[M6] Part 2: Thyroid & Parathyroid gland Flashcards by Marlo Roque

Butterfly-shaped glands found in the lower anterior neck

THYROID GLAND

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THYROID GLAND is a Butterfly-shaped glands found in the ____

lower anterior neck

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T/F: Thyroid gland is Bilobed

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thyroid tissue that connects the two lobes

Isthmus

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Thyroid gland functions:

Controls ____ and release of ____ from ____
Regulates ___ , ____ and ____
Acts on ___
Stimulates the ____
Physical ___ and ____
___ body temperature
____ consumption

-biosynthesis ; thyroid hormones ; thyroglobulin
-carbohydrates ; proteins ; lipid metabolism
-CNS
-heart
-growth ; development
-Basal
-Oxygen

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Thyroid gland acts on CNS by ____ and ____ of the ____

By maturation and development of the brain

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Thyroid gland Function:

Basal body temperature:
_____ TH = ____ body temperature

↑ TH = ↑ body temperature

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Thyroid gland Function:

Oxygen consumption
___ TH = ____ O2 demand

↑ TH = ↑ O2 demand

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The thyroid gland is composed of hollow spheres called ____

colloid follicles

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Colloid fills the ____

follicle cavities

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Follicle cells produce ___

thyroglobulin

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HISTOLOGY OF THYROID GLAND:

composed of Cuboidal cells called ___ or ____

Follicular cells ;
thyroid follicular cells

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Where T3 and T4 are produced/synthesized

follicular cells or thyroid follicular cells

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Arranged in spheres

follicular cells or thyroid follicular cells

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a gel-like matrix retained within the spherical structures of the follicular cells

Colloid

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found within the colloids

Thyroglobulin

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Major component of the colloid itself

Thyroglobulin

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Thyroglobulin has 2 ____

Has 2 tyrosine backbone

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Has 2 tyrosine backbone

Thyroglobulin

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Each tyrosine backbone has_____, therefore, each thyroglobulin has _____

1 iodine-binding site ;
2 iodine-binding sites

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Important substance in the synthesis of thyroid hormones

Thyroglobulin

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Produces calcitonin

Parafollicular C cells

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important element in the synthesis of thyroid hormones

Iodine

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Iodine deficiency =____

thyroid hormone deficient

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_____ = thyroid hormone deficient

Iodine deficiency

What are the 2 biologically active thyroid hormones:

T3, T4

What is T3

triiodothyronine

What is T4

tetraiodothyronine

More active thyroid hormones

T3 (triiodothyronine)

Not that biologically active thyroid hormones

T4 (tetraiodothyronine)

What are the 5 steps in Thyroid Hormone Synthesis

1. Iodide uptake 2. Iodide → iodine 3. Iodine uptake 4. Iodination of tyrosine (thyroglobulin) 5. Coupling of iodinated tyrosine

____ from ___ will enter the ____

Iodide diet follicular cells

Inside the ___, it will be ____ to form ____

follicular cells; oxidized ; iodine

Iodine in the ___ will attach to the ____ of the ____

colloid ; tyrosine backbone; thyroglobulin

For each ____, pwedeng ____ ang mag attach pero ____ all the time

thyroglobulin; 2 iodine; not

1 iodine attached

Monoiodothyronine (MIT)

2 iodine attached

Diiodothyronine (DIT)

Coupling reaction: DIT + MIT = ____

triiodothyronine

____ + ___ = triiodothyronine

DIT MIT

Coupling reaction: DIT + DIT = ____

tetraiodothyronine

____+ ____= tetraiodothyronine

DIT DIT

For T4 to be biologically active, ____ should be ____ (para maging T3)

