Term
| Embryological origin of thyroid? Of C cells? |
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Definition
| Endoderm. Neural crest cells and 4th branchial pouch. |
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Term
| Thyroglossal duct fails to close--> |
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Definition
|
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Term
| Effects of thyroid hormone |
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Definition
| Increases basal metabolic rate, increases mitochondria respiration, increases adrenergic receptor expression, increases oxygen consumption |
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Term
| Pericardiac effusion, non pitting edema, or puffy face is a sign of hyper or hypothyroidism? |
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Definition
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Term
| Lid lag and stare is a sign of hyper or hypothyroidism? |
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Definition
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Term
1. Pretibial myxedema is a sign of hyper or hypothyroidism?
2. Myxedema coma occurs in hyper or hypothyroidism? |
|
Definition
1. Hyperthyroidism
2. Hypothyroidism |
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Term
| Thin hair and brittle nails are a sign of hypo or hyperthyroidism? |
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Definition
|
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Term
| What is the recommended level of iodine intake? |
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Definition
|
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Term
| A pregnant female with goiter presents with hypothyroidism. What do you predict for the baby if left untreated? |
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Definition
| Cretinism. Baby will have short stature, mental retardation, abnormal hearing, gait, and posture. |
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Term
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Definition
| 1. Oxidizes iodine. 2. Couples MIT and DIT to iodotyrosines to form T3 and T4 |
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Term
| What transports iodine into the follicular cell from the blood? |
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Definition
| Sodium/iodine cotransporter |
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Term
| Alpha subunits are structurally similar among... |
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Definition
|
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Term
| Mutations in TSH occur in the alpha or beta subunit? |
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Definition
|
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Term
| Which thyroid hormone is produced more? Which one is more biologically active? Which one has a longer half life? |
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Definition
| More T4 is produced. T3 is more active. T4 has a longer half life. |
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Term
| What antibody is found in Hashimoto and Graves disease? |
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Definition
|
|
Term
| What protein is a marker of cancer recurrence? |
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Definition
|
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Term
|
Definition
| Large bolus of ingested iodine inhibits organification of iodine. Used to treat thyroid storm. Lasts a few days. |
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Term
| What proteins bind thyroid hormone in the circulation? |
|
Definition
| Thyroid binding globulin, transthyretin, albumin |
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Term
| How will an increase in TBG be reflected in a measurement of T4? |
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Definition
| total T4 will increase (but free T4 will not change) |
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Term
|
Definition
| Pregnancy, birth control pills, acute hepatitis, phenothiazines, clofibrate |
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Term
|
Definition
| Chronic hepatitis, androgens, glucocorticoids, phentoin, protein loss (renal disease, muscle wasting, liver failure) |
|
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Term
| What is the biggest source of T3? |
|
Definition
| De-iodination of T4 in liver and kidney |
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Term
| Type 1 deiodinases are found in ____ and supply T3 to ___ |
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Definition
| Liver, kidney, thyroid. To plasma. |
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|
Term
| Type 2 deiodinases are found in ____ and provide T3 to ___ |
|
Definition
| Brain, thyroid, fat, placenta, muscle. To local tissues. |
|
|
Term
| Function and distribution of type 3 deiodinases |
|
Definition
| Converts T4 to rT3 and T3 to T2. Found in brain, placenta, and skin. |
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Term
| Effects of thyroid hormone on CNS and CV |
|
Definition
| Stimulates axon growth. Stimulates heart rate, potential atrial fibrillation. |
|
|
Term
| Thyroid hormone effects on fat |
|
Definition
| Induces white fat differentiation, induces lipolysis, increases intracellular lipid accumulation |
|
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Term
|
Definition
| Nuclear transcription factor or via PI3K |
|
|
Term
| How does starvation affect TSH and T3? |
|
Definition
|
|
Term
| Would T3RU be increased or decreased in hyperthyroidism? |
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Definition
|
|
Term
| Nuclear imaging is used to evaluate hyper or hypothyroidism? |
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Definition
|
|
Term
Most cold nodules are...
Most malignant nodules are...
Most palpable nodules are... |
|
Definition
Cold...not malignant
Malignant...cold
Palpable...cold |
|
|
Term
| Differential for primary hypothyroidism (6) |
|
Definition
| Hashimoto, iodine deficiency, subacute/lymphocytic/post-partum thyroiditis, drugs, surgery, tumors |
|
|
Term
| Drugs that cause hypothyroidism |
|
Definition
| Lithium, amiodarone, iodides, PTU, methimazole, IFN- a or -b |
|
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Term
| Most common cause of hypothyroidism is |
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Definition
|
|
Term
Female with SLE and hx of Graves disease is positive for anti-TPO and anti-thyroglobulin; dx?
