HORMONES (DISEASE & METHODS) Flashcards
(176 cards)
1
Q
Hypermetabolic condition caused by excessive production of thyroid hormones
A
Primary Hyperthyroidism
2
Q
Thyrotoxicosis: excess TH
A
Primary Hyperthyroidism
3
Q
Primary Hyperthyroidism Common cause
A
Thyrotoxicosis
4
Q
Primary Hyperthyroidism Primary cause
A
Grav’es disease
Plummer’s disease)
Pituitary tumors
5
Q
Primary Hyperthyroidism Less minor cause
A
Subacute thyroiditis
6
Q
Grave’s disease
A
7
Q
Grave’s disease Causes:
A
Thyrotropin Receptor Antibodies (TRABS)
Thyroid Stimulating Immunoglobulins (TSIS)
8
Q
Grave’s disease Symptoms and manifestation:
A
Eye disease
Skin disease
Goiter
9
Q
Secondary causes of hyperthyroidism:
A
Thyrotoxicosis factitia
Iodide ingestion in excess
Thyroid carcinoma
Drug induced thyrotoxicosis
10
Q
Over stimulation of the thyroid
A
Secondary Hyperthyroidism
11
Q
Over production of thyroid stimulating hormone
A
Secondary Hyperthyroidism
12
Q
Secondary Hyperthyroidism Causes:
A
Carcinoma of the APG
TSH-secreting tumors
TRH-secreting tumors
13
Q
Increased TSH
A
Primary Hypothyroidism
14
Q
Decreased T3T4
A
Primary Hypothyroidism
15
Q
Hashimoto’s disease
A
Primary Hypothyroidism
16
Q
Unexplained weight loss
A
Thyrotoxicosis
17
Q
Inc HR
A
Thyrotoxicosis
18
Q
Sweating
A
Thyrotoxicosis
19
Q
Heat intolerance
A
Thyrotoxicosis
20
Q
Nervousness
A
Thyrotoxicosis
21
Q
Fatigue
A
Primary Hypothyroidism
22
Q
Weight gain
A
Primary Hypothyroidism
23
Q
Decreased mental and Physical output
A
Primary Hypothyroidism
24
Q
Cold intolerance
A
Primary Hypothyroidism
25
Fatigue and sluggishness
Hashimoto’s disease
26
Increase sensitivity to cold
Hashimoto’s disease
27
Constipation
Hashimoto’s disease
28
Pale dry skin
Hashimoto’s disease
29
Puffy face
Hashimoto’s disease
30
Hair loss
Hashimoto’s disease
31
Enlargement of the tongue: macroglossia
Hashimoto’s disease
32
Unexplained weight gain
Hashimoto’s disease
33
Sensitivity to cold
Hashimoto’s disease
34
Bradycardia
Hashimoto’s disease
35
Menstrual changes
Hashimoto’s disease
36
Central thyroid disease
Secondary Hypothyroidism
37
Serum T4 and T3 is low
Secondary Hypothyroidism
38
TSH concentration are either low or within reference interval
Secondary Hypothyroidism
39
Cause: Pituitary or hypothalamic disease
Secondary Hypothyroidism
40
Impaired speech and memory
Hypothyroidism
41
Fatigue
Hypothyroidism
42
Weight gain
Hypothyroidism
43
personality changes
Hypothyroidism
44
cold tolerance
Hypothyroidism
45
Increased serum cholesterol and LDL
Hypothyroidism
46
Enlarged thyroid gland (goiter)
Hyperthyroidism
47
Weight loss
Hyperthyroidism
48
heat intolerance
Hyperthyroidism
49
nervousness
Hyperthyroidism
50
exophthalmos
Hyperthyroidism
51
Normal functioning thyroid gland in the presence of an abnormal concentration of Thyroxine-binding-globulin
Euthyroid
52
TSH is suppressed
Subclinical hyperthyroidism
53
Free T4 is normal
Subclinical hypothyroidism
54
TSH minimally increased
Subclinical hypothyroidism
55
Most useful test
TSH
56
[?]= increased TSH
Primary hypothyroidism
57
TSH Normal range in most laboratories:
0.5 to 5 mIU/L
58
Measured by radioimmunoassay or chemiluminometric assay
Serum T4 and T3
59
ELISA
Serum T4 and T3
60
Current kits still are unable to accurately measure free T4 and T3
Serum T4 and T3
61
DIRECT TEST FOR BIOLOGICAL ACTIVE FORMS (FT3 AND FT4)
Direct Equilibrium Dialysis
62
More challenging method
DIRECT TEST FOR BIOLOGICAL ACTIVE FORMS (FT3 AND FT4)
63
T3 conc:
0.3
64
T4 conc:
0.03
65
Undiluted serum specimen are dialyzed for