1 iodine; removed

removal of iodine by the enzyme_____

Deiodination monodeiodinase

more specific term since 1 iodine lang ang tinatanggal

Monodeiodination

Pag nagtanggal ng iodine, dapat yung nasa ____ ang tatanggalin

outer ring

Pag yung nasa ___ ang natanggal, the T4 will become ___ or ____ which is ____

inner ring; rT3; reverse T3; biologically inactive

The REGULATION OF THYROID GLAND follows the ___

hypothalamic-pituitary-thyroidal axis

hypothalamic-pituitary-thyroidal axis: 1. The hypothalamus secretes the ____

thyrotropin releasing hormone (TRH)

hypothalamic-pituitary-thyroidal axis: 2. TRH stimulates the___ to secrete ____

pituitary gland; thyroid-stimulating hormones (TSH)

hypothalamic-pituitary-thyroidal axis: 3. TSH stimulates the ___ to produce ____ (___ , ____)

thyroid gland; thyroid hormones; T3, T4

hypothalamic-pituitary-thyroidal axis: 3. TSH stimulates the ___ to produce ____ (___ , ____)

thyroid gland; thyroid hormones; T3, T4

hypothalamic-pituitary-thyroidal axis: 4. ___ and ___ will then act on its ____ which contain the ____ specific to them

T3 ; T4 ; peripheral tissues; receptors

hypothalamic-pituitary-thyroidal axis: 5. If enough ___ and ____ are produced, the ____ will send signals to the ____ to stop production of ____, hence, the ____ will no longer produce ____, hence, no hormone will stimulate the____ to secrete ___ and ___

T3; T4 ; thyroid gland; hypothalamus ; TRH; pituitary gland; TSH; thyroid gland; T3; T4

hypothalamic-pituitary-thyroidal axis: 6. On the other hand, when T3 and T4 levels are ___, the thyroid gland will send signals to the ___ to secrete ___

low; hypothalamus; TRH

3 classifications of thyroid hormone disorders

Primary ; Secondary; Tertiary

the affected gland is the thyroid gland

Primary

Primary Hypothyroidism

↓ T3, T4

Primary Hyperthyroidism

↑ T3, T4

the problem is the pituitary gland

Secondary

Secondary Hypothyroidism

↓ TSH, T3, T4

Secondary Hyperthyroidism

↑ TSH, T3, T4

the problem is the hypothalamus

Tertiary

Tertiary Hypothyroidism

↓ TRH, TSH, T3, T4

Tertiary Hyperthyroidism

↑ TRH, TSH, T3, T4

What are the 2 Major Thyroid Hormones

Triiodothyronine (T3) Tetraiodothyronine (T4)

Triiodothyronine (T3) is Chemically known as ___

3, 5, 3’-triiodothyronine

With Most active hormonal activity

Triiodothyronine (T3)

More biologically active than T4

Triiodothyronine (T3)

Metabolic rate of every cell of the body

Triiodothyronine (T3)

Encourages cellular differentiation

Triiodothyronine (T3)

Tissue growth and development

Triiodothyronine (T3)

Triiodothyronine (T3) ____ oxygen consumption

Increased

Increased oxygen consumption

Triiodothyronine (T3)

Calorie and Vitamin/Mineral metabolism

Triiodothyronine (T3)

Triiodothyronine (T3) is an indicator of ___

hyperthyroidism recovery

Involved in brain maturation

Triiodothyronine (T3)

It can cause increase in heat production

Triiodothyronine (T3)

Accounts for 20% of the total thyroid hormone synthesized

Triiodothyronine (T3)

Triiodothyronine (T3) Accounts for ____ of the ____ synthesized

20%; total thyroid hormone

Triiodothyronine (T3) Reference Ranges: ADULT: ___

60 – 160 μg/dL

Triiodothyronine (T3) Reference Ranges: Children (1-14 y.o): ___

105 – 245 ng/dL

Mas mataas ang reference range ng T3 sa mga bata kasi involved sila sa ____ and ___

tissue growth and development

Tetraiodothyronine (T4) is Chemically known as ___

3, 5, 3’, 5’-tetraiodothyronine

Also known as thyroxine

Tetraiodothyronine (T4)

Tetraiodothyronine (T4) is AKA

thyroxine

Pre-hormone for T3

Tetraiodothyronine (T4)

_____ level of Tetraiodothyronine (T4) will inhibit ____, ___ level will stimulate ____

Increased ; TSH production decreased ; TSH production

Tetraiodothyronine (T4) Accounts for ____ of the ____ synthesized

80% ; total thyroid hormone

Accounts for 80% of the total thyroid hormone synthesized

Tetraiodothyronine (T4)