|
|
Definition
|
|
Term
| Granulomatous subacute thyroiditis presentation |
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Definition
| Hyperthyroid then hypothyroid then euthyroid. Occurs post illness. |
|
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Term
| Presentation of iodide deficiency |
|
Definition
| Cretinism in children, endemic goiter, under developed countries. May see Jod Basedow phenomenon. |
|
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Term
|
Definition
| Thyrotoxicosis in a pt who was iodide deficient and is now receiving adequate levels of iodine |
|
|
Term
| which hypothyroidism condition is associated with Down's syndrome? |
|
Definition
| chronic lymphocytic thyroiditis |
|
|
Term
| Low TSH, low thyroid hormone. Dx? |
|
Definition
|
|
Term
| What can secondary hypothyroidism degenerate to and how would this present? |
|
Definition
| Pituitary hyperplasia. Galactorrhea. |
|
|
Term
| Pathology of thyroid resistance syndrome |
|
Definition
| Autosomal dominant mutation in TR gene. Cannot bind thyroid hormone. |
|
|
Term
| Hypothyroidism with high T4 and high TSH. Dx? |
|
Definition
| Thyroid resistance syndrome |
|
|
Term
| Hoarse voice, dry skin, constipation, menstrual irregularity, weight gain. Dx? |
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Definition
|
|
Term
| Macroglossis, non pitting edema, pleural effusion, slow reflexes, somnolent, very sensitive to anesthesia. Dx? |
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Definition
|
|
Term
| Depressed, decreased alkaline phosphatase, normochromic normocytic anemia. Dx? |
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Definition
|
|
Term
| How does GFR, renal plasma flow, tubular reabsorption, serum creatinine, and BUN change in hypothyroidism? |
|
Definition
| GFR, renal plasma flow, and tubal reabsorption decrease. Serum creatinine and BUN do not change. |
|
|
Term
| Is LDL high or low in hypothyroidism? |
|
Definition
|
|
Term
|
Definition
| Severe hypothyroidism precipitated by cold or sepsis. 50% mortality. Respiratory failure, hypotheremic, bradycardic. High TSH. |
|
|
Term
| Sick euthyroid syndrome: TSH, rT3? |
|
Definition
| Post illness. Low or normal TSH, increased rT3. Decreased conversion of T3 to T4. Not treated. |
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Term
|
Definition
| Pt raises arms above head. This causes face to swell and become red. Seen in pts with goiters. |
|
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Term
|
Definition
| hyperplastic epithelium, excess colloid, autoimmune (Hashimoto's), DeQuervain's granuloma, Reidels fibrous tissue, goitrogens, cancer |
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Term
| Onycholysis, fine hair, pretibial myxedema, amenorrhea, infertility. Dx? |
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Definition
|
|
Term
| Propotosis, red conjunctiva. Dx? |
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Definition
|
|
Term
| Apathetic hyperthyroidism |
|
Definition
| Elderly pts do not present sympathetic signs, only depressed with possible afib |
|
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Term
|
Definition
| High heart rate, infection, dehydration, fever, cardiovascular collapse, death |
|
|
Term
| 3 characteristics of Graves |
|
Definition
| Hyperthyroidism and toxicosis, dermopathy, ophthalmopathy |
|
|
Term
| Increased deep tendon reflexes, TSI positive |
|
Definition
|
|
Term
| What is seen on a RAIU for Graves? |
|
Definition
| Diffuse symmetrical homogenous uptake |
|
|
Term
|
Definition
| PTU or methimazole, iodine, ablation, beta blockers |
|
|
Term
|
Definition
| Agranulocytosis, liver toxicity |
|
|
Term
| Local area of increased uptake. Dx? |
|
Definition
| Solitary nodule toxic adenoma |
|
|
Term
| Patchy nuclear uptake. Dx? |
|
Definition
| Multi nodular toxic goiter |
|
|
Term
| Pathology of solitary toxic nodule |
|
Definition
| Autonomous excess secretion of thyroid hormone, hyperplasia, suppresses function of surrounding thyroid tissue |
|
|
Term
| Labs in subacute thyroiditis |
|
Definition
| Elevated T4, normal T3, low TSH |
|
|
Term
|
Definition
| Painful subacute granulomatous thyroiditis |
|
|
Term
| Fever, malaise, pain extending from neck to anterior chest wall. Biopsy shows giant nucleated cells. Very tender nodule. Dx? |
|
Definition
| Subacute granulomatous thyroiditis (DeQuervain) |
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Term
|
Definition
|
|
Term
| High T4, low TSH, normal WBC, high ESR. Dx? |
|
Definition
|
|
Term
| Female gave birth one week ago and is experiencing palpitations, heat intolerance, and frequent stool passage. Dx? |
|
Definition
|
|
Term
| Pathology of hyperthyroidism and molar pregnancy or choriocarcinoma |
|
Definition
| HCG mimics TSH and activates receptors |
|
|
Term
|
Definition
|
|
Term
| Thyroid hormone production in ovary |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What ICU drugs can inhibit TSH? (3) |
|
Definition
| dopamine, glucocorticoids, ADH |
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