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MIDTERMS > THYROID GLAND CCHM > Flashcards

THYROID GLAND CCHM Flashcards

1
Q

Primarily made up of two lobes resting on each side of the trachea and are bridged together with isthmus
↑ This isthmus is tied the two lobes with the tissue of it running anterior to the trachea
↑ Posteriorly located to the trachea is the parathyroid gland

A

THYROID GLAND

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2
Q

in humans start to develop in the fetus at about 4th to 8th week of gestation
↑ Upon reaching the 11th week, that would be the time its capable of secreting its hormones
* Located in front of the lower anterior neck
* Bow tie or butterfly like (also a bowtie structure)
- * secretes ___, ___ and ___

A

Thyroid glands
- T3 and T4 and calcitonin

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3
Q

structural units of thyroid
-Each of it has a core which is made up of a ___

A

Follicles
- colloid

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4
Q

homogenous viscous fluid consisting mainly of a glycoprotein iodine complex called
___

A

Colloid
- thyroglobulin

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5
Q

is made up of an amino acid
which is tyrosine, so together, this compound binds with the iodine and is the one responsible
for the production of thyroid hormones (T3, T4,
and calcitonin)

A

Thyroglobulin

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6
Q

Follicular cells are responsible for the production and
synthesis of 2 major thyroid hormones__and __

A

(T3 & T4)

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7
Q

control the rate at which cells burn fuels from food for energy
➢ CNS activity and brain development
➢ Cardiovascular stimulation, bone and tissue growth and development
➢ GI regulation and sexual maturation

A

fOLLICULAR CELLS
T3 (triiodothyronine) and T4 (thyroxine)

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8
Q

➢ is the hormone responsible for the regulation of calcium
➢ Helps in lowering the Ca+ concentration in the blood
circulation whenever it detects that the individual has hypercalcemia
➢ Helps in promoting bone absorption of calcium

A

pARAFOLLICULAR CELLS (C-CELLS)
Calcitonin

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9
Q

Majority of the ___ are bound to protein as its carrier protein
↑ Majority are bound to ___
which primarily carries about 60% of the __ present in the blood circulation
↑ Some of the T4 is bound to ___ specifically the ___
↑ The least concentration is those that are bound to ___ molecule

A

thyroid hormones
thyroxine-binding globulin
T4
prealbumin
thyroxine-binding prealbumin
albumin

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10
Q

In terms of percentage, majority are bound and only about less than 0.2 of __ are found in its free form

A

T3 (free thyroxine FT4 and free triiodothyronine FT3)

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11
Q

___ AND __ are responsible
for the regulation of the release of T3 and T4
- These work together thru the ____

A

Hypothalamus and Pituitary glands
- hypothalamic pituitary thyroid axis

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12
Q

The hypothalamus, specifically the supraoptic and the supraventricular nuclei of the hypothalamus would be responsible for the release of the
___ which would in turn direct the pituitary gland in the production of of it

A

thyrotropin releasing hormone (TRH) or thyroid stimulating
hormone TSH

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13
Q

For tissue growth
↑ Important for metabolism
* For development of the CNS
* Elevated heat production
↑ Regulates body temperature
* Control of oxygen consumption
* It influences carbohydrate and protein metabolism
* For energy conservation

A

THYROID HORMONES FUNCTION

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14
Q

Considered as the active form of the thyroid hormone
↑ It is about 3-8 times more metabolically active as compared to T4
↑ Majority of it in the circulation is primarily a product of deiodination of T4 which typically happens in the __ or ___
* Also known as the ___
* It has the most active thyroid hormonal activity.
* Almost 75-80% is produced from the tissue deiodination of T4

A

TRIIODOTHYRONINE (T3)
- liver or in the kidney
-3,5,5’ triiodothyronine

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15
Q

Principal application:
* In diagnosing ____
* Better indicator of recovery from hyperthyroidism (as well as recurrence)

A

T3 thyrotoxicosis

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16
Q

More commonly called as the ___
* ____
* Principal secretory product of the thyroid gland
* The major fraction of organic iodine in the circulation
* A pre-hormone for T3 production
- The only source is the__
* Elevated level causes inhibition of TSH secretion, and vice versa
-Low levels on the other hand promotes the excretion of TSH by the pituitary gland or specifically
the feedback loop thru hypothalamic pituitary and thyroid axis

