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In what three way is the thyroid gland important for metabolic homeostasis?
energy metabolism oxygen consumption cardiac contractility
Where is the thyroid gland locateD?
inferior to larynx and spanning the ventral aspect of the trachea
Follicular thyroid cells make what?
T4, T3, rT3
Parafollicular cells make what?
Calcitonin
What do C cells make?
calcitonin
What does the parathyroid gland make?
PTH
How is the thyroid gland regulated?
negative feedback loop hypothalamus pituitary gland thyroid gland
What are hormones produced by thyroid gland?
thyroxine T4 triiodothyronine T3 calcitonin
How is T3 formed?
deiodination of T4 in peripheral tissues
Which thyroid hormone has a longer half-life and more pharmacologically active?
T4
Iodide deficiency causes what main symptom?
goiter formation
What is the minimum dietary intake of iodine in US?
150 mcg
What is the mechanism of action of thyroid hormone?
it is lipid soluble, enters the cell nucleus and activates gene expression
how is thyroid function regulated?
negative feedback mechanism : high levels of T3, T4 and low levels of Iodine
The disruption of normal hypothalamic-pituitary-axis leads to what two main conditions?
hypothyroidism hyperthyroidism
Moist sweating is a symptom of hyperT or hypoT?
hyper
Feeling hot or warm is a symptom of hyperT or hypoT?
hyper
drooping lids is a symptom of hyperT or hypoT?
hypo
infertility is a symptom of hyperT or hypoT?
hypo
decreased fertility is a symptom of hyperT or hypoT?
hypr
anaemia is a symptom of hyperT or hypoT?
both
bulging of eyes is a symptom of hyperT or hypoT?
hyper
tachycardia is a symptom of hyperT or hypoT?
hyper
decreased appetite is a symptom of hyperT or hypoT?
hypo
increased bowel movements is a symptom of hyperT or hypoT?
gyper
stiffness, fatigue, decrease reflexes is a symptom of hyperT or hypoT?
hypo
polyuria is a symptom of hyperT or hypoT?
hyper
increased erythropoiesis, anaemia is a symptom of hyperT or hypoT?
hyper
hypermennorhea is a symptom of hyperT or hypoT?
hypo
hypogonadism is a symptom of hyperT or hypoT?
hypo
lethargy, slowed mental process is a symptom of hyperT or hypoT?
hypo
nervousness is a symptom of hyperT or hypoT?
hyper
decreased vital capacity is a symptom of hyperT or hypoT?
hyper
hypoventilation is a symptom of hyperT or hypoT?
hypo
Where are parathyroid glands located?
posterior aspect of thyroid fland
What hormone is produced by the parathyroid glands?
parathyroid hormone
What effects does parathyroid hormone have on the body?
-regulator of serum calcium -antagonist of calcitonin
Cause of hyperparathyroidism?
Primary- cell adenoma Secondary - compensatory response to chronic hypocalcemia which can be caused by malabsorption or decreased renal activation of Vit D
What are the typical treatment for hypo and hyperthyroidism?
Hypo- replacement therapy Hyper - antithyroid drugs, surgical excision of abnormal tissue, radioactive Iodine ablation
what is another term for hyperthyroidisim?
thyrotoxicosis
What is the cause of Grave's disease?
autoimmune disease that leads to overactivity of thyroid via stimulatory autantibody
What are the symptoms of GRaves diosease?
exophthalmic goiter, so eyes protrude
What is the treatment for grave's disease?
removal or destruction of some thyroid tissue by surgery or radiation low TSH and TRH
What causes nodular thyroid disease?
autonomously functioning follicular cells symptoms of hyperthyroidism
What are the thyroid diseases that lead to hypothyroidism?
Hashimoto's disease Cretinism Myxedema
What causes Hashimoto's disease?
autoimmune disease, also iodine defiicient diet
What are the symptoms of Hashimoto's disease?
hypothyroidism symptoms
What are the causes for cretinism?
low thyroid function since birth
What are the symptoms of cretinism?
-they are short and stocky -hypothyroidism since birth
What is the treatment for cretinism?
thyroid treatment/supplementation, without this in first two months child becomes mentally retarded
What causes myxedema?
hypothyroidism in adults, can be due to wide variety of reasons
What are the symptoms for myxedema?
most important is droopy eyelids and edema around eyes
What are the typical test used for monitoring patients being treated with thyroid hormones?
TSH levels TSH suppression test T4 levels (free and bound)
What are the causes of hyperthyroidism?
grave's disease Nodular thyroid disease abnormal secretion of TSH via TSH secreting tumors Thyroiditis Thyroid storm
What is the course of treatment for TSH secreting tumors?
microsurgery to remove tumor radiation medication treatment
What are the causes for nontoxic goiters?
iodine deficiency chemical defect which causes impaired secretion of thyroxine
Nontoxic goiters have a high incidence among what group of people?
more females, age 2-60 yrs
What is the common course of treatment for nontoxic goiters?
biopsy suppression of TSH with thyroxine iodide supplementation
what are the two types of thyroid neoplasms?
benign and malignant like the carcinomas
What is the most common and least common thyroid neoplasms?
radiation of head and neck regions
What are the clinical symptoms of hyperparathyroidism?
hypercalcemia pathological fractures compression fractures of vertebral bodies kidney stones fatigue headache depression anorexia nausea vomiting
What are the causes of hypoparathyroidism?
damage to thyroid gland like from surgery hypomagnesemia due to chronic alcoholism, malnutrition and malabsorption
Pathophysiology of hypoparathyroidism?
decrease serum calcium increase serum phosphate
What are clinical symptoms of hypoparathyroidism?
tetany muscle spasms hyperreflexia convulsions laryngeal spsms
Which thyroid neoplasm is deadliest
A aplastic carcinoma
Primary hyperparathyroidism
Cell adenoma secretes PTH
Secondary hyper parathyroidism
Compensatory response to chronic hypocalcemia due to decrease bit d renal activation or malnutrition

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