PGY 412: Endocrine Disorders
67 Cards in this Set
Front | Back |
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In what three way is the thyroid gland important for metabolic homeostasis?
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energy metabolism
oxygen consumption
cardiac contractility
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Where is the thyroid gland locateD?
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inferior to larynx and spanning the ventral aspect of the trachea
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Follicular thyroid cells make what?
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T4, T3, rT3
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Parafollicular cells make what?
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Calcitonin
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What do C cells make?
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calcitonin
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What does the parathyroid gland make?
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PTH
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How is the thyroid gland regulated?
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negative feedback loop
hypothalamus
pituitary gland
thyroid gland
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What are hormones produced by thyroid gland?
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thyroxine T4
triiodothyronine T3
calcitonin
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How is T3 formed?
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deiodination of T4 in peripheral tissues
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Which thyroid hormone has a longer half-life and more pharmacologically active?
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T4
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Iodide deficiency causes what main symptom?
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goiter formation
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What is the minimum dietary intake of iodine in US?
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150 mcg
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What is the mechanism of action of thyroid hormone?
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it is lipid soluble, enters the cell nucleus and activates gene expression
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how is thyroid function regulated?
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negative feedback mechanism : high levels of T3, T4 and low levels of Iodine
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The disruption of normal hypothalamic-pituitary-axis leads to what two main conditions?
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hypothyroidism
hyperthyroidism
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Moist sweating is a symptom of hyperT or hypoT?
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hyper
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Feeling hot or warm is a symptom of hyperT or hypoT?
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hyper
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drooping lids is a symptom of hyperT or hypoT?
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hypo
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infertility is a symptom of hyperT or hypoT?
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hypo
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decreased fertility is a symptom of hyperT or hypoT?
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hypr
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anaemia is a symptom of hyperT or hypoT?
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both
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bulging of eyes is a symptom of hyperT or hypoT?
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hyper
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tachycardia is a symptom of hyperT or hypoT?
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hyper
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decreased appetite is a symptom of hyperT or hypoT?
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hypo
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increased bowel movements is a symptom of hyperT or hypoT?
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gyper
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stiffness, fatigue, decrease reflexes is a symptom of hyperT or hypoT?
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hypo
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polyuria is a symptom of hyperT or hypoT?
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hyper
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increased erythropoiesis, anaemia is a symptom of hyperT or hypoT?
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hyper
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hypermennorhea is a symptom of hyperT or hypoT?
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hypo
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hypogonadism is a symptom of hyperT or hypoT?
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hypo
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lethargy, slowed mental process is a symptom of hyperT or hypoT?
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hypo
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nervousness is a symptom of hyperT or hypoT?
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hyper
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decreased vital capacity is a symptom of hyperT or hypoT?
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hyper
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hypoventilation is a symptom of hyperT or hypoT?
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hypo
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Where are parathyroid glands located?
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posterior aspect of thyroid fland
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What hormone is produced by the parathyroid glands?
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parathyroid hormone
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What effects does parathyroid hormone have on the body?
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-regulator of serum calcium
-antagonist of calcitonin
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Cause of hyperparathyroidism?
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Primary- cell adenoma
Secondary - compensatory response to chronic hypocalcemia which can be caused by malabsorption or decreased renal activation of Vit D
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What are the typical treatment for hypo and hyperthyroidism?
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Hypo- replacement therapy
Hyper - antithyroid drugs, surgical excision of abnormal tissue, radioactive Iodine ablation
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what is another term for hyperthyroidisim?
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thyrotoxicosis
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What is the cause of Grave's disease?
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autoimmune disease that leads to overactivity of thyroid via stimulatory autantibody
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What are the symptoms of GRaves diosease?
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exophthalmic goiter, so eyes protrude
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What is the treatment for grave's disease?
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removal or destruction of some thyroid tissue by surgery or radiation
low TSH and TRH
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What causes nodular thyroid disease?
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autonomously functioning follicular cells
symptoms of hyperthyroidism
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What are the thyroid diseases that lead to hypothyroidism?
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Hashimoto's disease
Cretinism
Myxedema
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What causes Hashimoto's disease?
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autoimmune disease, also iodine defiicient diet
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What are the symptoms of Hashimoto's disease?
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hypothyroidism symptoms
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What are the causes for cretinism?
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low thyroid function since birth
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What are the symptoms of cretinism?
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-they are short and stocky
-hypothyroidism since birth
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What is the treatment for cretinism?
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thyroid treatment/supplementation, without this in first two months child becomes mentally retarded
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What causes myxedema?
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hypothyroidism in adults, can be due to wide variety of reasons
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What are the symptoms for myxedema?
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most important is droopy eyelids and edema around eyes
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What are the typical test used for monitoring patients being treated with thyroid hormones?
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TSH levels
TSH suppression test
T4 levels (free and bound)
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What are the causes of hyperthyroidism?
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grave's disease
Nodular thyroid disease
abnormal secretion of TSH via TSH secreting tumors
Thyroiditis
Thyroid storm
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What is the course of treatment for TSH secreting tumors?
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microsurgery to remove tumor
radiation
medication treatment
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What are the causes for nontoxic goiters?
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iodine deficiency
chemical defect which causes impaired secretion of thyroxine
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Nontoxic goiters have a high incidence among what group of people?
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more females, age 2-60 yrs
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What is the common course of treatment for nontoxic goiters?
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biopsy
suppression of TSH with thyroxine
iodide supplementation
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what are the two types of thyroid neoplasms?
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benign and malignant like the carcinomas
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What is the most common and least common thyroid neoplasms?
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radiation of head and neck regions
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What are the clinical symptoms of hyperparathyroidism?
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hypercalcemia
pathological fractures
compression fractures of vertebral bodies
kidney stones
fatigue
headache
depression
anorexia
nausea
vomiting
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What are the causes of hypoparathyroidism?
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damage to thyroid gland like from surgery
hypomagnesemia due to chronic alcoholism, malnutrition and malabsorption
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Pathophysiology of hypoparathyroidism?
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decrease serum calcium
increase serum phosphate
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What are clinical symptoms of hypoparathyroidism?
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tetany
muscle spasms
hyperreflexia
convulsions
laryngeal spsms
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Which thyroid neoplasm is deadliest
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A aplastic carcinoma
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Primary hyperparathyroidism
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Cell adenoma secretes PTH
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Secondary hyper parathyroidism
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Compensatory response to chronic hypocalcemia due to decrease bit d renal activation or malnutrition
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