16 to 18 hours at 37 deg. Celsius
66
Dialysate is analyzed using
RIA
67
DIRECT TEST FOR BIOLOGICAL ACTIVE FORMS (FT3 AND FT4) NV:
20-128 ng/ml
68
Synthesized and secreted exclusively by thyroid follicular cells
Thyroglobulin
69
Proof of residual thyroid tissue: benign or malignant
Thyroglobulin
70
Ideal tumor marker for thyroid cancer patients
Thyroglobulin
71
Should be undetectable after successful treatment
Thyroglobulin
72
Thyroglobulin Measured by :
radioimmunoassay, enzyme-linked immunoassay
73
Tests to detect antibodies to the
TSH receptor
Thyroid autoimmunity
74
TSAb, TSI
Thyroid autoimmunity
75
Thyroid stimulating antibody
Thyroid autoimmunity
76
TRAD, TSHR-Ab
Thyroid autoimmunity
77
TSH receptor antibody
Thyroid autoimmunity
78
OTHER TOOLS
1. Nuclear medicine evaluation
2. Thyroid ultrasound
3. Fine needle aspiration
79
Makes use of radioactive iodine
1. Nuclear medicine evaluation
80
Measured via X-ray
1. Nuclear medicine evaluation
81
Determines anatomy of the thyroid gland
2. Thyroid ultrasound
82
Detects small to medium-sized tumors
2. Thyroid ultrasound
83
Most accurate tool for thyroid nodules
3. Fine needle aspiration
84
Ultrasound
3. Fine needle aspiration
85
80% due to parathyroid adenoma (tumor; less common)
86
Seen in kidney and bone disease
Secondary Hyperparathyroidism
87
often asymptomatic
Primary Hyperparathyroidism
88
if symptomatic: hypercalcemia
Primary Hyperparathyroidism
89
Seen in chronic renal failure
Secondary Hyperparathyroidism
90
Due to vitamin D deficiency
Secondary Hyperparathyroidism
91
Due to injury of the PTG
Primary Hypoparathyroidism
92
Persistent hypocalcemia
Primary Hypoparathyroidism
93
Tetany and altered neuromuscular activity
Primary Hypoparathyroidism
94
Deficiency of blood calcium causes neurons and muscle fibers to depolarize and produce action potentials spontaneously
Primary Hypoparathyroidism
95
Primary Hypoparathyroidism End results:
-Twitches, spasms and tetany of skeletal muscle
96
Decreased Sodium and chloride
Hyperaldosteronism
97
Cortisol
Hyperaldosteronism
98
Urinary steroids
Hyperaldosteronism
99
Increased ACTH
Hyperaldosteronism
100
Hypernatremia
Hypoaldosteronism
101
Hypokalemia
Hypoaldosteronism
102
Hypertension
Hypoaldosteronism
103
Metabolic alkalosis
Hypoaldosteronism
104
Cushing’s syndrome
Hypercortisolism
105
Pituitary gland tumor
Hypercortisolism
106
Ectopic ACTH-secreting tumor
Hypercortisolism
107
Primary adrenal gland disease
Hypercortisolism
108
Familial Cushings disease
Hypercortisolism
109
Weight gain and fatty deposits
Hypercortisolism
110
Pink and purple stretch marks in the skin of the abdomen, thighs, brests and arm
Hypercortisolism
111
Slow healing cuts
Hypercortisolism
112
Thinning fragile skin that bruises easily
Hypercortisolism
113
Addison’s disease
Hypocortisolism
114
Darkening areas of skin (hyperpigmentation)
Hypocortisolism
115
Severe fatigue
Hypocortisolism
116
Unintentional weight loss
Hypocortisolism
117
Gastrointestinal problems, such as nausea, vomiting and abdominal pain
Hypocortisolism
118
Lightheadedness or fainting
Hypocortisolism
119
Salt cravings
Hypocortisolism
120
Muscle or joint pains
Hypocortisolism
121
Makes use of fasting plasma, and levels in pregnant patients are
three to four time higher
Aldosterone Assay
122
Urine sample is to be used must be collected for a 24 hour specimen in 10g boric acid to maintain pH <7.5
Aldosterone Assay
123
Exogenous steroid to suppress innate cortisol production
Dexamethasone Suppression
124
Measure cortisol
Dexamethasone Suppression
125
• Normal :