A

TETRAIODOTHYRONINE (T4)
- thyroxine
- 3,5,3’5’ tetraiodothyronine
- thyroid gland

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17
Q

is the most important element in the biosynthesis of thyroid hormones
-ideal amount___ (below can cause deficiency)

A

iodine
- 50ug/day

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18
Q

Iodination of tyrosine residues in the thyroglobulin results in formation of ___ and ___

A

monoiodotyrosine (MIT) and
diiodotyrosine (DIT)

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19
Q

Product of T3

A

One monoiodothyronine + one
diiodothyronine

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20
Q

4

A

Two diiodothyronine molecules

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21
Q

▪___ converts T4 into T3

A

Deiodination

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22
Q

Latent Period around 12hrs

A

T3

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23
Q

Latent Period around 72hrs

A

T4

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24
Q

Biological
Half-life OF T3

A

around 2 days

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25
Q

Biological
Half-life of t4

A

around 7-9 days

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26
Q

refers to the time it takes for the hormone to lose half of its physiological activity

A

Half-life

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27
Q

is where the effect of the activity of
hormone can be seen to a particular tissue of organ.

A

Latent period

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28
Q

Increase____
* Increase __,__ AND____
* Potentiate actions of the ____
* Interaction with other Endocrine systems
* Effect on the CNS
* Increase vitamin A and retinal synthesis
* Helps in heat generation thru ___

A

ACTION OF T3 & T4
- basal metabolic rate (BMR)
- Protein, Carbohydrate and Fat metabolism
- Catecholamines (adrenaline and epinephrine)
- thyronamines

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29
Q

complete absence

A

Agenesis

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30
Q

from base of tongue to
trachea
- The position of the thyroid is wrong

A

Incomplete descent

31
Q

– complete failure to descend
from base of tongue

A

Lingual thyroid

32
Q

– segment of duct persists
and presents as lump years later

A

Thyroglossal cyst

33
Q
  • Refers to an excess of circulating thyroid hormone
  • Most patients are slim & thin (due to calorie burning)
  • Increase appetite and decrease weight
  • Presence of exophthalmia (eyes protruded)
  • Heat intolerance
  • Increase activity
    Tachycardia
A

HYPERTHYROIDISM

34
Q

▪ Applied to a group of syndromes caused by high levels of free thyroid hormones in the circulation.
- Pertaining to constellation of findings in which thyroid gland becomes overactive in such a way
that it produces too much thyroxine
↑ Peripheral tissues are presented with and they respond to excess of the thyroid hormone
POSSIBLE REASONS:
▪ Excess in thyroid hormone ingestion
▪ Leakage from the thyroid follicles
▪ Excessive production of the thyroid gland

A

THYROTOXICOSIS

35
Q

TSH level is low despite the high level of thyroxine in which primarily due to the excessive circulating thyroxine or thyroid hormone telling the brain to stop or suppress further production, therefore causing the TSH to be low.

A

Plummer’s disease

36
Q

Mood swings
▪ Restless
▪ Sleep difficulties
▪ Tremor of hands
▪ Palpitations
▪ Sore eyes (trouble focusing, irritation and
sensitivity)
▪ Goiter
▪ Heat intolerance and would perspire a lot
▪ Weight loss

A

THYROTOXICOSIS

37
Q

(muscle hypertrophy in the
eyes)

A

Exophthalmos

38
Q

(the non-pitting swelling
that occurs on the shins)

A

Pretibial myxedema

39
Q

Hyperthyroidism with peculiar edema behind the eyes called exophthalmos which causes the
eye to protrude
- Hypersecretion of ____
-has a strong familial disposition which means it may be seen
among families
➢ Autoimmune disease
↑ the body is creating antibodies that activate the Thyroid Stimulating Hormone Receptor
(TSHR)
➢ Whole gland is smoothly enlarged and the whole gland is overactive
➢ Occurs 6x more commonly in women than in men
➢ TSH receptor antibodies

A

GRAVE’S DISEASE
=thyroid stimulating immunoglobulins (TSIs)

40
Q

are the antibodies which cause the
activation of the TSHR

A

thyroid stimulating immunoglobulins (TSIs)