Tetraiodothyronine (T4) Reference Ranges: Adult:_____

5.5 – 12.5 μg/dL

Tetraiodothyronine (T4) Reference Ranges: Neonates:_____

11.8 – 22.6 ng/dL

T/F: Thyroid hormones may be bound or free

Thyroid hormones may be ____ or ____

bound ; free

How many % of thyroid hormones are protein bound

99.9%

How many % of T4 is unbound/free (FT4)

0.04%

How many % of T3 is unbound/free (FT3)

0.4%

WHAT ARE THE 3 THYROID BINDING PROTEINS

Thyroxine Binding Globulin (TBG) Thyroxine Binding Prealbumin Albumin

Major transporter for T3

Thyroxine Binding Globulin

Also binds 70% to 75% of T4

Thyroxine Binding Globulin

Thyroxine Binding Globulin Also binds ___ to ____ of ____

70% 75% T4

Binds 15% to 20% of T4

Thyroxine Binding Prealbumin

Thyroxine Binding Prealbumin Binds ___ to ____ of ____

15% 20% T4

Transport protein for T3

Albumin

Binds 10% of T4

Albumin

Albumin Binds ___ of ____

10% T4

T/F: Only free thyroid hormones are biologically active

Only ___ thyroid hormones are biologically active

free

Binding of thyroid hormones to binding proteins is affected by _____ Example: ____ estrogen = ____ thyroid-binding proteins = ____concentration of bound thyroid hormones

several factors; ↑ estrogen = ↑ thyroid-binding proteins = ↑ concentration of bound thyroid hormones

Kapag ang pinapatest ng patient is T3 and T4, it refers to the ____ of T3 and T4

total population

T/F: There is a separate test for FT3 and FT4 which measures free T3 and T4

There is a separate test for FT3 and FT4 which measures _____

free T3 and T4

What are the 11 Laboratory Analysis in Thyroid Gland

1. Thyroid Stimulating Hormone (TSH) 2. Serum T3 And T4 3. Thyrotropin-Releasing Hormone (TRH) 4. Thyroglobulin 5. T3 Resin Uptake 6. Free Thyroxine Index (FT4I) 7. Thyroid Antibody Screen 8. TRH Stimulation Test 9. Radioactive Iodine Uptake (RAIU) 10. Thyroid Ultrasound 11. Thyroid Needle Biopsy

Also known as thyrotropin

Thyroid Stimulating Hormone (TSH)

Thyroid Stimulating Hormone (TSH) is AKA

thyrotropin

Most useful test for assessing thyroid function

Thyroid Stimulating Hormone (TSH)

Used to differentiate primary hypothyroidism from secondary hypothyroidism

Thyroid Stimulating Hormone (TSH)

Thyroid Stimulating Hormone (TSH) is used to differentiate ____ from ____

primary hypothyroidism secondary hypothyroidism

Primary hypothyroidism TSH LEVEL ___

N – ↑

Primary hypothyroidism T3 and T4 LEVEL ___

↓

Secondary hypothyroidism TSH LEVEL ___

↓

Secondary hypothyroidism T3 and T4 LEVELS ___

↓

Used to monitor and adjust thyroid hormone replacement therapy

Thyroid Stimulating Hormone (TSH)

3 Generation Test in Thyroid Stimulating Hormone (TSH)

Second Generation Third Generation Fourth generation

0.1 mU/L detection limit

Second Generation

Second Generation: ____

0.1 mU/L detection limit

0.01 mU/L detection limit

Third Generation:

Third Generation: _____

0.01 mU/L detection limit

More sensitive generation test

Third Generation:

Generation test that Monitor and adjust thyroid hormone therapy

Third Generation

for research purposes only, not used for diagnosis

Fourth generation

Serum T3 And T4 measures: ________ _________

Total T3 and T4 Free T3 and T4 (FT3, FT4)

Serum T3 And T4 methods: (3)

Radioimmunoassay Chemiluminometric assay Immunometric technique

Measures relationship between TSH and TRH secretions

Thyrotropin-Releasing Hormone (TRH)

Thyrotropin-Releasing Hormone (TRH) Measures relationship between ____ and ____ secretions

TSH TRH

Used to confirm euthyroid Grave’s disease

Thyrotropin-Releasing Hormone (TRH)

