enlarged thyroid that does not indicate __

A

functional status

seen in hypo,hyper and normal funcitoning

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52
Q

High levels of thyroid hormone secretion
caused by TSI suppress __

A

anterior pituitary TSH secretion

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53
Q

Goiter caused by excessive amounts of __ secretion

A

TSH

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54
Q

most common form of hyperthyroidism

A

grave’s disease

55
Q

graves disease is an autoimmune diseases where thyroid stimulating immunoglobulins (TSIs) stimulate __

A

thyroid gland to excess

TSI acts like TSH

56
Q

treatment of hyperthyroidism

A

Radioactive I 131 thyroid ablation or Antithyroid Drugs

57
Q

what is rarely used to treat hyperthyroidism?

A

surgery

58
Q

what is given for
adrenergic symptoms while awaiting
resolution for hyperthyroidism?

A

propanolol (b blocker)

59
Q

__ administered to prevent
hypothyroidism in patients who have undergone ablation or surgery

A

L- thyroxine

60
Q

Hyperthyroidism Oral Symptoms

A

-burning mouth
-gum disease
-excessive salivation
-increased caries risk
-weak mandible

61
Q

Thyroid Storm (Thyrotoxicosis) is elevated thyroid hormones due to __

A

stressful events or serious illness

62
Q

Thyroid Storm (Thyrotoxicosis) symptoms

A

fever, tachycardia, elevated BP, nausea, vomiting,
diarrhea, breathing problems

63
Q

in patients with hyperthyroidism or those that exhibit signs/symptoms of thyroid storm, __ contraindicated and treatment __

A

epinephrine, deferred

64
Q

what type of patient would you not want to give epinephrine to?

A

Hyperthyroid

65
Q

Hashimoto’s is an autoimmune reaction that destroys the __

A

thyroid gland

66
Q

what is the most common cause of hypothyroidism?

A

Hashimoto’s

67
Q

Hashimoto’s leads to inflammation in the thyroid that leads to fibrosis and decrease in secretion of __

A

thyroid hormone

68
Q

Hashimoto’s treatment

A

L- thyroxine (T4)

69
Q

in hypothyroid states goiter due to __ deficiency

A

iodine

70
Q

in hypothyroid states no goiter due to __ deficiency

A

TSH

71
Q

Is hypothyroidism due to
iodine deficiency a primary
or secondary endocrine
disorder?

A

primary

72
Q

in what might you see loss of lateral eyebrow and coarse dry hair?

A

hypothyroidism

hyPOthY NO eYebrow

73
Q

what is seen in severely hypothyroid patients?

A

myxedema

74
Q

myxedema is increased quantities of __ bound with protein plus water accumulate in skin

A

hyaluronic acid and chondroitin sulfate

puffy eye lids and increase skin folds

severe Hypothyroid

75
Q

what thyroid hormone is required for postnatal brain maturation?

A

Thyroxine (T4) without causes cretinism

76
Q

Patients with hypothyroidism are sensitive to __ nervous system depressants and __ so these medications should be
used sparingly

A

central, barbiturates

77
Q

cretinism is caused by

A

-absent thyroid gland
-iron deficiency (most common)

78
Q

Hypothyroidism Oral Manifestations

A

-dysgeusia
-delayed tooth eruption
-increased periodontal disease
-macroglossia
-poor wound healing (Lack of VA)
-salivary gland enlargement

DDIMPS

79
Q

how phosphate is stored in the body

A

-85% bones
-14-15% cells
-<1% EC fluid

80
Q

how calcium is stored in the body

A

-99% bone
-1% cells
-0.1% EC fluid

81
Q

free calcium is __ regulated

A

tightly

82
Q

calcium too high= neuronal __

A

depression

83
Q

control points for calcium and phosphate- absorption via __

A

intestines

84
Q

calcium too low= neuronal __

A

hyper-excitability (tetany)

85
Q

what are the 3 ways Calcium is regulated?

A
  1. absoprtion
  2. excretion
  3. temporary storage
86
Q

control points for calcium and phosphate- excretion via __

A

urine (calcium and phosphate) and feces (calcium only)

87
Q

what hormone increases calcium and decreases phosphate

A

parathyroid hormone (PTH)

88
Q

what hormones regulate calcium?

A
  1. PTH
  2. Calcitrol (Vitamin D3)
  3. Calcitonin
89
Q

control points for calcium and phosphate- temporary storage via __

A

bones

90
Q

how does PTH increases calcium levels

A

-mobilizes from bone
-enhances renal reabsorption
-increases intestinal absorption (indirectly)

91
Q

what hormones increases calcium and phosphate?