41
Q

➢ The thyroid turns into a woody or stony- hard mass
↑ Under the microscope, thyroid gland tissues are seen undergone fibrosis

A

RIEDEL’S THYROIDITIS (RIEDEL’S STRUMA)

42
Q

Known as the painful thyroiditis
↑ Viral infections might be responsible for triggering
this condition
Associated with
▪ Neck pain
▪ Low grade fever
▪ Swing in thyroid function tests.
↑ Patient would also experience myalgia (feeling of muscle pain)
↑ Tender diffuse goiter
↑ Swings in the different thyroid function test
➢ Thyroid peroxidase antibodies are absent
➢ In the laboratory, ESR and thyroglobulin levels are elevated

A

SUBACUTE GRANULOMATOUS/ SUBACUTE
NONSUPPURATIVE THYROIDITIS
(DE QUERVAIN’S THYROIDITIS)

43
Q
  • Develops whenever insufficient amounts of thyroid hormone are available to tissues
  • Patients are obese in nature
  • Decrease appetite; Increase in body weight
  • Edematous; Increase cholesterol level
  • Cold intolerance
  • Decrease activity
  • Bradycardia – decrease in the heart rate
A

HYPOTHYROIDISM

44
Q

a is a primary type of hypothyroidism
(primary thyroid failure causing decline in the production of the thyroid hormones by the thyroid
glands)
➢ Caused by autoimmune damage to the thyroid, or surgical removal
➢ Underactive thyroid gland
➢ Describes the peculiar nonpitting swelling (edema) of the skin
➢ The skin becomes infiltrated by
___
➢ Primary thyroid failure -> decline in thyroxine secretion by thyroid gland

A

MYXEDEMA
- mucopolysaccharides

45
Q

Decrease Basal Metabolic Rate (BMR)
▪ Deepening voice
▪ Depression and tiredness
▪ Cold intolerance “Puffy face”
▪ Anemia
▪ Weight gain
▪ Slow speech
▪ Dry & yellow skin
-Caused by hypercarotenemia
(increase beta carotene in the blood circulation)
▪ Constipation
▪ Bradycardia (Heartrate < 60bpm)
▪ Eventual myxedema coma

A

HYPOTHYROIDISM

46
Q

Also known as the ____
➢ The most common cause of primary hypothyroidism
➢ Described by ___
➢ An autoimmune disease in which thyroid gland is attacked by variety of antibody mediated immune response
↑ The possible antibody seen in patients is the ___ or
they may also have __ antibodies
➢ The thyroid is replaced by a nest of lymphoid tissue
➢ Associated with enlargement of the thyroid gland (goiter)
➢ Acquired hypothyroidism in later childhood due to development of autoantibodies to thyroid tissue
components

A

HASHIMOTO’S DISEASE
(CHRONIC AUTOIMMUNE THYROIDITIS)
- chronic lymphocytic
thyroiditis
- Hashimoto in 1912
-thyroid peroxidase antibodies (TPO Ab)
- thyroglobulin

47
Q

A congenital condition of severely stunted physical and mental growth due to untreated congenital deficiency of thyroid hormones (congenital hypothyroidism) due to maternal
nutritional deficiency of iodine
Physical and mental retardation to newborns
➢ hyposecretion of thyroid hormones during fetal life or infancy
➢ Iodine deficiency

A

CRETINISM

48
Q

tests for phenylketonuria
-This is done also to differentiate if the problem is either cretinism or a condition that involves an aminoacidopathy
phenylketonuria

A

Guthrie test

49
Q

Characterized with problems not involving the T3 and T4, but rather directly involves the thyroid
stimulating hormone which regulates the hormones
➢ caused by TSH (thyrotrophin) deficiency

A

SECONDARY HYPOTHYROIDISM

50
Q

➢ an enlarged thyroid gland which is a symptom of many thyroid disorders (hypo, hyper, or euthyroid state)
▪ It may cause deficiency or decrease in function, overactivity or hyper, or may be in euthyroid state

A

GOITER

51
Q

pertains to nonthyroidal illness where abnormal thyroid function test with normal thyroid gland is observed
- Usually seen in critically ill or hospitalized patients
▪ Their thyroid gland is normally
functioning, but the level of their thyroid function test is abnormal