Thyrotropin-Releasing Hormone (TRH) is used t o confirm ____

euthyroid Grave’s disease

euthyroid Grave’s disease is a type of __ (hypothyroidism/hyperthyroidism)

hyperthyroidism

Thyrotropin-Releasing Hormone (TRH) is INCREASED in ___

primary hypothyroidism

Thyrotropin-Releasing Hormone (TRH) is DECREASED in ___

hyperthyroidism

Glycoprotein synthesized and secreted only by the thyroid follicular cells

Thyroglobulin

Proof of presence of thyroid tissues

Thyroglobulin

Ideal tumor marker for thyroid cancer patients

Thyroglobulin

Post-operative marker of thyroid cancer

Thyroglobulin

Thyroglobulin Method: ____

Immunoassays

Analyzes the capacity of TBG to bind thyroid hormones

T3 Resin Uptake

Indirect measurement of the number of free binding sites on the TBG molecules

T3 Resin Uptake

Measures the remaining binding sites

T3 Resin Uptake

T3 Resin Uptake: ↑ thyroid-binding sites = ____ thyroid hormones

↓

T3 Resin Uptake: ↓ thyroid-binding sites = ____ thyroid hormones

↑

Indirectly assesses the concentration of circulating FT4

Free Thyroxine Index (FT4I)

FT4I = ____ x ___

total T4; T3 resin uptake

Thyroid Antibody Screen T/F: There are thyroid disorders that are autoimmune

Thyroid Antibody Screen There are thyroid disorders that are _____

autoimmune

the immune system attacks the body because of the presence of autoantibodies

Autoimmune

Thyroid Antibody Screen: Naturally or physiologically, antibodies must only attack ____, _____ should not be attacked

foreign substances; self-antigens

antibodies directed against self-antigens are produced

Autoimmunity

* TSH receptor antibody * Antithyroglobulin * Thyroid peroxidase antibody are all under what lab analysis?

THYROID ANTIBODY SCREEN

TSH receptor antibody OR __

anti-TSH receptor

TSH receptor antibody is Associated with ____

Grave’s disease

Associated with Grave’s disease

TSH receptor antibody

Associated with some, if not all, autoimmune hypothyroidism

Antithyroglobulin

Antithyroglobulin is Associated with some, if not all, ____

autoimmune hypothyroidism

Thyroid peroxidase antibody OR __

anti-TPO

Associated with Hashimoto’s thyroiditis

Thyroid peroxidase antibody

Thyroid peroxidase antibody is associated with ___

Hashimoto’s thyroiditis

Measures pituitary TSH stores

TRH Stimulation Test

Considered conclusive for hyperthyroidism

TRH Stimulation Test

TRH Stimulation Test Considered conclusive for hyperthyroidism where: Inject ____ TRH ____ After administration, ____ is collected (___is measured)

500 μg ; intravenously blood sample ; TSH

TRH Stimulation Test: NORMAL: ___

↑ TSH

In TRH Stimulation Test, ↑ TSH is ___

NORMAL

TRH Stimulation Test: no rise in TSH before and after administration of TRH indicates ___

Hyperthyroidism

Measures the ability of thyroid gland to trap iodine

Radioactive Iodine Uptake (RAIU)

RAIU

Radioactive Iodine Uptake

Radioactive Iodine Uptake (RAIU): High uptake: _____

metabolically active gland

↑ RAIU + undetectable TSH =________

autonomous thyroid gland activity

Radioactive Iodine Uptake (RAIU): Low uptake: _____

metabolically inactive gland

Radioactive Iodine Uptake (RAIU): Hot nodules: _____

high RAIU;

Radioactive Iodine Uptake (RAIU): Cold/Indeterminate: _____

low to no RAIU

Less likely to be cancerous nodules

Hot nodules:

Tends to be cancerous nodules

Cold/Indeterminate:

Assessment of thyroid anatomy

Thyroid Ultrasound

Characterization of palpable abnormalities

Thyroid Ultrasound

Normally, a healthy individual may have a thyroid nodule as small as ____

<1 cm

Through fine needle aspiration biopsy (FNAB)

