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Physiology Exam 2 > Endo 3 > Flashcards

Endo 3 Flashcards

1
Q

What percentage of thyroid hormones is T3?

A

7%

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2
Q

What percentage of thyroid hormone is T4?

A

93%

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3
Q

Is T3 or T4 more potent?

A

T3

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4
Q

What does calcitonin do to calcium levels?

A

decrease calcium levels

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5
Q

What do thyroid hormones do to catecholamines?

A

have a permissive action
(action is greater than the sum of the two parts)

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6
Q

Where is calcitonin secreted from?

A

parafollicular cells

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7
Q

Where is thyroglobin stored?

A

in the colloid of the thyroid follicle

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8
Q

What element is required for the formation of thyroid hormones?

A

iodine

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9
Q

What helps to increase the intracellular concentrations of iodine?:

A

Na/I symporters

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10
Q

What is the anion exchanger that allows iodine to exit the thyrocyte to access the colloid?

A

pendrin (Cl/I exchanger)

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11
Q

Where are T3 and T4 made?

A

in the colloid

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12
Q

What enzyme is required for the formation of thyroid hormones?

A

peroxidase

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13
Q

What do T3 and T4 bind to?

A

thyroglobin

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14
Q

What are the steps of T3 and T4 secretions into the blood?:

A
  1. colloid is internalized by endocytosis
  2. vesicles fuse with lysosomes in the cell
  3. proteases cleave T3 and T4 from TG
  4. T3 and T4 diffuse out of the cell and into capillaries
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15
Q

What are plasma proteins that T3 and T4 bind to?

A

thyroxin binding globulin, transthyretin, and albumin

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16
Q

Does T3 or T4 have a longer half life?

A

T4

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17
Q

What converts T4 to T3?

A

deiodinase

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18
Q

How can individual cell types regulate amounts of active thyroid hormone?

A

regulating deiodinase activity

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19
Q

What is unique about deiodinases?

A

they have selenocysteines that contain selenium in place of sulfur

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20
Q

What are some things that can inhibit deiodinase activity?

A

selenium deficiency, burns, trauma, advanced cancer, cirrhosis, chronic kidney disease, MI and febrile states, fasting, and stress

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21
Q

What would deiodoninase insufficiency appear similar to?

A

signs of hypothyroidism

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22
Q

Does T3 or T4 actions occur sooner?

A

T3

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23
Q

What are the cardiovascular effects of thyroid hormones?

A

increase cardiac output, tissue blood flow, heart rate, heart strength, and respiration

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24
Q

What are the metabolic effects of thyroid hormones?

A

increase mitochondria, Na/K ATPase, O2 consumption, glucose absorption, gluconeogenesis, glycogenolysis, lipolysis, protein synthesis, and BMR

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25
Q

Where does negative feedback of thyroid hormone occur?

A

in the anterior pituitary

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26
Q

What is the main circulating form of thyroid hormone?

A

T4

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27
Q

What type of release is thyroid hormone?

A

pulsatile
-output starts to raise at 9pm
-peaks at midnight
-declines during the day

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28
Q

How does thyroid hormone stimulate carbohydrate metabolism?

A

-cause uptake of glucose by cells
-enhance glycolysis and gluconeogenesis
-increase rates of CHO absorption from GI tract

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29
Q

How does thyroid hormone stimulate fat metabolism?

A

-increase lipid mobilization and oxidation of fatty acids by the cells
-required to convert beta carotene to vitamin A
-decreases circulating cholesterol levels

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30
Q

How do thyroid hormones effect the nervous system?

A

-required for normal development
-impact reflex time
-muscle tremors due to increased reactivity of neuronal synapses
-feeling of tiredness, but difficulty sleeping
-anxiety, worry, and paranoia

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31
Q

How do thyroid hormones effect the cardiovascular system?

A

-increased expression of beta adrenergic receptors
-increased blood flow, heart rate, and heart contractility

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32
Q

How do thyroid hormones effect the endocrine system?

A

-activation of bone formation causes a need for increase PTH secretion

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33
Q

How do thyroid hormones effect the GI system?

