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Summer 2020 - Physiology 2 - Endocrine > Thyroid - Final Wrap Up > Flashcards

Thyroid - Final Wrap Up Flashcards

1
Q

How much does the body’s metabolic rate decrease if there is no thyroid secretion?

A

Decreases BMR by 40-50%

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2
Q

An excess of thyroid secretion increases the BMR by ______%

A

An excess of thyroid secretion increases the BMR by 60-100%

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3
Q

Where is the thyroid located?

A

Below Larynx, Anterior and to each side of Trachea

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4
Q

What hormones are secreted by the Thyroid?

A

Thyroxine (T4)

Triiodothyronine (T3)

Reverse T3 (rT3) - Inactive

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5
Q

What does the Thyroid produce to regulate Calcium?

A

Calcitonin from Parafollicular C-Cells

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6
Q

What is the Thyroid Gland made of?

A

Follicles of Cuboidal Epithelial Cells around a Colloid Matrix

Follicle is the Functional Part

Colloid is where 2-3 months supply of hormones are stored

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7
Q

How much Iodine is needed for Normal Thyroid Hormone secretion?

A

1mg of Iodine per week

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8
Q

How much Thyroxine (T4) is secreted per day?

A

80 - 100 mcg/day

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9
Q

How much does the Thyroid secrete Thyroxine (T4) vs. Triiodothyronine (T3)?

A

T4 - 93% –> all will convert to T3

T3 - 7%

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10
Q

What is the difference b/t T4 & T3?

A

T3 is 4x more potent & clears faster d/t less protein binding

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11
Q

What stimulates Thyroid secretion starting from the Hypothalamus?

A

Hypothalmus –> Thyrotropin-Releasing Hormone (TRH) –> Anterior Pituitary –> Thyroid-Stimulating Hormone (TSH) –> Thyroid –> Releases T3 & T4

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12
Q

Only free Thyroid Hormones are active, but the other 99% are bound to what?

A

Thyroid Binding Globulin or Albumin

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13
Q

How is T4 converted to T3?

A

TH released from protein & taken up by tissues that uses enzymes to convert T4 to T3

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14
Q

What do Thyroid Hormones do?

A

↑Gene Transcription

↑Protein & Enzyme Production (BMR)

↑Mitochondria (Energy)

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15
Q

What is the Half-Life of T4 vs. T3?

A

T4: 6-7 days

T3: 1 day

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16
Q

How do Thyroid Hormones affect Carbs?

A

↑Glucose Uptake in Cells & GI

↑Glycolysis, Gluconeogensis

↑Insulin Secretion

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17
Q

How do Thyroid Hormones affect Fats?

A

Mobilizes Lipids

↓Fat Stores & Cholesterol

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18
Q

Thyroid hormones is supposed to decrease body weight. Why might that not happen?

A

Increased Appetite

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19
Q

What are the CV effects of Thyroid Hormone?

A

↑HR & Contractility

Vasodilation d/t ↑O2 Consumption

↑Blood Flow

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20
Q

How does Thyroid Hormone affect Muscles?

A

↑Strengh, but can weaken if there is too much TH

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21
Q

What is Primary Hypothyroidism?

A

Elevated TSH w/ No T4 or T3 Production caused by Hashimoto’s Thyroiditis

Also caused by Poor Iodine Intake, Radiation or Surgery

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22
Q

What is Secondary Hypothyroidism?

A

Not enough T3 or T4 d/t TSH not being released

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23
Q

What is Tertiary Hypothyroidism?

A

Problem w/ Hypothalamus not releasing Thyrotropin Releasing Hormone (TRH)

24
Q

What can happen if Hypothryroidism happens in Infancy?

A

Cretinism - Mental Retardation & Growth Defects

25
Q

What is the Most rare & severe form of Hypothyroidism?

A

Myxedema Coma w/ decreased breathing, blood sugar, BP, & Temp

Triggered by Illness, Infection & Medicine

26
Q

Which Induction meds should be used for pts w/ Hypothyroidism?

A

Ketamine

Pancuronium

Rocuronium

27
Q

What happens w/ Thyroiditis?

A

Thyroid inflammation that causes excessive TH release, but not increased production

28
Q

What is Thyrotoxicosis?

A

Oversupply of TH on Peripheral Tissues

29
Q

What’s the most common cause of Hyperthyroidism?

