Thyroid/parathyroid

Question 1

What does TSH do

Answer 1

increase production/release of thyroid hormone

increase iodide uptake and takes care of thyroid tissue

Question 2

What helps inhibit production of TSH

Answer 2

somatostatin with the negative feedback loop

Question 3

What joins the 2 lobes of the thyroid

Answer 3

isthmus
*pyramidal lobe projects upwards

Question 4

What vessel supplies the thyroid

Answer 4

superior thyroid artery (off external carotid) and inferior thyroid artery

Question 5

what innervates the thyroid

Answer 5

recurrent laryngeal nerve

Question 6

What is the importance of the laryngeal nerve

Answer 6

voice!
*if damaged, patient will be mute

Question 7

What type of cells make up the thyroid

Answer 7

follicular cells surrounded by colloid

*Follicular cells are what creates the thyroid hormone

Question 8

What binds to the follicular cells

Answer 8

binding site for TSH
*triggers release of stored TH

Question 9

What neurotransmitters can also control TSH

Answer 9

acetylcholine
catecholamines

Question 10

Where are C cells found and what do they do

Answer 10

In the thyroid gland and secrete calcitonin to lower calcium levels in the blood

Question 11

How does calcitonin lower calcium levels

Answer 11

inhibit osteoclastic activity and promotes osteoblastic activity

Question 12

What is the active form of TH

Answer 12

T3

Question 13

Where is thyroglobulin made

Answer 13

follicular cells

Question 14

What does thyroid peroxidase do

Answer 14

oxidize the iodide into active form of iodine

Question 15

What does T3 and T4 get packaged into before going into circulation

Answer 15

lysosomes

Question 16

Where is iodide absorbed

Answer 16

In the GI track

Question 17

Where is iodide secreted from

Answer 17

kidneys

Question 18

What promotes iodide trapping

Answer 18

TSH

Question 19

What does TH assist with

Answer 19

synthesizing enzymes, proteins, transport proteins

Question 20

How does TSH effect carbohydrate and fat intake

Answer 20

Increase carb metabolism encouraging glucose uptake and glycolysis

stimulates fat metabolism
decreases cholesterol

Question 21

How does TSH help decrease cholesterol

Answer 21

Increase GI motility and force cholesterol into the bile so there is increased excretion

Question 22

How does TH effect heart

Answer 22

Increases CO, HR, Heart strength, respiration, and tissue blood flow

Question 23

How high above normal can the metabolic rate go above normal

Answer 23

As high as 100% above normal the metabolic rate

Question 24

What is thyrotoxicosis

Answer 24

Elevation in TH due to problem over secretion from gland, over stimulation from pituitary, ectopic production or excess exogenous intake

Question 25

What is the major primary cause of Graves disease

Answer 25

Thyrotoxicosis

Question 26

What is Graves disease

Answer 26

autoimmune disorder that causes 50-80% of hyperthyroidism

Question 27

What type of hypersensitivity is graves disease considered

Answer 27

type 2

Question 28

What ophthalmic manifestations occur with graves disease

Answer 28

Lid lag Exophthalmus edema etc.

Question 29

What are the dermatologic conditions of graves disease

Answer 29

Pretibial myxedema *from thyroid stimulation immunoglobulins causing increased stimulation of T lymphocytes

Question 30

What generally causes nodular thyroid disease

Answer 30

Times during high demand or inadequate production, some cells hypertrophy to compensate *generally after the stressor is gone, the gland will normalize

Question 31

What occurs if the enlarged thyroid does not normalize after the stressor goes away

Answer 31

It will turn into a toxic adenoma or toxic multi nodular goiter

Question 32

Since nodular thyroid disease is not autoimmune, what associate symptoms will not occur

Answer 32

Eye or skin involvement

Question 33

How will someone with hyperthyroid present

Answer 33

heat intolerance sweating weight loss diarrhea weakness excitable fatigue but inability to sleep