A

-increased appetite and food intake
-increased rate of secretion and motility of GI tract

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34
Q

What does hypothyroidism do with poop?

A

constipation

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35
Q

What does hyperthyroidism do with poop?

A

diarrhea

36
Q

What is goiter?

A

enlarged thyroid that does indicate functional status

37
Q

What causes goiter?

A

excessive amounts of TSH secretion
-die to increase TSH bound to thyroglobin in the colloid of the follicles

38
Q

What is a disease associated with hyperthyroidism?

A

Graves disease

39
Q

What is Grave’s disease?

A

autoimmune disease that has thyroid stimulating immunoglobins that stimulate the thyroid gland to secrete excess thyroid hormones

40
Q

What are the levels of the hormones in Grave’s disease?

A

decreased TRH, decreased TSH, and increased T3 and T4

41
Q

What are the treatments of hyperthyroidism?

A

radioactive I for thyroid ablation
-propanolol as a beta blocker to suppress the sympathetic response caused by thyroid hormones
-L-thyroxine is given to replace the thyroid hormones that can not be made anymore

42
Q

What are the oral symptoms of hyperthyroidism?

A

burning mouth syndrome, gum disease, excessive salivation, weakening of mandible, increased caries risk

43
Q

What is thyroid storm?

A

elevated thyroid hormone with stressful events or seriousillness

44
Q

What are symptoms of thyroid storm?

A

fever, tachycardia, elevated BP, nausea, vomiting, diarrhea, breathing problems

45
Q

What should you avoid if a person is experiencing thyroid storm?

A

epinephrine

46
Q

What is Hashimoto’s thyroiditis?

A

disease associated with hypothyroidsm
-autoimmune reaction against thyroid gland destroys gland rather than stimulating it

47
Q

What is the treatment of hashimotos?

A

L-thyroxine
-due to needing more thyroid homrone since the thyroid gland has been fiborisezed whateber

48
Q

Does hypothryoidism with iodide or TSH deficiency cause a goiter?

A

iodide deficiency

49
Q

Is hypothyroidism due to an iodide deficiency a primary or secondary disorder?

A

primary
-the iodine is added in the thyroid gland which is the last step

50
Q

What are some symptoms of hypothyroidism?

A

coarse, dry, and brittle hair
loss of lateral eyebrows
pallor
macroglossia
weight gain
peripheral edema
lethargy and impaired memory
periorbital edema and puffy face
deep, coarse voice
diminished perspiration, cold intolerance
slow pulse, enlarged heart
gastric atrophy
constipation
menorrhegia
muscle weakness

51
Q

What type of patients can experience myxedema?

A

severely hypothyroid patients

52
Q

What causes myxedema?

A

increased quantities of hyaluronic acid and chondroitin sulfate bound with protein plus water accumulate in skin

53
Q

What causes cretinism?

A

-congenital absence of thyroid gland
-iodine deficient diet (most common cause worldwide)

54
Q

What does cretinism cause?

A

causes physical and mental retardation of neonates
-skeletal growth is more inhibited than soft tissue growth
(obese, stocky, and short with large protruding tongue)

55
Q

What are the oral manifestations of hypothyroidism?

A

-macroglossia
-dysgeusia
-poor wound healing and increase risk of infection (decreases activity of fibroblasts)
-increases periodontal disease
-salivary gland enlargement

56
Q

What type of drugs are patients with hypothyroidism sensitive to?

A

depressants and barbiturates

57
Q

Where is the body’s phosphate stored?

A

-85% in bones
-14-15% in cells
-less than 1% in EC fluid

58
Q

Where is the body’s calcium stored?

A

-0.1% in EC fluid
-1% in cells and organelles
-the rest is in the body (bones?)

59
Q

What happens when the body’s calcium is too low?

A

neuronal hyper-excitability (tetany)

60
Q

What happens when the body’s calcium is too high?

A

neuronal depressionW

61
Q

What are the three main ways the body can maintain calcium and phosphate levels?

