Exam 2 Study Guide Thyroid Disorders Flashcards Preview

Human Disease and Therapeutics > Exam 2 Study Guide Thyroid Disorders > Flashcards

Flashcards in Exam 2 Study Guide Thyroid Disorders Deck (64):
1

What are infrequent ectopic sites of the thyroid in the oral cavity?

Intralingual
Lingual Thyroid Tissue

2

Excessive activation of the thyroid leads to...

a hypermetabolic state causing protein catabolism and enhanced sympathetic NS activity.

3

Thyroid disease is most common in...

Females

4

What is "thyroid storm"?

Fever
Tachycardia
Sweating
Shaking
Agitation
Unconsciousness

5

What disease is affiliated with Hyperthyroidism?

Grave's Disease (in 90% of cases)

6

What are causes of Grave's disease?

Autoimmune-antibodies function as agonists to thyroid-related receptors- causing excessive thyroid receptor activation.

7

What are the symptoms of Grave's disease?

Hyperthyroidism
Exophthalmos
Thyroid gland hyperplasia

8

What is Plummer's Disease?

A multi lobular goiter

5-10% of hyperthyroidism cases

9

What disease is affiliated with Hypothyroidism?

Hashimoto's Disease

most common in females

10

Characteristics of a goiter...

-Most common thyroid lesion
-Rare with Hypothyroidism
-Not a cancer
-Iodine Deficiency
-Diagnosed with fine needle aspiration (look for colloid)

11

What is the most common thyroid neoplasm?

Thyroid adenomas

*not malignant

12

Thyroid Carcinomas are typically...

Low risk and low metastasis

*Most common is Papillary carcinoma

13

What are mostly benign and found in 6% of women and 2% of males?

Thyroid Nodules

14

What drugs are used to treat Hyperthyroidism?

Thiomides
Iodides-Lugo Solution
Beta Blockers
Radiation Iodine

15

What is an example of a thiomide and how dies it work?

propylythiouracil (PTU)
- inhibits the thyroid peroxidase reaction and blocks synthesis of the hormone.

16

How doe Iodides-Lugol solution work?

Inhibit hormon release

17

How do beta blockers (propranolol) treat hyperthyroidism?

Inhibit the conversion of T4 to T3

18

How does Radiation iodine treat hyperthyroidism?

Destroys thyroid parenchyma

19

How do you treat Hypothyroidism?

Thyroid replacement

Synthroid or Levothroid

20

What is the function of the Parathyroid?

-Secrete PTH regulated by free calcium in blood.
- Low Ca++ = increased PTH
-PTH activates Osteoclasts and bone resorption to increase serum Ca++
-also increases tubular reabsorption of calcium
-Activates vitamin D
-Increases GI absorption

21

Hyperparathyroidism causes what?

Hypercalcemia

*Primary and Secondary

22

What are the characteristics of Primary Hypercalcemia?

-Common Endocrine Disorder (adenoma)
-cause Arrhythmias
-Elevated serum Ca++
-Hypophosphatemic

23

What are symptoms of Primary Hypercalcemia?

Osteoporosis (fractures)
Constipation
Weakness
Anorexia
Stones
Ulcers
depression
coma

24

What is the treatment for Primary Hypercalcemia

Surgery

25

What is Secondary Hypercalcemia?

Intestinal malabsorption of Vitamin D or Calcium

26

What drugs are used to treat Osteoporosis?

Denosumab (Xgeva)
Teraparatide (Forteo)
Estrogens and Estrogen Modulators
Bisphosphonates

27

How does Denosumab (Xgeva) work?

antibody to the osteoclastic-stimulating protein (RANK)
-This drug blocks osteoclast number and activity

28

How does Teraparatide (Forteo) work?

a recombinant form of parathormone segment which selectively activates osteoblasts and stimulates new bone formation.

29

How does estrogen (Modulators) work?

Prevent bone loss in early post-menopausal period

* should be used in combination with progestin to protect against venous thrombi

30

How do bisphosphonates work?

Suppress activity of osteoclasts and inhibit bone resorption

*BRONJ

31

What are examples of Bisphosphonates?

Ibandronate (Boniva)
Alendronate (Fosamax)

32

What drugs promote osteoporosis?

Glucocorticoids

-antagonizes Vit. D stimulated intestinal Ca++ transport and stimulates renal secretion (Blocks osteoblasts)

33

What are the symptoms of Hypoparathyroidism?