Thyroid Needle Biopsy

Most accurate tool in thyroid nodule evaluation

Thyroid Needle Biopsy

Identification and treatment of thyroid malignancy

Thyroid Needle Biopsy

1st test to be performed for evaluating thyroid abnormalities

Thyroid Needle Biopsy

Pwedeng through palpation of nodule or assisted by ultrasound

Thyroid Needle Biopsy

What are the two types of thyroid disorders

Hypothyroidism Hyperthyroidism

Thyroid hormone deficiency

HYPOTHYROIDISM

Hypothyroidism is categorized as ____

Categorized as primary, secondary or tertiary

HYPOTHYROIDISM Usually referring to __

primary hypothyroidism

Inability to provide thyroid hormones for the metabolic needs of the cells

HYPOTHYROIDISM

HYPOTHYROIDISM Inability to provide ______ for the metabolic needs of the cells

thyroid hormones

HYPOTHYROIDISM Symptoms

o Thyroid gland enlargement o Fatigue o Impairment of mental process o Loss of appetite o Myxedema o Cold intolerance o Weight gain

HYPOTHYROIDISM (SYMPTOMS) Thyroid gland enlargement is a.k.a

goiter

HYPOTHYROIDISM (SYMPTOMS) TSH stimulates cell growth

Thyroid gland enlargement (goiter)

HYPOTHYROIDISM (SYMPTOMS) Thyroid gland enlargement (goiter) example

primary hypothyroidism

HYPOTHYROIDISM (SYMPTOMS) Thyroid gland enlargement (goiter) When __ and __ levels are (high/low), the thyroid gland will send signals to the _______ to produce ____ which will stimulate the _______ to produce TSH

T3 and T4 low hypothalamus TRH pituitary gland

HYPOTHYROIDISM (SYMPTOMS) Low cardiac output

Myxedema

HYPOTHYROIDISM Inadequate secretion of thyroid hormones by thyroid gland

Primary Hypothyroidism

Primary Hypothyroidism Causes

Lack of dietary iodine Thyroid tissue destruction Autoantibodies

Primary Hypothyroidism (Laboratory Results) Decreased:

T3, T4, FT3, FT4, FT4I, T3 uptake

Primary Hypothyroidism (Laboratory Results) Increased:

TSH, TRH

Diseases associated with Primary Hypothyroidism

Hashimoto’s Thyroiditis Congenital Hypothyroidism Myxedema

Also known as chronic lymphocytic thyroiditis

Hashimoto’s Thyroiditis

Hashimoto’s Thyroiditis a.k.a

Chronic lymphocytic thyroiditis

Involves massive infiltration of thyroid gland by lymphocytes

Chronic lymphocytic thyroiditis

Chronic lymphocytic thyroiditis Involves massive infiltration of thyroid gland by ______

lymphocytes

Most common form of primary hypothyroidism

Hashimoto’s Thyroiditis

Autoantibodies bind to cell membrane causing cell lysis and inflammatory reactions

Hashimoto’s Thyroiditis

Hashimoto’s Thyroiditis Autoantibodies bind to ____ causing _____ and ________

cell membrane cell lysis inflammatory reactions

Goiter

Hashimoto’s Thyroiditis

Hashimoto’s Thyroiditis (Laboratory Results) Decreased

T3, T4, FT3, FT4, FT4I, T3 uptake

Hashimoto’s Thyroiditis (Laboratory Results) Increased

TSH, TRH

Hashimoto’s Thyroiditis (Laboratory Results) ______ positive

Anti-TPO

Also known as cretinism

Congenital Hypothyroidism

a.k.a cretinism

Congenital Hypothyroidism

Defect in the development or function of the gland

Congenital Hypothyroidism

Occurs at birth

Congenital Hypothyroidism

If left untreated within 3 months, there will be irreversible neurologic and mental deficiency

Congenital Hypothyroidism

Congenital Hypothyroidism If left untreated within ____, there will be irreversible ________ and _______ deficiency

3 months Neurologic Mental

Involved in the newborn screening in the US

Congenital Hypothyroidism

Congenital Hypothyroidism Symptoms

Retarded physical and mental development

One of the features of patients with cretinism is ___

dwarfism

Congenital Hypothyroidism (Laboratory Results) Decreased

T3, T4

Congenital Hypothyroidism (Laboratory Results) increased

TSH

Peculiar non pitting swelling of the skin

Myxedema

severe form of Hypothyroidism

Myxedema coma

Myxedema Clinical features

Puffy face Weight gain Slow speech Eyebrows thinned Dry and yellow skin Anemia

involves decrease in production of TSH leading to low serum levels of thyroid hormones

