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CEP > L14: Thyroid disease > Flashcards

L14: Thyroid disease Flashcards

1
Q

What are the types of cells in a thyroid gland

A
  • C-cells: produce calcitonin which are involved in calcium homeostasis
  • colloid cells: store thyroid hormones
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2
Q

What is the HPR axis ?

A

Hypothalamus secretes TRH to the anterior pituitary gland
Anterior pituitary gland secretes TSH to the thyroid gland
Thyroid gland secretes T3 and T4 to the cardiovascular, digestive and neurological system
T3 and T4 inhibit the hypothalamus and anterior pituitary gland via negative feedback

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3
Q

What is hyperthyroidism

A

High levels of thyroid hormone in the body

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4
Q

What is hypothyroidism

A

Low levels of thyroid hormone in the body

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5
Q

What are the 3 main causes of hyperthyroidism

A
  • Graves’ disease
  • Thyroiditis (inflammation)
  • toxic nodular goitre
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6
Q

What is graves disease

A

An autoimmune disease causes by antibodies binding to TSHR receptors on follicular cells which cause the continuous secretion of thyroid hormones

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7
Q

Symptoms of hyperthyroidism

A

Cardiovascular:

  • tachycardia
  • atrial fibrillation

Digestive:

  • weight loss
  • diarrhoea

Neurological

  • anxiety
  • tremor
  • myopathy

Eye:

  • double vision
  • staring eyes
  • itching
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8
Q

Diagnosis of graves disease

A
  • serum TSH levels
  • antibodies of TSH receptors
  • isotope uptake scans
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9
Q

Treatment of hyperthyroidism

A
  • surgery removal of thyroid gland

- drugs of carbimazole and proythiouracil which block thyroperoxidase enzyme to produce thyroid hormones

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10
Q

How are thyroid hormones produced

A
  • TSH made by the anterior pituitary gland binds to TSH receptor on follicular cells of the thyroid gland
  • I/NA symporter takes in iodine from the blood
  • idoine is taken into the calloid
  • idoine residues are joined to thyroglobulin precursor by thryoperoxidase enzyme to form MIT and DIT
  • MIT+DIT= T3, DIT+DIT=T4
  • thyroid hormones are released by exocytosis
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11
Q

What happens to T4

A

Mono-iodination occurs with T4 so an idioine is removed to give the active hormone of T3.
This occurs by deiodinase enzyme which is created in the peripheral tissue

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12
Q

What is T4 and T3 bound to in the blood

A
  • TBG
  • Albumin
  • transthyretin
  • rest of it is free
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13
Q

What are the main causes of hypothyroidism

A
  • iodine deficiency
  • treatment of hyperthyroidism
  • hashimoto thyroidits
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14
Q

What is hashimoto thyroiditis

A

An autoimmune disease where nflammation of the thyroid gland where it becomes swelled up then shrinks after

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15
Q

Where is iodine deficiency most common

A

In mountainous areas where there is not enough fish to eat

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16
Q

Symptoms of hypothyroidism

A

Cardiovascular:

  • bradycardia
  • heart failure
  • pericardial effusion

Digestive:

  • weight gain
  • constipation

Neurological

  • psychosis
  • depression

Skin

  • vitiligo
  • Myxoedema
17
Q

Diagnosis of hypothyroidism

A
  • serum tsh levels
18
Q

Treatment of hypothyroidism

A
  • levothyroxine
19
Q

What is a goitre

A

Enlargement of the thyroid gland

20
Q

Why does a goitre or nodule have to be assessed

A

Goitre and nodules are common but you can get rare cancers present. You need to identify patients with malignancy

21
Q

How to asses a nodule and goitre

A

Asses thyroid function
- TSH levels

Asses size

  • symptoms
  • x-ray
  • MRI
  • respiratory flow loop

Asses pathology

  • radionucleide scanning
  • ultrasound scanning
22
Q

What are the types of thyroid cancer

A

Medullary carcinoma- from c-cells
Papillary and follicular carcinoma- from follicular cells
Papillary and follicular can differentiate to become anaplastic which is the most extreme type of thyroid cancer

23
Q

Treatment of thyroid cancer

A
  • surgery to remove gland
  • Radioiodine ablation
  • thyroxine suppression
24
Q

What is thyroxine

A

The name of t4

CEP (12 decks)

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