A

calcitriol

intestinal absorption

92
Q

what stimulates bone matrix resorption to increase calcium?

A

Vit. D3 and PTH

93
Q

calcitriol increases calcium and phosphate levels by?

A

intestinal absorption

94
Q

how many glands are there on the posterior surface of the thyroid gland?

A

4

95
Q

what hormone decreases calcium and phosphate?

A

calcitonin

96
Q

what stimulates bone matrix deposition and inhibits osteoclasts to decrease calcium?

A

calcitonin

97
Q

PTH decreases phosphate by increasing __

A

renal excretion

98
Q

PTH secreted by __ cells

A

chief

99
Q

PTH decreases calcium by decreasing

A

renal excretion

100
Q

increasing rate of PTH secretion hypertrophy of
parathyroid gland can be due to

A

-pregnancy
-rickets
-lactation

101
Q

increasing calcium ECF concentration __ activity and size of parathyroid gland

A

decreases

102
Q

PTH increases calcium by increasing

A

intestinal absorption and bone resorption

103
Q

decreased calcium ECF concentration __ PTH secretion

A

increases

104
Q

PTH increases calcium by reabsorption of calcium by renal tubules which reduces __

A

excretion

105
Q

decreasing activity and size of the thyroid gland can be due to

A

-increased Vit. D
-excess calcium in diet
-bone resorption other than PTH

106
Q

PTH increases calcium by converting 25-
hydroxycholecalciferol to __ which causes intestinal
calcium absorption

A

dihydroxycholecalciferol
(Vitamin D/Calcitriol)

107
Q

PTH increases calcium by __ resorption

A

bone

108
Q

what stimulates bone resorption?

A
  • PTH
  • Vitamin D2 (excess)

cause Rank L to be secreted binds to osteoclast receptor

109
Q

What stimulates an increase in OPG?

A

Calcitonin

bone depostion

110
Q

what hormone is not a major controller of calcium in humans?

A

calcitonin

111
Q

osteoporsis is due to

A

imbalnce in between bone formaiton and resportion

112
Q

what is treatment for osteoporosis?

A
  • excersise
  • estrogen
  • biphosphonates
113
Q

PTH decreases phosphate by decreased reabsorption by renal tubules leading to increased __

A

urinary excretion

114
Q

calcitriol in the intestines increases __

A

absorption of calcium and phosphate

115
Q

calcitonin is secreted by __ cells

A

parafollicular (C cells)

116
Q

Primary Hyperparathyroidism extreme __ activity in bones cause cystic bone disease

A

osteoclastic

117
Q

Primary Hyperparathyroidism is caused by

A

tumor

118
Q

Primary Hyperparathyroidism symptoms?

A
  • bones (can have cysts)
  • stones
  • abdominal groans
  • psychic moans
119
Q

calcitonin is released in response to elevated __

A

free plasma calcium

120
Q

calcitonin lowers calcium by decreasing activity of __, thus decreasing bone resorption

A

osteoclasts

121
Q

Primary Hyperparathyroidism is excess PTH secretion due to a __

A

parathyroid gland tumor

122
Q

Secondary Hyperparathyroidism causes hypocalcemia mainly due to __

A

Vit. D deficiency

or chronic renal failure

123
Q

Chronic Renal Disease

A

can not synthesize active D3

can cause osteomalacia in adults

124
Q

osteitis fibrosa cystica hypercalcemia leads to __

A

polyuria and calcuria

125
Q

osteitis fibrosa cystica low phosphate due to increased __

A

renal excretion

126
Q

osteitis fibrosa cystica leads to muscle __ and easy __

A

weakness, fatigue

127
Q

osteitis fibrosa cystica osteoblastic activity leads to high secretion of __

A

alkaline phosphatase (ALP)

128
Q

chronic renal disease cannot synthesize __

A

Vit. D3

129
Q

Vit D deficiency leads to __ in children and __ in adults

A

rickets, osteomalacia

130
Q

Primary Hypoparathyroidism less common results from accidental __

A

surgical parathyroid gland removal

131
Q

hypocalcemia increases membrane __ permeability

A

Na+

132
Q

hypocalcemia leads to neuromuscular excitability and __

A

muscles spasms, tetany

133
Q

PTH is released when

A

Ca is low

Physio (34 decks)

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