Secondary Hypothyroidism

Secondary Hypothyroidism involves decrease in production of ___ leading to low serum levels of ____

TSH thyroid hormones

Secondary Hypothyroidism (Laboratory Results) Decreased

T3, T4, FT3, FT4, FT4I, T3 uptake, TSH

Secondary Hypothyroidism (Laboratory Results) Increased

TRH

Lack of TRH production caused by hypothalamic failure

Tertiary Hypothyroidism

Tertiary Hypothyroidism Lack of TRH production caused by _____ failure

hypothalamic

Tertiary Hypothyroidism (Laboratory Results) Decreased

ALL (T3, T4, FT3, FT4, FT4I, T3 uptake, TSH, TRH )

Patients are asymptomatic

Subclinical Hypothyroidism

Subclinical Hypothyroidism Normal

FT3, FT4

Subclinical Hypothyroidism Slightly increased

TSH

Also known as thyrotoxicosis

HYPERTHYROIDISM

HYPERTHYROIDISM a.k.a

thyrotoxicosis

T/F: Increase in thyroid hormone is not toxic to all cells

F; TOXIC to all cells

Caused by excessive thyroid hormone in the circulation

HYPERTHYROIDISM

Causes the cells to be overactive

HYPERTHYROIDISM

HYPERTHYROIDISM Causes the cells to be ___

overactive

HYPERTHYROIDISM Symptoms

o Weight loss o Loss of muscle mass o Hyperactivity yet quick fatigability o Insomnia o Increased sweating o Nervousness o Palpitations o Goiter o Exophthalmia

HYPERTHYROIDISM (Symptoms) Due to increased O2 demand

Hyperactivity yet quick fatigability

HYPERTHYROIDISM (Symptoms) Due ↑ body temperature

Increased sweating

HYPERTHYROIDISM (Symptoms) Due ↑ cardiac output

Palpitations

HYPERTHYROIDISM (Symptoms) Due to ↑ in thyroid hormones

Goiter

HYPERTHYROIDISM (Symptoms) Bulging of the eyes

Exophthalmia

a condition wherein patients have very high thyroid hormone levels which could lead to stroke due to increased CNS output, body temperature, and cardiac output

Thyroid storm

Thyroid storm a condition wherein patients have very (high/low) thyroid hormone levels which could lead to ____ due to increased ______, _____, and _____

high stroke CNS output body temperature cardiac output

Group of syndromes caused by high levels of free thyroid hormones in the circulation

Thyrotoxicosis

Thyrotoxicosis Group of syndromes caused by high levels of (bound/free) thyroid hormones in the circulation

free

T3 Thyrotoxicosis a.k.a

Plummer's disease

T3 Thyrotoxicosis FT3: FT4: TSH:

FT3: ↑ FT4: N TSH: ↓

T4 Thyrotoxicosis FT3: FT4: TSH:

FT3: N to low FT4: ↑ TSH: ↓

Diseases associated with Hyperthyroidism

Grave’s Disease Reidel’s Thyroiditis Subclinical Hyperthyroidism De Quervain Thyroiditis

Grave's dx Clinical features

Exophthalmos Pretibial myxedema

Grave's dx (Laboratory Results) Increased

T3, T4, FT4I, T3 uptake

Grave's dx (Laboratory Results) Normal or Decreased

TSH

Grave's dx (Laboratory Results) _______ positive

Anti-TSH receptor

HYPERTHYROIDISM Autoimmune disorder

Grave’s Disease

Grave’s Disease Occurs ____ more in women than in men

5% – 6%

Thyroid turns into woody or stony-hard mass

Reidel’s Thyroiditis

Reidel’s Thyroiditis Thyroid turns into ___ or ___ mass

woody stony-hard

Calcification of the thyroid gland

Reidel’s Thyroiditis

HYPERTHYROIDISM No clinical symptoms

Subclinical Hyperthyroidism

Subclinical Hyperthyroidism (Laboratory Results) Normal

FT3, FT4

Subclinical Hyperthyroidism (Laboratory Results) Decreased

TSH

De Quervain Thyroiditis a.k.a

Subacute granulomatous thyroiditis Subacute nonsuppurative thyroiditis

Painful inflammation of the thyroid gland associated with Increased ESR and Thyroglobulin