A

Euthyroid state

52
Q

Another hormone produced by the thyroid gland
↑ Regulates calcium
↑ Release of calcitonin by the parafollicular cells is
stimulated if there is hypercalcemia
➢ Produced by parafollicular cells
➢ Involve in calcium deposition
➢ Marker for medullary thyroid cancer

A

CALCITONIN

53
Q
  • increased plasma Ca2+ concentration stimulates the
    parafollicular cells of the thyroid to produce calcitonin
A

STIMULUS

54
Q

– inhibition of osteoclast
activity which decreases the plasma concentration
↑ The bone will keep the calcium in the osteoclast

A

Calcitonin action on bone

55
Q

– increased urinary excretion of Ca2+ (as well Na+ and PO43-)
which again decreases the plasma concentration

A

Calcitonin action on the kidneys

56
Q

Gland posterior to the thyroid gland
* Four tiny glands attached to the thyroid
* Actions directed to bone, kidney, and intestines
* Controls calcium and phosphate metabolism with the
help of calcitonin

A

PARATHYROID GLAND

57
Q
  • releases ___
  • is primarily responsible for maintaining Ca concentration by affecting activities of the
    bone, kidney, and intestine
  • is released whenever the patient has hypocalcemia
    ↑ At the same time, it would also help in the activation of vitamin D to increase calcium in the blood circulation by facilitating its absorption in the small intestines while kidney reabsorbs calcium
A

PARATHYROID GLAND
- Parathyroid hormone (PTH)

58
Q

synthesize and secrete
hormone PTH

A

Chief cells

59
Q

non secretory cell
➢ seen only after puberty

A

Oxyphil cells

60
Q

To prevent hypocalcemia (regulates blood calcium)
- is not released if the Ca level is normal
↑ It would only be released in cases of hypocalcemia
- Preserves calcium and phosphate within normal range
- * Promotes bone resorption
Stimulates inactive vitamin D to activated vitamin D3
↑ Helps incr

A

PARATHYROID HORMONE

61
Q

Considered primary if the condition involves presence of adenoma in parathyroid gland
➢ The most common cause of
hypercalcemia
➢ Accompanied by phosphaturia

A

PRIMARY HYPERPARATHYROIDISM

62
Q

Happens when there is an increase in the production of PTH in response to decrease serum calcium
➢ Diffuse hyperplasia of all 4 glands (parathyroid glands attached to thyroid gland)
➢ Patient develops severe bone disease
➢ Causes Vitamin D deficiency and chronic renal failure

A

SECONDARY HYPERPARATHYROIDISM

63
Q

The body produces less than the normal PTH
Causes:
▪ Due to accidental injury to the parathyroid glands (neck) during surgery
▪ Can be idiopathic (unknown cause)
▪ Other cause:
▪ Autoimmune parathyroid destruction
* Individuals are unable to maintain calcium concentration in blood without calcium supplementation

A

HYPOPARATHYROIDISM

64
Q

Where smooth muscle goes into auto contraction
- is the involuntary muscular spasm
* Can be used to observe where decreases in Ca2+ have occurred
- occurs if there is
hypocalcemia

A

TETANY

65
Q

tetany in the hands can be induced by decreased Ca2+
↑ ____ is used to induce ischemia (about 20mmHg) for 3 minutes
to know if there would be carpopedal spasm

A

tROUSSEAU’S sign
- Sphygmomanometer

66
Q

the facial nerve can be “tapped” to induce a muscle twitch
↑ This is performed by tapping the facial nerve about 2cm anterior to the external auditory meatus

A

cHVOSTEK’S sign

67
Q

Calcium level < 6mg/dl

A

Laryngeal stridor & tonic- clonic
seizures

68
Q

Calcium level < 8mg/dl

A

leads to tetany and
altered neuromuscular
activity

69
Q

____ causes elevated bicarbonate
reabsorption (leading to ALKALOSIS)

A

Low PTH

70
Q

dec ca and mg

A

tetany

71
Q

Rickets
↑ Bone deformities is observed
Osteomalacia

A

Deficiency in vitamin D

72
Q

PTH level measurement:

A

➢ Overnight fasting

73
Q

PTH Related tests:
1
2
3

A
  • Calcium
  • Phosphorus
  • Creatinine
74
Q
A

MIDTERMS (21 decks)

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