Thyroid Module

Question 1

name the 2 types of cells in the thyroid?

Answer 1

parafollicular (C) cells

follicular cells

Question 2

what kind of tissue do parafollicular cells exist in?

Answer 2

connective tissue

Question 3

where are parafollicular cells in relation to follicular?

Answer 3

adjacent to them

Question 4

what substance do follicular cells make?

Answer 4

thyroglobulin

Question 5

what substance do parafollicular cells make?

Answer 5

calcitonin

Question 6

T or F:

the majority of all secreted hormones is triiodothyronine?

Answer 6

false

Question 7

what organ(s) convert T4 to T3?

Answer 7

liver

kidneys

Question 8

thyroid hormones have a role in:
increasing protein synthesis
increasing glucose plasma levels
increasing insulin plasma levels
increasing fatty acid plasma levels
thermogenesis
bone turnover
immunity
gut motility

T or F?

Answer 8

T
T
F
T
T
F
T

Question 9

what action does GH have on the liver and what is the result of this?

Answer 9

increased gluconeogenesis =

increased plasma glucose

Question 10

what action does GH have on fat tissue and what is the result of this?

Answer 10

increased lipolysis =

increased plasma fatty acids

Question 11

what action does GH have on muscle and what is the effect of this?

Answer 11

protein synthesis=

decreased plasma amino acids

Question 12

T or F:

thyroid hormones decrease protein synthesis

Answer 12

false

Question 13

T or F:

thyroid hormones increase glucose and fatty acids

Answer 13

true

Question 14

T or F:

thyroid hormones decrease fat storage

Answer 14

true

Question 15

why do thyroid hormones increase cardiac activity and CO?

Answer 15

they increase responsiveness to neurotransmitters eg adrenaline and NA

Question 16

what is hyperkinesis?

Answer 16

excessive body movement

Question 17

what is oligomenorrhoea?

Answer 17

irregular periods

Question 18

who is most commonly affected by graves disease?

Answer 18

middle aged women

Question 19

what is the autoantibody involved in graves?

Answer 19

thyroid stimulating immunoglobulin (TSI)

Question 20

what happens in graves?

Answer 20

TSI makes the thyroid gland keep releasing thyroid hormone and it cant be suppressed as it is stopping TSH from being released

Question 21

normal T3 values?

Answer 21

9.9-22

Question 22

normal fT4 values?

Answer 22

0.9-2.6

Question 23

what is exopthalamus?

Answer 23

water build up and retro orbital swelling of the eye

Question 24

why are the eyes particularly affected in graves?

Answer 24

there are lots of receptors in the tissue and muscle surrounding the eyeball stimulated by TSI

Question 25

how often after diagnosis of graves is exopthalamus usually discovered?

Answer 25

1-2yrs

Question 26

when can exopthalamus lead to loss of function?

Answer 26

if collagen fibres deposit in the eye

Question 27

symptoms of exopthalamus?

Answer 27

``` difficulty moving eye gritty eyes blurred vision decreased colour vision redness of the eyes ```

Question 28

how long after diagnosis of graves can you get pretibial myxoedema?

Answer 28

1-2yrs

Question 29

what co-morbidity do patients usually have before they present with pretibial myxoedema?

Answer 29

graves eye disease

Question 30

what is the pathology of pretibial myxoedema?

Answer 30

plaque formation?

Question 31

is pretibial myxoedema often unilateral or bilateral?

Answer 31

bilateral

Question 32

is pretibial myxoedema pitting?

Answer 32

no

Question 33

what could be causing chest pain in patients with thyroid problems?

Answer 33

development of angina

Question 34

2nd most common cause of hyperthyroidism?

Answer 34

toxic multinodular goitre

Question 35

is hyperthyroidism more common in iodine rich or deficient areas/

Answer 35

deficient

Question 36

what type of hyperthyroidism is hardest to treat?

Answer 36

when its caused by cancer

Question 37

what are the additional symptoms found in de quervains thyroiditis?

Answer 37

fever malaise local tenderness

Question 38

why can low iodine cause hypothyroidism?

Answer 38

thyroid cant synthesise MIT or DIT so it cant release thyroid hormones

Question 39

why do you get a goitre in iodine deficient hypothyroidism?

Answer 39

TSH stimulation | thyroid enlargement

Question 40

what substance is attacked by antibodies in autoimmune thyroiditis?

Answer 40

TPO aka thyroid peroxidase

Question 41

what condition would increased TSH and normal T4 indicate?

Answer 41

treated hypothyroidism

Question 42

what condition would decreased TSH, T4 and T3 indicate?

Answer 42

pituitary disease

Question 43

what condition would decreased TSH with normal T4 and T3 indicate?

Answer 43

subclinical hyperthyroidism

Question 44

how are carbimazole and PTU given?

Answer 44

high dose initially and then gradiually reduced over 12-18 months

Question 45

main side effect of carbimazole?

Answer 45

agranulocytosis

Question 46

symptoms of agranulocytosis?

Answer 46

dry cough | sore throat