De Quervain Thyroiditis

De Quervain Thyroiditis Painful inflammation of the thyroid gland associated with Increased ___ and _____

ESR Thyroglobulin

De Quervain Thyroiditis ____ negative

Anti-TPO

Produced by the parafollicular C cells

CALCITONIN

CALCITONIN Produced by the _______

parafollicular C cells

Participated in calcium homeostasis by responding to hypercalcemia

CALCITONIN

CALCITONIN Participated in _______ by responding to _______

calcium homeostasis hypercalcemia

Hypocalcemic agent:

CALCITONIN

Calcitonin is a hypocalcemic agent because: it stimulates _______ of Calcium

renal excretion

Calcitonin is a hypocalcemic agent because: Depresses release of Calcium from the bone (________)

bone resorption

Calcitonin is a hypocalcemic agent because: Inhibits bone-dissolving activity of ______

osteoclasts

Osteoclasts are ______

bone macrophage

Calcitonin is a hypocalcemic agent because: Indirectly regulates _______ by stimulating ________

phosphorus renal reabsorption

The renal reabsorption of phosphorus leads to (inc/dec) in phosphorus

↑ phosphorous

CALCITONIN (Laboratory Analyses) Methods

Serum Calcitonin Pentagastrin Stimulation Test

CALCITONIN (Laboratory Analyses) Marker for medullary thyroid carcinoma (MTC)

Serum Calcitonin

CALCITONIN (Laboratory Analyses) Serum Calcitonin is a marker for ________

medullary thyroid carcinoma (MTC)

CALCITONIN (Laboratory Analyses) Measured before and 6 months after thyroid surgery

Serum Calcitonin

CALCITONIN (Laboratory Analyses) Serum Calcitonin is measure before and ______ after thyroid surgery

6 months

CALCITONIN (Laboratory Analyses) Used for the diagnosis of medullary thyroid carcinoma

Pentagastrin Stimulation Test

CALCITONIN (Laboratory Analyses) Pentagastrin Stimulation Test is used fore the diagnosis of ______

medullary thyroid carcinoma (MTC)

Located bilaterally in the posterior side of the thyroid gland

PARATHYROID GLAND

PARATHYROID GLAND Located ____ in the _____ side of the thyroid gland

bilaterally posterior

PARATHYROID GLAND Most individuals have ___ parathyroid glands

PARATHYROID GLAND Most individuals have 4 parathyroid glands, some may only have ___, some have ___

2 8

Because of its location, it is the smallest endocrine gland

PARATHYROID GLAND

What is the only hormone Parathyroid gland secrete?

Parathyroid hormone (PTH)

Regulates Blood Calcium

PARATHYROID HORMONE

PARATHYROID HORMONE Regulates ___

Blood Calcium

Involved in the metabolism of both calcium and phosphorus by the kidney and bone

PARATHYROID HORMONE

PARATHYROID HORMONE Involved in the metabolism of both ___ and ____ by the kidney and bone

calcium phosphorus

PARATHYROID HORMONE Involved in the metabolism of both calcium and phosphorus by the ___ and ____

kidney bone

Stimulates conversion of Vitamin D to activated Vitamin D3

PARATHYROID HORMONE

PARATHYROID HORMONE Stimulates conversion of ____to _____

Vitamin D activated Vitamin D3

PARATHYROID HORMONE Increases bone resorption of calcium into plasma by stimulating osteoclast

In bone

PARATHYROID HORMONE (In Bone) Increases ____ of calcium into plasma by stimulating _______

bone resorption osteoclast

PARATHYROID HORMONE Increases renal reabsorption of calcium

In the Kidney

Hypercalcemic, hypophosphatemic agent

PARATHYROID HORMONE

Can regulate calcium and phosphorus within the normal range

PARATHYROID HORMONE

____ will be produced kapag may konting change sa _____ and _______ concentrations

PTH calcium phosphorus concentrations

PARATHYROID HORMONE Regulation

free-standing varied input modulation

PARATHYROID HORMONE T/F: Regulation is influenced by the concentration

Laboratory Analyses of PTH Enumerate

PTH C-Terminal Analysis PTH N-Terminal Analysis

Laboratory Analyses of PTH Examines intact PTH molecule

PTH C-Terminal Analysis

PTH C-Terminal Analysis Examines __________ molecule

intact PTH molecule

Laboratory Analyses of PTH Specific for detecting hyperparathyroidism

PTH C-Terminal Analysis

PTH C-Terminal Analysis Specific for detecting ______

hyperparathyroidism

Laboratory Analyses of PTH Measured both the whole PTH molecule and the amino-terminal fragments in the serum