A

-absorption via intensity
-excretion via urine and feces
-temporary storage via bones

62
Q

What are the three hormones that regulate the plasma calcium?

A
  1. Parathyroid hormone
  2. Calcitriol
  3. Calcitonin
63
Q

What does parathyroid hormone do to the levels of calcium and phosphate?

A

increase plasma calcium and decrease phosphate

64
Q

What does calcitriol do to the levels of calcium and phosphate?

A

increase plasma calcium and phosphate

65
Q

What does calcitonin do to the levels of calcium and phosphate?

A

decrease plasma calcium and phosphate

66
Q

What is the primary hormone that enhances intestinal of calcium?

A

calcitriol

67
Q

What are the actions of PTH that change the plasma concentrations of calcium and phosphate?

A

-mobilize calcium from bone
-enhance renal reabsorption of calcium
-increases intestinal absorption of calcium (indirectly)

68
Q

How do Vitamin D3 and PTH stimulate bone resorption>

A

in times of decreased calcium, osteoblasts will secrete RANKL
-RANKL binds to the osteoclasts and activate them
-osteoclasts will start to break down bone to increase plasma calcium

69
Q

How does calcitonin stimulate bone deposition?

A

_OPG is released and binds to RANKL
-RANKL can no longer activate osteocalsts
-osteoblasts will apoptose

70
Q

What are risk factors for osteoporosis?

A

-vitamin D deficiency
-inadequate calcium intake
-glucocortioid medications
-reduced physical activity
-estrogen deficiency

71
Q

What are the treatments for osteoporosis?

A

-exercise
-physical therapy
-estrogen
-calcium
-vitamin D
disphosphonates

72
Q

What are the parathyroid glands?

A

four pea sized glands on posterior surface of the thyroid gland

73
Q

What secretes PTH? (cell type)

A

chief cells

74
Q

What can cause hypertrophy of parathyroid gland?

A

pregnancy, rickets, lactation

75
Q

What can decrease the size of the parathyroid gland?

A

-increased vitamin D intake
-excess quantities of calcium in the diet
-bone resportion caused by factors other the PTH

76
Q

How does PTH increase plasma calcium?

A

-bone resorption
-reabsorption of calcium by renal tubule which reduces excretion
-make active vitamin D which causes intestinal calcium absorption

77
Q

How does PTH decrease plasma phosphate?

A

decreases reabsorption by renal tubules leading to increased urinary secretion

78
Q

What three places help to make calcitriol?

A

skin, liver, kidney, and intestinal epithelium

79
Q

What type of hormone is calcitonin?

A

peptide hormone
-secreted by parafollicular cells

80
Q

Is calcitonin a major controlled of Calcium in humans?

A

nah

81
Q

What is primary hyperparathyroidism?

A

excess PTH secretion due to a parathyroid gland tumor

82
Q

What does primary hyperparathyroidism cause?

A

extreme osteoclastic activity in bone
-cystic bone disease

83
Q

What are some of the symptoms of primary hyperparathyroidism?

A

-hypercalcemia leads to polyuria and calcuria
-low phosphate due to increased renal excretion
-muscle weakness and east fatiagbilty (decrease entry of Na into the neurons)
-osteoblastic activity also increased leading to high secretions of alkaline phosphatase

84
Q

What is secondary hyperparathyroidism?

A

high PTH levels occur as compensation for hypocalcemia not due to primary abnormalities of parathyroid glands

85
Q

What are causes of secondary hyperparathyroidism?

A

vitamin D deficiency
chronic renal disease
-can not make vitamin D3

86
Q

What does vitamin D deficiency lead to?

A

in children-rickets
in adults-osteomalacia
high PTH which causes bone resorption

87
Q

What is primary hypoparathyroidism?

A

usually due to accidental surgical removal
-decreases plasma Ca levels
-increase membrane Na permeability leading to neuromuscular excitability and muscle spasms (tetany)
-spasms of laryngeal muscles obstruct respiration causing death unless appropriate treatment applied

Physiology Exam 2 (6 decks)

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