Question 34

What is the most common thyroid disorder

Answer 34

hypothyroidism

Question 35

What is secondary hypothyroidism commonly due to

Answer 35

trauma lesions CVA

Question 36

What is the most common type of hypothyroidism

Answer 36

iodine deficiency

Question 37

What is the most common cause of hashimotos

Answer 37

Hypothyroidism

Question 38

What is the cause of central hypothyroidism

Answer 38

tumor, hemorrhage, TBI, CVA Sheehan syndrome

Question 39

What is central hypothyroidism

Answer 39

damage to the hypothalamus leading to a decrease in TRH or damage to the anterior pituitary to decrease TSH

Question 40

What is hashimotos thyroiditis

Answer 40

Autoimmune thyroiditis with autoantibodies attaching to follicular cells

Question 41

What do the autoantibodies in hashimotos attack

Answer 41

thyroglobulin thyroid peroxidase TSH receptors (follicular cell damage)

Question 42

What is occurring within the thyroid with hashimotos

Answer 42

Infiltrates will lead to apoptosis of follicular cells = fibrosis and decrease TH production

Question 43

What is transient hyperthyroidism

Answer 43

As the apoptosis of the follicular cells occur, all the hormones are released

Question 44

What is myxedema

Answer 44

Prolonged significant hypothyroidism that leads to increased hyaluronic acid and chondroitin sulfate

Question 45

What is myxedema coma

Answer 45

Rare and often fatal condition associated with untreated, longstanding hypothyroidism in which the body cant compensate (not actual coma)

Question 46

What is cretinism

Answer 46

Occurs when there is profoundly low thyroid hormone during development, infancy, or early childhood

Question 47

What is cretinism associated with

Answer 47

genesis or underdeveloped *typically from iodine deficiency

Question 48

what can be some causes for thyroid goiters

Answer 48

inability to trap iodide not enough peroxidase

Question 49

What does the parathyroid gland do

Answer 49

Release PTH to regulate (increase) calcium concentration

Question 50

What cells are the primary creator of PTH

Answer 50

Chief cells

Question 51

What needs to be present for calcium to be absorbed

Answer 51

Vitamin D

Question 52

What type of receptors do chief cells have

Answer 52

g-protein calcium receptor

Question 53

What hormone is involved with vitamin D activation

Answer 53

PTH

Question 54

What type of hormone is vitamin D

Answer 54

Steroid

Question 55

What converts vitamin D to its active form

Answer 55

hydroxylation in liver or by the kidney

Question 56

What electrolyte is needed for normal cellular metabolism

Answer 56

phosphorus

Question 57

Excretion of phosphorus is controlled by what

Answer 57

PTH

Question 58

What is hypophosphatemia linked to

Answer 58

antacids

Question 59

What is hyperphosphatemia linked to

Answer 59

Kidney dysfunction

Question 60

What are causes of primary hyperparathyroidism

Answer 60

Solitary parathyroid adenoma gland hyperplasia MEN syndrome Cancer

Question 61

What are some causes of secondary hyperparathyroidism

Answer 61

CKD Vit D deficiency

Question 62

What are some causes of tertiary hyperparathyroidism

Answer 62

Around even after the underlying PTH issue is corrected

Question 63

What is the most common cause of paraneoplastic syndrome

Answer 63

SCC

Question 64

What will be seen in labs in someone with hyperparathyroidism

Answer 64

Elevated PTH Hypercalcemia Hypophosphatemia elevated phosphate in urine hypercalcinuria

Question 65

Signs of hypercalcemia

Answer 65

Fatigue nephrotlithiasis Arrythmia neurologic symptoms polydipsia/polyuria

Question 66

What is hypoparathyroidism generally associated with

Answer 66

damage to the parathyroid Neck radiation removal of the gland

Question 67

What are some infiltrative disorders associated with hypoparathyroidism

Answer 67

Hemochromatosis Sarcoidosis Wilsons disease (Copper)

Question 68

What can happen to a persons muscles with hypocalcemia

Answer 68

Tetani *can leed to laryngospasm