PTH N-Terminal Analysis

PTH N-Terminal Analysis Measured both the _____ molecule and the ___________ in the serum

whole PTH amino-terminal fragments

Inability to maintain Calcium in blood without calcium supplementation

HYPOPARATHYROIDISM

Decreased PTH secretion

HYPOPARATHYROIDISM

Usually, it is due to post-surgical cases

HYPOPARATHYROIDISM

HYPOPARATHYROIDISM Usually, it is due to _____

post-surgical cases

↑ PTH = ↓ TH = ↓ calcium

HYPOPARATHYROIDISM

HYPOPARATHYROIDISM ↑ PTH = ↓ TH = (inc/dec) calcium

↓ calcium

Feature of HYPOPARATHYROIDISM

Tetany

HYPOPARATHYROIDISM Tetany signs

Chvostek’s sign Trousseau’s sign

HYPOPARATHYROIDISM (Tetany signs) facial cramps/contraction

Chvostek’s sign

HYPOPARATHYROIDISM (Tetany signs) carpal spasm

Trousseau’s sign

HYPOPARATHYROIDISM Causes

Accidental injury to the parathyroid gland Autoimmune parathyroid destruction

3 classifications of HYPOPARATHYROIDISM

1. Primary Hypoparathyroidism 2. Idiopathic Hypoparathyroidism 3. Pseudohypoparathyroidism

HYPOPARATHYROIDISM Problem with the parathyroid gland

Primary Hypoparathyroidism

HYPOPARATHYROIDISM ↓ PTH

Primary Hypoparathyroidism Pseudohypoparathyroidism

HYPOPARATHYROIDISM Unknown cause

Idiopathic Hypoparathyroidism

HYPOPARATHYROIDISM Unknown cause

Idiopathic Hypoparathyroidism

HYPOPARATHYROIDISM ↓ serum calcium, ↑ phosphorous

Idiopathic Hypoparathyroidism

HYPOPARATHYROIDISM lack of responsiveness of the parathyroid hormone by the renal system

Pseudohypoparathyroidism

HYPOPARATHYROIDISM The kidneys do not respond to the parathyroid hormones

Pseudohypoparathyroidism

Classifications of Hyperparathyroidism

1. Primary Hyperparathyroidism 2. Secondary Hyperparathyroidism 3. Tertiary Hyperparathyroidism

HYPERPARATHYROIDISM Most common cause of hypercalcemia

Primary Hyperparathyroidism

HYPERPARATHYROIDISM Due to parathyroid adenoma

Primary Hyperparathyroidism

Primary Hyperparathyroidism Due to ____

parathyroid adenoma

Primary Hyperparathyroidism (Laboratory Results) Increased

PTH, ionized calcium

HYPERPARATHYROIDISM Develops in response to hypocalcemia

Secondary Hyperparathyroidism

Secondary Hyperparathyroidism Causes

Vitamin D deficiency, Chronic renal failure

Secondary Hyperparathyroidism Increased

PTH

Secondary Hyperparathyroidism Decreased

Ionized calcium

HYPERPARATHYROIDISM Occurs with secondary hyperthyroidism

Tertiary Hyperparathyroidism

Tertiary Hyperparathyroidism Occurs with ______

secondary hyperthyroidism

HYPERPARATHYROIDISM Phosphates level are normal to high

Tertiary Hyperparathyroidism

HYPERPARATHYROIDISM Calcium phosphates precipitate in soft tissues.

Tertiary Hyperparathyroidism

Tertiary Hyperparathyroidism Calcium phosphates precipitate in ____

soft tissues.

HYPERPARATHYROIDISM Primary, secondary, and tertiary hyperparathyroidism is accompanied by _______

phosphaturia

presence of phosphates in the urine

Phosphaturia

[M6] Part 2: Thyroid & Parathyroid gland Flashcards

(357 cards)