A

Grave’s Disease - Autoantibodies activate TSH receptor causing goiter & exophthalmos

30
Q

How is Hyperthyroidism treated?

A

Antithyroids
(Methimazole & Propulthiouracil)

Propranolol

Radioactive Iodine

Surgery

31
Q

When do Thyroid Storms usually occur and what are the symptoms?

A

6-18 hrs Post-Op

Hyperthermia

Tachycardia

Dysrhythmias

CHF

Shock

32
Q

How is a Thryoid Storm treated?

A

Sodium Iodide

B-Blockers

Cortisol

PTU

Tylenol

Fluids

33
Q

How long do Antithyroids & Sodium Iodide take to work?

A

Sodium Iodide: 10 days

Antithyroids: 6-8 wks

34
Q

What happens w/ Hypocalcemia?

A

Nervous System Excitement

↑Na Permeability

Tetany

Seizures

Carpopedal Spasm

Chvostek’s

Wide QT

35
Q

What happens w/ Hypercalcemia?

A

Skeletal Muscle Weakness

Nervous System Depression

Short QT

Wide PR

Constipation

Anorexia

36
Q

How is Hypercalcemia treated?

A

Maintain UOP

Hydration

Mithramycin

37
Q

What makes Phosphorus levels fluctuate more than Calcium?

A

Phosphorus moves b/t ECF & Bone as well as ECF & ICF

38
Q

What is the main controller of Phosphorus Levels?

A

Kidneys

Phosphorus absorbed via GI & balanced out via Urine

39
Q

What are the 4 Parathyroid Glands made of and what do they do?

A

Chief & Oxyphil Cells

Make & Secrete parathyroid hormones r/t blood calcium & ↑Vitamin D Production

40
Q

What can cause Parathyroid glands to be Enlarged?

A

Prolonged Stimulation

Pregnancy

Lactation

41
Q

What are the Calcium Regulators?

A

Parathyroid Hormone

Vitamin D

Calcitonin

42
Q

How does PTH affect Bones?

A

Breaks down bone to release calcium into blood

Rapid: Activates bone cells

Delayed: Activates Osteoclasts

43
Q

How does PTH affect the Kidneys?

A

↑Ca+ reabsorption in distal tubles

↓Phosphate reabsorption in renal tubules

44
Q

An increase in PTH will increase excretion of ______, ______, & ______, by increasing reabsorption of ______, ______, & ______, in the distal tubles & collecting ducts

A

An increase in PTH will increase excretion of phosphate, potassium, & sodium, by increasing reabsorption of calcium, magnesium, & hydrogen, in the distal tubles & collecting ducts

45
Q

What produces the opposite effects of the Parathyroid Hormone?

A

Calcitonin - inhibits bone resorption & increases Ca+ & Phosphate excretion

46
Q

What does Vitamin D do?

A

↑Calcium absorption from GI

Bone Absorption & Deposition

47
Q

What are symptoms of Hypoparathyroidism?

A

Tetany

Cramps

Grand Mal Seizures

CV Collapse

48
Q

What should be corrected before correcting Calcium?

A

Magnesium - suppresses PTH release

49
Q

What can Primary Hyperparathyroidism cause?

A

Hypercalcemia

Hypercalciuria

Hypophosphatemia

Hyperphosphaturia

Abnormal Cardiac Function

Kidney Stones

50
Q

What can cause Primary Hyperparathyroidism?

A

Parathyroid Tumor / Hyperplasia

Pregnancy

51
Q

What causes Secondary Hyperparathyroidism?

A

PTH Hypersecretion from Hypocalcemic Stress d/t Vit. D Deficiency or Chronic Renal Disease

52
Q

What condition can be seen in children w/ Vit. D deficiency?

A

Rickets - weak bones that bow

53
Q

1 gm of Calcium Chloride = ? Calcium Gluconate?

A

3 gm Calcium Gluconate

54
Q

What are indications for Calcium Therapy?

A

Hyperkalemic EKG Changes

Hypotension r/t B-Blockers or CC-Blockers

Mag Toxicity

55
Q

When is Calcium Therapy contraindicated?

A

Pts w/ Digoxin Toxicity

Summer 2020 - Physiology 2 - Endocrine (5 decks)

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