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Pathophysiology > W.12: Disturbances of Thyroidal Function > Flashcards

W.12: Disturbances of Thyroidal Function Flashcards

1
Q

What is transporting iodide from follicular cell to colloid?

A

Pendrin (Na-dependent Cl/I- transporter)

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2
Q

What is transporting T3 and T4 from thyroid follicle into blood?

A

MCT: Monocarboxylate transporter

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3
Q

Hypothalamus releases what hormone to stimulate the pituitary?

A

Thyroid releasing hormone (TRH)

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4
Q

Pituitary releases what hormone to stimulate the thryoid?

A

Thyroid stimulating hormone (TSH)

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5
Q

Free T3 and T4 has ….. feedback on the pituiary and hypothalamus

A

Negative

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6
Q

T4 can be converted to two other substances..?

A

T3 and rT3 (reverse T3, ineffecvtive)

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7
Q

Half life of T4

A

1 week

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8
Q

Half life of T3

A

1 day

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9
Q

% of T4 bound to TBG

A

70%

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10
Q

% of T4 bound to TBPA

A

20%

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11
Q

% of T4 bound to albumin

A

9.96%

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12
Q

% of T4 unbound (free)

A

0.04%

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13
Q

Type 1 deiodinase found in?

A

Liver and kidney

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14
Q

Type 2 deiodinase found in?

A

Pituitary, placenta, brain

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15
Q

Type 3 deiodinase function?

A

T4 to rT3

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16
Q

4 actions of TSH on thyroid

A
  1. Stimulate iodine uptake
  2. Hormonogenesis
  3. Release of T3 and T4 (via cAMP)
  4. Inc. thyroid gland size and vascularity
17
Q

How does thyroid hormone affect fetal development?

A

Affecting neural and skeletal system

18
Q

How does thyroid hormone affect oxygen consumption and heat production?

A

Controls BMR, T3 is considered the major regulator of mitochondrial activity

19
Q

How does thyroid hormone affect the sympathetic system?

A

Similar to the effects caused by catecholamines

20
Q

How does thyroid hormone affect the endocrine system?

A

Inc. cortisol metabolism and clearance

21
Q

How does thyroid hormone affect the musculoskeletal system?

A

Inc. the turnover of bone

22
Q

Values of hormones in hypothryoidism

A
  • TSH > 4.2mIU/L

- Free T4 is low

23
Q

Values of hormones in subclinical hypothyroidism

A
  • TSH > 4.2mIU/L

- Free T4 is normal

24
Q

Values of hormones in euthyroid

A
  • TSH 0.3-4.2 mIU/L

- Free T4 normal

25
Q

Values of hormones in subclinical hyperthyreosis

A
  • TSH <0.3mIU/L

- Free T3/T4 normal

26
Q

Values of hormones in hyperthyreodism

A
  • TSH < 0.3mIU/L

- Free T3/T4 elevated

27
Q

How common is hypothyroidism?

A

Occurs in 3.8-4.6% of the population (10 times more common in women)

28
Q

Typical symptoms of hypothyroidism

A
  • Slow HR, reduced CO, low voltage, dec. GFR, anemia
  • Weight gain, constipation
  • Myxoedema, hair loss, dry skin, carotenoderma
  • Tiredness, depression, psychosis, memory loss
29
Q

Primary causes of hypothyroidism (6)

A
  1. Hashimoto’s thyroiditis (autoimmune)
  2. After treatment of hyperthryoidism
  3. Inflammation
  4. Iodine def.
  5. Congenital (incomplete development, enzyme defects)
  6. Drugs (amiodarone, lithium)
30
Q

Hashimoto’s thyroiditis

A

Destruction of the thyroid gland by autoantibodies against thyroglobulin, thyroperoxidase, and other thyroid tissue components

31
Q

Postpartum thyroiditis

A
  • Usually a transient phenomenon observed following pregnancy
  • Believed to result from modifications to the immune system necessary in pregnancy
32
Q

Subacute thyroiditis

A

Acute inflammatory disease probably caused by a virus

33
Q

Progression of subacute thyroiditis

A

Phase 1: Hyperthyroidism
Phase 2: Euthyroid
Phase 3: Hypothyroidism
Phase 4: Euthyroid

34
Q

Subclinical hypothyroidism

A

Isolated elevated TSH level, but normal T3/T4, symptoms may or may not be present

35
Q

Subclinical hypothyroidism: Prevalence

A

Worldwide 1-10%, highest rate in women above 60 yrs

36
Q

8 underlying causes of hyperthyroidism

A
  1. Graves disease
  2. Plummers disease
  3. Marine-Lenhart syndrome
  4. Subacute thyroiditis
  5. Hashimoto thyroiditis hyperthyroid phase
  6. Thyreotoxicosis Facilita
  7. Trophoblastic disease
  8. Struma ovarii
37
Q

Characteristic symptoms of Graves disease

A

Opthalmopathy (exophthalmus), dermopathy (pretibial myxedema)

Pathophysiology (14 decks)

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