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case 16: diabetes > chemical pathology: thyroid disease > Flashcards

chemical pathology: thyroid disease Flashcards

(45 cards)

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1
Q

What three hormone are produced by the thyroid

A

T3, T4 & calcitonin

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2
Q

Where does the hormone act

A

Intracellular hormone that binds inside nucleus & alter gene expression

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3
Q

What is the three functions of thyroid hormones

A
  1. Growth
  2. Mental development
  3. Affects general metabolic activity
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4
Q

What is the hormone’s pathway

A
  1. Hypothalamus secretes TRH
  2. Stimulating the pituitary to secrete TSH
  3. Stimulating the thyroid to secrete T3 & T4
  4. T4 gets converted to T3
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5
Q

How does thyroid hormones get transported

A

Bound to plasma proteins

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6
Q

What is the three plasma proteins that bind thyroid hormone

A

Thyroxine binding globulin
Albumin
Transthyretin

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7
Q

When is the drug biologically active

A

Unbound

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8
Q

What factor increase TBG

A

Estrogen

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9
Q

What three factors decrease TBG

A

Protein losing states, malnutrition & corticosteroids

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10
Q

Is the bound or free thyroid hormone tested

A

Free hormone

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11
Q

What response first after treatment

A

T4 changes rapidly & TSH takes longer

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12
Q

What is the three thyroid tests

A
  1. TSH
  2. Free T4
  3. Free T3
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13
Q

When is TSH used for testing

A

First line testing & for screening

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14
Q

When is free T4 used for testing

A

Abnormal TSH, known disease or for monitoring disease

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15
Q

When is free T3 used for testing

A

T3 toxicity, non-thyroidal illness, drugs

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16
Q

What is three other thyroid tests that can be done

A
  1. Thyroglobulin
  2. Calcitonin
  3. Thyroid antibodies
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17
Q

When is thyroglobulin used for testing

A

Tumour marker for thyroid cancer

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18
Q

When is calcitonin used for testing

A

Tumour marker for medullary thyroid cancer

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19
Q

When is thyroid antibodies used for testing

Study These Flashcards
A

Autoimmune disease

20
Q

What is the thyroid antibody present in Graves

Study These Flashcards
A

Anti-TSH receptor antibody

21
Q

What is the thyroid antibody present in Hashimoto’s

Study These Flashcards
A

Anti-thyroid peroxidase antibody

22
Q

What is the clinical features of hyperthyroidism

Study These Flashcards
A

Eyelid retraction, proptosis, diplopia
Weight loss, sweating, heat intolerance or fatigue

23
Q

What is the three causes of hyperthyroidism

Study These Flashcards
A
  1. Graves disease
  2. Multinodular goiter
  3. Toxic adenoma
24
Q

What is the testing results for hyperthyroidism

Study These Flashcards
A

TSH <0.01
T3 & T4 high

25
What is the clinical features of hypothyroidism
Not specific symptoms Dryness coarsening of skin & hair Lethargy, tiredness, cold intolerance, weight gain
26
What is the two causes of hypothyroidism
Autoimmune Iatrogenic
27
What is the testing results for hypothyroidism
TSH high T3 & T4 low Prolactin high Cholesterol high CK high
28
What is congenital hypothyroidism
Most common treatable cause of mental retardation
29
What is the cause of congenital hypothyroidism
Sporadic due to enzyme deficiency or thyroid not developing
30
What is the clinical presentation of congenital hypothyroidism
Few/no clinical manifestation, Jaundice Decreased activity Increased sleep
31
What is the complications of congenital hypothyroidism
Poor bone growth Motor & cognitive impairment
32
What is the results of sub clinical hypothyroidism
TSH high & normal T4
33
What is the three risks of sub clinical hypothyroidism
Increased risk for developing overt hypothyroidism CVD & dyslipidemia
34
What is the results of sub clinical hyperthyroidism
TSH low & normal T4
35
What is the three risks of sub clinical hyperthyroidism
Increased risk for developing overt hyperthyroidism Atrial fibrillation & decreased bone density
36
What is the cause of non thyroidal illness
Severe illness that changes thyroid function
37
What is the three cause of non thyroidal illness
1. Decreased peripheral conversion of T4 to T3 2. Changes in concentration/affinity of binding proteins 3. Disturbance in HPT axis
38
What two things causes a decrease in TSH & T4
1. NTI 2. Recent treatment of hyperthyroidism
39
What three things causes a decrease in TSH & normal T4
1. Subclinical hyperthyroidism 2. NTI 3. Recent treatment of hyperthyroidism
40
What causes a decrease in TSH & increase T4
Overt hyperthyroidism
41
What causes a increase in TSH & decrease in T4
Overt hypothyroidism
42
What three things causes a increase in TSH & normal T4
1. Subclinical hypothyroidism 2. Recent treatment of hypothyroidism 3. NTI
43
What causes a increase in TSH & T4
Recent treatment of hypothyroidism
44
What two things causes a normal TSH & decreased T4
1. NTI 2. Recent treatment of hyperthyroidism
45
What causes a normal TSH & increased T4
Intermittent T4 therapy

case 16: diabetes (8 decks)

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