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Lab Med > Endocrine 2 > Flashcards

Endocrine 2 Flashcards

1
Q

thyroid hormone, in which 25% is secreted by thyroid, 80% formed by liver and kidney; is more free

A

T3

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2
Q

what is the onset of action of T3?

A

2-3 hours

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3
Q

thyroid hormones that is produced and mostly secreted by the thyroid, 99% bound to proteins

A

T4

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4
Q

what is the onset of action of T4?

A

2-3 days

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5
Q

why does T4 have more storage than T3?

A

T4 has high affinity for proteins

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6
Q

a disorder of low proteins will cause a disorder in what?

A

T3 and T4 levels

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7
Q

what is the main function of thyroid hormones?

A

glucose metabolism

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8
Q

a condition of low thyroid hormone that slows metabolism

A

hypothyroidism

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9
Q

failure of the thyroid gland itself

A

primary hypothyroidism

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10
Q

pituitary or hypothalamic disease causing reduced TSH/TRH

A

secondary hypothryoidism

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11
Q

what are 2 things that can cause hypothryoidism?

A

iodine deficiency
damaged thyroid due to radiation

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12
Q

condition that presents as swollen face, large tongue/fontanelle, distended abdomen, umbilical hernia, and scaley skin

A

congenital hypothyroidism

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13
Q

the most common type of acquired hypothyroidism, in which autoantibodies attack and destroy thyroid glands

A

hashimoto’s disease

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14
Q

what are the lab findings in hashimoto’s disease? (3)

A

decreased free T4
increased TPO antibody
increased TSH

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15
Q

what is enlargement of the thyroid gland called?

A

goiter

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16
Q

what is the treatment for hypothyroidism?

A

levothyroxine

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17
Q

what test should we start with when we suspect thyroid problems?

A

TSH

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18
Q

elevated thyroid hormones

A

hyperthyroidism

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19
Q

what are the lab findings in hyperthyroidism?

A

high T3/T4
low TSH

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20
Q

what is the metabolic consequences of excess thyroid hormones called?

A

thyrotoxicosis

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21
Q

what is the most common cause of hyperthyroidism?

A

grave’s disease

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22
Q

what are 3 symptoms seen in hyperthryoidism?

A

puffy eyes
anxiety
tremor

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23
Q

4 treatment options for hyperthyroidism

A

beta blockers
antithyroid meds
radioiodine therapy
surgery

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24
Q

an indirect measure of FT3/FT4

A

thyroid binding globulin (TBG)

25
Q

which lab test will assess pituitary function and reflect long term thyroid status?

A

TSH

26
Q

which test will reflect acute changes, is sensitive, and measures both free and bound thyroid hormone? (affected by TBG)

A

total T4

27
Q

which test is an indicator of hyperthyroidism, and measures both bound and free thyroid hormone? (affected by TBG)

A

total T3

28
Q

which test measures unbound T4 and is the most accurate reflection of thyrometabolic status?

A

free T4

29
Q

what 2 things can cause low TBG levels?

A

high androgen
nephrotic syndrome

30
Q

what 2 things can cause high TBG levels?

A

high estrogen
pregnancy

31
Q

indirect measure of serum thyroid hormone binding capacity

A

T3 resin uptake

32
Q

what is the relationship between T3 resin uptake and TBG binding sites?

A

inversely proportional

33
Q

gives an indirect measure of free thyroid hormone levels

A

free T4 index

34
Q

how would the free T4 index present in hyperthyroidism?

A

high

35
Q

how would the free T4 index present in hypothyroidism?

A

low

36
Q

what test would indicate autoimmune disorders if it is positive?

A

antithyroid antibodies

37
Q

what increases circulating TBG and may increase the T4 dosage requirements in women with primary hypothyroidism?

A

estrogen/hormone therapy

38
Q

what type of cushing’s syndrome is characterized by a tumor on the adrenal gland of the kidney?

A

adrenal cushing’s syndrome

39
Q

what type of cushing’s syndrome is characterized by the pituitary producing too much ACTH?

A

pituitary cushing’s syndrome

40
Q

what type of cushing’s syndrome is characterized by a tumor or mass releasing additional cortisol?

A

ectopic cushing’s syndrome

41
Q

what are 4 manifestations of cushing’s syndrome?

A

moon face
buffalo hump
obesity
hypertension

42
Q

what should I ask a patient if they present with striae?

A

recent steroid use

43
Q

a test that measures the response of the adrenal glands to ACTH

A

dexamethasone suppression test

44
Q

what would indicate an abnormal response to a dexamethasone suppression test?

A

no cortisol suppresion

45
Q

what is the cause of an abnormal response to a dexamethasone suppression test?

A

primary overproduction - adrenal tumor

46
Q

where is 90% of plasma cortisol?

A

bound to corticosteroid binding globulin (CBG)

47
Q

where is CBG synthesized?

A

liver

48
Q

what labs would be found in addison’s disease?

A

high ACTH
low cortisol

49
Q

a disease characterized by hypo-adrenal function

A

addison’s disease

50
Q

what does an elevated ACTH level indicate in an ACTH stimulation test?

A

primary adrenal insufficiency

51
Q

what does a low/normal ACTH level indicate in an ACTH stimulation test?

A

secondary adrenal insufficiency

52
Q

a disorder in which the pituitary gland produces insufficient ADH, so the kidneys make a lot of urine

A

diabetes insipidus

53
Q

diabetes insipidus in which there is a decreased excretion of ADH due to damage to the hypothalamus or pituitary gland

A

central DI

54
Q

diabetes insipidus in which the kidney is resistant to ADH

A

nephrogenic DI

55
Q

what test can be used to determine type of diabetes insipidus?

A

water deprivation test

56
Q

what kind of diabetes insipidus does our patient have if in a water deprivation test, there is no change in urine osmolality, but increased urine osmolality after given a vasopressor

A

central Di

57
Q

what kind of diabetes insipidus does our patient have if in a water deprivation test, there is no change in urine osmolality, even after given a vasopressor

A

nephrogenic DI

58
Q

what is the most often used medication for diabetes insipidus, especially in pregnancy?

A

desmopressin

Lab Med (19 decks)

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