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Med Path Fall 2020 > Endocrine 2 > Flashcards

Endocrine 2 Flashcards

1
Q

Where are thyroid hormones stored?

A

Extracellularly for 2-3 months

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2
Q

Hypothalamus secretes ___ which stimulates pituitary gland to secrete ___ which stimulates thyroid to secrete ___ and ____

A

TRH
TSH
T3/T4 can now turn off hypothalamus and pituitary

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3
Q

percentages in pop with hypo or hyper thyroidism

A

80% have hypo. T3 and T4 are low. TSH is high.

20% have hyper T3 and T4 are high. TSH is low.

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4
Q

1 cause of hypothyroidism in US and world.

A

US: Hashimotos 90-97%
World: Insufficient iodine intake

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5
Q

Hypothyroidism ocular symptoms

A

1/3 of eyebrows missing (queen Ann’s sign)
Superior limbit keratoconj
Exophthalmos

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6
Q

Symptoms of hashimotos

A

Myxedema- deposition of mucopolysaccharides. Causes edema.

Lethargy, cold intolerance, decrease ap, weight gain.

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7
Q

Tx hashimotos with

A

levothyroxine / synthroid

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8
Q

Main cause of hyperthryoidism

A

Graves autoimmune disease. 60-80%

Others: Goiter, excess iodine.

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9
Q

What autoimmune disease is most commonly associated with TED

A

Graves

50% of graves pt’s develop TED

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10
Q

Thyroid eye disease

A

Lymphocytic infiltration of orbital soft tissue.

Fibroblasts deposit mucopolysacharids and cause edema (myxedema) = enlarged EOMs.

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11
Q

Most common cause of proptosis/diplopia in adults

A

TED.
Myxedema causing swelling/enlarged EOMs.
Could be unilateral or bilateral

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12
Q

___% of graves pt’s develop TED

__% of TED patients have graves

A

50

85

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13
Q

Is TED severity related to severity of systemic disease?

A

No

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14
Q

Contraindications if pt has TED

A

smoking!

4x increased risk of TED

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15
Q

Early and late signs of TED

A

Early- eyelid retraction (90%)

Late- exophthalmos (60%) and EOM restriction/diplopa (40%)

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16
Q

TPO/thyroperioxidase

A

Enzyme that synthesizes T3/T4. May see TPO antibodies in both hashimotos and graves, although more common in hashimotos. (95%)

17
Q

Which thyroid disease would you see a TSH receptor antibody?

A

Graves (90%)

18
Q

Response to low serum calcium levels

A

Parathyroid secretes PTH to raise Calcium levels in the blood by increasing osteoclast activity and increasing calcium reabsorption

19
Q

Response to high serum calcium levels

A

Parafollicular cells in thyroid secrete calcitonin to lower serum calcium levels.
Calcitonin tones ur bones!

20
Q

75% of hypoparathyroidism is due to

A

Neck surgery

21
Q

Result of hypoparathyroidism

A

Hypocalcemia, increased phosphorus levels.
(PTH usually increases serum calcium levels. Without, will result in low calcium)

Causes muscle cramps and paresthesia.
Ocular: Cataracts

Decreased PTH, decreased calcium, increased phos

22
Q

85% of hyperparathyroidism is due to

A

Parathyroid adenoma.

23
Q

Result of hyperparathyroidism

A 
Excess PTH secreted, resulting in an increased level of calcium in the blood. 
95% only involve 1 of 4 glands
Symptoms- 50-80% are asymptomatic 
Osteoporosis 
Kidney stones

Will see increase in PTH, increase in calcium and decrease in phos

Ocular: Band keratopathy due to calcium build up
Conj concretions in palpebral conj

24
Q

Ocular results of hypo and hyperparathyroidism

A

Hypoparathyroidism- Decrease PTH = decrease calcium levels. Cataracts.

Hyperparathyroidism- Increase PTH= increase calcium levels. Band keratopathy and palpebral conj concretions.
*Most people are asymptomatic tho

25
Q

Vitamin D deficiency can result in what based off age

A

Rickets in children
Osteomalacia in adults
(Softening and weakening of bones)

26
Q

Pineal gland location

A

Posterior midbrain in the brainstem

produces melatonin

27
Q

Parinaud syndrome

A

Pineal gland tumor.
Upward gaze deficit - sunset
Dx with MRI
Due to pinealoma or hydrocephalus

Signs: Lid retraction, papilledema, nystagmus.

28
Q

Causes of parinaud syndrome/Dorsal midbrain syndrome.

A

Due to pinealoma or hydrocephalus (accumulation of CSF in the brain)

29
Q

Thyroid gland targets which cells in the body

A

All

30
Q

Thyroid gland regulates

A

The basal metabolic rate.

O2, body temp, gastric motility, HR

31
Q

Why do you get a goiter with hypo and hyperthyroidism?

A

Hypo- body trying to stimulate it

Hyper- due to overaction

32
Q

How to treat hyperthyroidism

A

Radioactive iodine= TOC

33
Q

Most common cause and symptoms of hypoparathyroidism and hyper

A

Hypo- neck surgery (80%), muscle cramps, numb limbs, brittle nails/hair.
Hyper-Parathyroid adenoma, asymptomatic

Med Path Fall 2020 (20 decks)

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