Flashcards in Exam 2 Study Guide Thyroid Disorders Deck (64)
What are infrequent ectopic sites of the thyroid in the oral cavity?
Lingual Thyroid Tissue
Excessive activation of the thyroid leads to...
a hypermetabolic state causing protein catabolism and enhanced sympathetic NS activity.
Thyroid disease is most common in...
What is "thyroid storm"?
What disease is affiliated with Hyperthyroidism?
Grave's Disease (in 90% of cases)
What are causes of Grave's disease?
Autoimmune-antibodies function as agonists to thyroid-related receptors- causing excessive thyroid receptor activation.
What are the symptoms of Grave's disease?
Thyroid gland hyperplasia
What is Plummer's Disease?
A multi lobular goiter
5-10% of hyperthyroidism cases
What disease is affiliated with Hypothyroidism?
most common in females
Characteristics of a goiter...
-Most common thyroid lesion
-Rare with Hypothyroidism
-Not a cancer
-Diagnosed with fine needle aspiration (look for colloid)
What is the most common thyroid neoplasm?
Thyroid Carcinomas are typically...
Low risk and low metastasis
*Most common is Papillary carcinoma
What are mostly benign and found in 6% of women and 2% of males?
What drugs are used to treat Hyperthyroidism?
What is an example of a thiomide and how dies it work?
- inhibits the thyroid peroxidase reaction and blocks synthesis of the hormone.
How doe Iodides-Lugol solution work?
Inhibit hormon release
How do beta blockers (propranolol) treat hyperthyroidism?
Inhibit the conversion of T4 to T3
How does Radiation iodine treat hyperthyroidism?
Destroys thyroid parenchyma
How do you treat Hypothyroidism?
Synthroid or Levothroid
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
Hyperparathyroidism causes what?
*Primary and Secondary
What are the characteristics of Primary Hypercalcemia?
-Common Endocrine Disorder (adenoma)
-Elevated serum Ca++
What are symptoms of Primary Hypercalcemia?
What is the treatment for Primary Hypercalcemia
What is Secondary Hypercalcemia?
Intestinal malabsorption of Vitamin D or Calcium
What drugs are used to treat Osteoporosis?
Estrogens and Estrogen Modulators
How does Denosumab (Xgeva) work?
antibody to the osteoclastic-stimulating protein (RANK)
-This drug blocks osteoclast number and activity
How does Teraparatide (Forteo) work?
a recombinant form of parathormone segment which selectively activates osteoblasts and stimulates new bone formation.
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
How do bisphosphonates work?
Suppress activity of osteoclasts and inhibit bone resorption
What are examples of Bisphosphonates?
What drugs promote osteoporosis?
-antagonizes Vit. D stimulated intestinal Ca++ transport and stimulates renal secretion (Blocks osteoblasts)
What are the symptoms of Hypoparathyroidism?
Dental changes in children
What is the most common cause of Hypoparathyroidism?
Accidental removal at thyroid surgery.
What are secondary hormonal regulators of Bone Mineral Homeostasis?
* acts opposite of PTH by inhibiting osteoclastic activity.
*can use to treat Paget's Disease
What is the Pituitary gland?
Brains endocrine gland, secretes through blood-brain barrier.
What to directions does the pituitary gland secrete?
Anterior - Portal circulation from hypothalamus
Posterior - axons go into systemic circulation
What is GIH known as?
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)
Which disease results in increased growth hormone before puberty?
*Acromegaly after puberty
What is the most common cause for Hypopituitarism?
Consecratory pituitary adenomas
*loss of sex characteristics (sterility)
*Retards child growth
What is the function of the adrenal glands?
Medulla makes and releases catecholamines
Cortex makes Steroids ( mineralocorticoids, glucocorticoids, and sex steroids)
What are the features of Primary Acute Cortical Insufficiency?
What are the features of Secondary adrenocortical Insufficiency?
Due to hypothalamic or pituitary problem
-No hyper pigmentation
What is adrenal crisis?
Sudden for increase of steroid output
*can be caused by massive adrenal hemorrhage
What are the two disorders associated with Hypercortisolism?
Secondary Adrenocortisol Insufficiency
What are the features of Cushing Disease?
Adrenal then shrinks due to feedback
Low ACTH, High Cortisol
Adrenals Act autonomously
What are the symptoms of Cushing Disease?
Poor wound healing
*basically someone in chronic corticosteroid treatment
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.
What is Hyperaldosteronism (Conn Syndrome)?
-Na+ retention and K+ excretion
-Supression of renin-angiotensin system
What are the 3 Adrenal Cortical Tumors?
Adenomas (Common -usually non-functional)
Pheochromocytoma (adrenal medullary tumor)
What are characteristics of Pheochromocytoma?
Increases secretion of Catecholamines
Clinically looks like increased sympathetic function
-Hypertension and flushing
Cortisol is synthesized from...
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
What are short to medium acting Glucocorticoids?
Hydrocortisone, Cortisone, Prednisone
What is a long acting Glucocorticoid?
Glucocorticoids are used for
Inflammatory bowel disease
Acute Respiratory Distress Disorder
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.
What causes Cushings Disease?
Chronic high levels of Cortisol - usually due to ACTH-secreting tumor
What Drugs can be used for Cushings Disease?
*treats osteoporosis and Paget's Disease
What does Ketoconazole do?
Inhibits adrenal steroid synthesis
What does Metyrapone do?
selective inhibitor of cortisol/corticosterone synthesis.
What is Paget's Disease (Osteitis Deformans)
Excessive bone removal followed by excessive bone formation = weakened bone and fractures.
*may be triggered by virus