• Cushing's syndrome:
decreased cortisol (suppressed)
increased cortisol (not suppressed)
126
Tumor in adrenal medulla: excess epinephrine
Pheochromocytoma
127
Hypertension, headache
Pheochromocytoma
128
Increased heart rate
Pheochromocytoma
129
Malignant tumor of adrenal medulla seen in children which may lead to abdominal mass
Neuroblastoma
130
Methods for Cortisol determination
Makes use of
urine or plasma samples
131
is best for screening test of pheochromocytoma and urinary VMA and HVA
urinary metanephrine
132
cathecolamine release is intermitent
Methods for Cortisol determination
133
Appears before age 20
Diabetes Mellitus: Type 1
134
Autoimmune Disease - immune system destroys beta cells of pancreas
Diabetes Mellitus: Type 1
135
Treatment: Insulin injections
Diabetes Mellitus: Type 1
136
[?] of people with diabetes have type 2
85-90%
137
Develops after age
Diabetes Mellitus: Type 2
138
More common in overweight
Diabetes Mellitus: Type 2
139
Milder symptoms
Diabetes Mellitus: Type 2
140
Treatment: manage diet and exercise
Diabetes Mellitus: Type 2
141
Precocious puberty in girls
Increased Estrogen
142
Feminization in males
Increased Estrogen
143
Pregnancy
Increased Estrogen
144
Oral contraceptive use
Increased Estrogen
145
Polycystic ovary disease
Increased Estrogen
146
Free & bound fractions are measured
PLASMA ESTRADIOL
147
RIA commercial kits: I-labeled tracer for direct assay of estradiol
PLASMA ESTRADIOL
148
Principal route of excretion
URINE ESTRADIOL
149
Provides adequate info about endogenous prod'n
URINE ESTRADIOL
150
commonly associated Primary Hyperthyroidism
Grav’es disease
151
: cause of goiter
Autonomous production of multiple thyroid nodules (Plummer’s disease)
152
: overprod of TSH
Pituitary tumors
153
: inflammation of TG leading to release of stored TH
Subacute thyroiditis
154
: Autoimmune disease that leads to generalized over activity of the thyroid gland; commonly assoc disease to hyperthyroidism
Grave’s disease
155
: binds to and activated TSH receptors
Thyrotropin Receptor Antibodies (TRABS)
156
: Abs mimics the action of TSH
Thyroid Stimulating Immunoglobulins (TSIS)
157
Eye disease aka
Grave’s opthalmopathy/thyroid eye disease
158
Grave’s opthalmopathy/thyroid eye disease; associated w/
bulging of eyes, double vision, inflamed eye tissues
159
Skin disease aka
Grave’s dermopathy
160
- reddening patches in the skin
Grave’s dermopathy
161
: common manifestation; overstimulation due to two Abs; treatment: surgical
Goiter
162
: iatrogenic; ingestion excessive TH (supplement/injected)
Thyrotoxicosis factitia
163
: ingestion of iodized salt
Iodide ingestion in excess
164
: problem in APG/hypothalamus in TSH secretion
Over stimulation of the thyroid
165
: causes elevation of TSH
Carcinoma of the APG
166
: Autoimmune disorder in which the immune system creates antibodies that damage the thyroid gland; chronic
Hashimoto’s disease
167
: accumulation of fluid/edema
Puffy face
168
Enlargement of the tongue:
macroglossia
169
Serum T4 and T3 screening tests
Current kits still are unable to accurately measure free T4 and T3
170
(tumor; less common)
parathyroid adenoma
171
(absorption of Ca from intestines)
vitamin D deficiency
172
PTH (produced by the kidneys)
chronic renal failure
173
(benign tumor; elevated ACTH; overstimulated AG)
Pituitary gland tumor
174
(low metabolic rate)
Weight gain and fatty deposits
175
- most widely accepted principle for quantitative colorimetric determination of estrogens
Kober reaction
176
Kober reaction (+ result:)
pink