Hypocalcemia
Decreased PTH
Tetany
Dental changes in children

34

What is the most common cause of Hypoparathyroidism?

Accidental removal at thyroid surgery.

35

What are secondary hormonal regulators of Bone Mineral Homeostasis?

Calcitonin

* acts opposite of PTH by inhibiting osteoclastic activity.
*can use to treat Paget's Disease

36

What is the Pituitary gland?

Brains endocrine gland, secretes through blood-brain barrier.

37

What to directions does the pituitary gland secrete?

Anterior - Portal circulation from hypothalamus
Posterior - axons go into systemic circulation

38

What is GIH known as?

Somatostatin

39

What are the 3 secretions from the pituitary and what can cause them to be disturbed?

Prolactin (Reproductive function)
Growth Hormone (Gigantism, Acromegaly)
Corticotropin (Affect ACTH causing Cushing's Disease)

*Adenomas

40

Which disease results in increased growth hormone before puberty?

Gigantism

*Acromegaly after puberty

41

What is the most common cause for Hypopituitarism?

Consecratory pituitary adenomas

*loss of sex characteristics (sterility)
*Retards child growth
*Hypothyroidism

42

What is the function of the adrenal glands?

Medulla makes and releases catecholamines
Cortex makes Steroids ( mineralocorticoids, glucocorticoids, and sex steroids)

43

What are the features of Primary Acute Cortical Insufficiency?

Weakness
Nausea
Hyponatremia
Hypotension
Skin Pigmentation

*Addison Disease

44

What are the features of Secondary adrenocortical Insufficiency?

Due to hypothalamic or pituitary problem

-hypoglycemia
-No hyper pigmentation
-Aldosterone Normal

45

What is adrenal crisis?

Sudden for increase of steroid output

*can be caused by massive adrenal hemorrhage

46

What are the two disorders associated with Hypercortisolism?

Cushing Disease
Secondary Adrenocortisol Insufficiency

47

What are the features of Cushing Disease?

Adrenal Hyperplasia
Adrenal then shrinks due to feedback
Low ACTH, High Cortisol
Adrenals Act autonomously

48

What are the symptoms of Cushing Disease?

Moon Face
Osteoporosis
Buffalo Hump
Obesity
Thin Skin
Amenorrhea
Poor wound healing

*basically someone in chronic corticosteroid treatment

49

What is Secondary Aderoncortsol Insufficiency?

-The result of extended use of exogenous steroids (Prednisone)

-Normal adrenal function is suppressed, but then tx is abruptly stopped causing a hypocortisolic reaction.

50

What is Hyperaldosteronism (Conn Syndrome)?

-Na+ retention and K+ excretion
-Supression of renin-angiotensin system

51

What are the 3 Adrenal Cortical Tumors?

Adenomas (Common -usually non-functional)
Carcinomas (rare)
Pheochromocytoma (adrenal medullary tumor)

52

What are characteristics of Pheochromocytoma?

Usually benign
Increases secretion of Catecholamines
Clinically looks like increased sympathetic function
-Hypertension and flushing

53

Cortisol is synthesized from...

Cholesterol

54

What is the primary use of Glucocorticoids?

Rapid and dramatic anti-inflammatory effects
- Suppress leukocytes and cytokines/chemokines
-Topical inhibits histamine relate and skin thinning

55

What are short to medium acting Glucocorticoids?

Hydrocortisone, Cortisone, Prednisone

56

What is a long acting Glucocorticoid?

Dexamthazone

57

Glucocorticoids are used for

Allergic reactions
Inflammatory bowel disease
Acute Respiratory Distress Disorder
Dermatitis

58

What is the treatment for Addison's Disease?

Since the adrenal glands produce too little cortisol and aldosterone
Hydrocortisone combined with salt-retaining hormone will treat it.

59

What causes Cushings Disease?

Chronic high levels of Cortisol - usually due to ACTH-secreting tumor

60

What Drugs can be used for Cushings Disease?

Ketoconazole
Metyrapone

*treats osteoporosis and Paget's Disease

61

What does Ketoconazole do?

Inhibits adrenal steroid synthesis

62

What does Metyrapone do?

selective inhibitor of cortisol/corticosterone synthesis.

63

What is Paget's Disease (Osteitis Deformans)

Excessive bone removal followed by excessive bone formation = weakened bone and fractures.

*may be triggered by virus

64

Paget's disease would see high what in the serum?

Alkaline Phosphates