MET EOYS5 Flashcards by patrick ellis

How would hypothyrodism present with regards to T3/T4 and TSH levels? [2]
How would hyperthyrodism present with regards to T3/T4 and TSH levels? [2]

Hypothyroidism:
* Low T3/T4
* Low TSH

Hyperthyroidism
* High T3/T4
* Low TSH

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Which of the following would you use to treat hypothyroidism?

Propylthiouracil
Levothyroxine
Iodine 131
Carbimazole
Iodine 123

Which of the following would you use to treat hypothyroidism?

Propylthiouracil
Levothyroxine
Iodine 131
Carbimazole
Iodine 123

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Which of the following would you use to diagnose a toxic adenoma ?

Propylthiouracil
Levothyroxine
Iodine 131
Carbimazole
Iodine 123

Which of the following would you use to diagnose a toxic adenoma ?

Propylthiouracil
Levothyroxine
Iodine 131 - used to treat
Carbimazole
Iodine 123

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Which of the following is the remnant of the umbilical vein?

A
B
C
D

Which of the following is the remnant of the umbilical vein?

A
B
C
D - ligament teres

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Which of the following deiodinase enzymes makes more inactive from of thyroid hormone?

D1
D2
D3
D4

Which of the following deiodinase enzymes makes more inactive from of thyroid hormone?

D1 & D2 convert T4 to T3 and cause activation
D3 : ** **
D4

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Pendred syndrome is a cause of hypothyroidism due to lack of which channel? [1]

PDS (pendred syndome - PDS)

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What is the name for naturally form of active thyroid hormone?

Levothyroxine
Liothyronine
Thyrotrophin
Thyroxine

What is the name for naturally form of active thyroid hormone?

Levothyroxine
Liothyronine: T3
Thyrotrophin
Thyroxine

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Which sign of ascites is present in this CT

Ascites
Caput medusae
Oesophageal varices
Spider naevi

Which sign of ascites is present in this CT

Ascites
Caput medusae
Oesophageal varices
Spider naevi

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Which of the following occurs in graves disease

Increased insulin turnover; increased gluconeogenesis; increased insulin secretion
Increased insulin turnover; decreased gluconeogenesis; increased insulin secretion
Decreased insulin turnover; decreased gluconeogenesis; increased insulin secretion
Increased insulin turnover; increased gluconeogenesis; decreased insulin secretion

Which of the following occurs in graves disease

Increased insulin turnover; increased gluconeogenesis; increased insulin secretion
Increased insulin turnover; decreased gluconeogenesis; increased insulin secretion
Decreased insulin turnover; decreased gluconeogenesis; increased insulin secretion
Increased insulin turnover; increased gluconeogenesis; decreased insulin secretion

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Which of the following can Graves Disease lead to?

Osteoarthritis
Osteomalacia
Osteoporosis
Pagets Disease

Which of the following can Graves Disease lead to?

Osteoarthritis
Osteomalacia
Osteoporosis
Pagets Disease

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Which of the following types of anaemia is associated with Graves Disease?

IDA
B12 deficiency
Thalassemia
Haemolytic

Which of the following types of anaemia is associated with Graves Disease?

IDA
B12 deficiency / pernicious
Thalassemia
Haemolytic

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Label A-C

A: Ligamentum venosum
B: Falciform ligament
C: Round ligament of the liver/ Ligamentum teres

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Explain mech. of portal htn causing ascites

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Why does jaundice occur if gall stone occurs in common bile duct?

Stone blocks bile leaving the gall bladder and the Liver.

So bilirubin in bile is not able to be broken down

accumulates in blood causing jaundice and biliary colic.

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What symptoms would occur here? [3]

biliary colic, jaundice and pancreatitis

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Portosystemic Anastomoses at the Esophagus is made from? [2]

splenic (HPV) and azygous veins (IVC)

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Caput meduase is caused by htn in anastomoses in which two veins?

Paraumbilical veins (ligamentum teres recanalised)

Intercostal and inferior epigastric veins

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Label A-F

A: splenic artery
B: gastroduodenal artery
C: hepatic artery proper
D: SMA
E: SMV
F: Hepatic portal vein

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Label A-C

A: Coronary Ligament
B: Right Triangular Ligament
C: Left triangular Ligament

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What is the chemical name for active form of thyroid hormone?

What is the chemical name for inactive form of thyroid hormone?

Study These Flashcards

Liothyronine (T3)
Thyroxine (T4)

Branchial pouch embryology:

Pouch = endodermal outpouching of pharynx

Which pouch made the inferior parathryoid and thymus? [1]
Which pouch made the superior parathryoid and ultimobranchial body? [1]

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Pouch 3 - inferior parathyroid and thymus
Pouch 4 - superior parathyroid and ultimobranchial body
Ultimobranchial body - C-cells

Where does the thryoid originate? [1]

What duct does it move down to get to perm position? [1]

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Thyroid originates from foramen cecum

Travels along thyroglossal duct. to cricoid cartilage

Normally thyroglossal duct disappears but in some it can remain: contains thyroid tissue

How is T3 transported around the body? [3]

Study These Flashcards

Predominately via Thyroid Binding Globulin

Also by albumin and transthyretin

Why are pregnant people in a hypothryoid state?

Study These Flashcards

In pregnancy: the level of oestrogen increases: increases sialylation of TBG (increases the half life) so it is cleared slowly from plasma: less free thyroid hormone

T4 -> T3 (activation) of free TH: What are the effect of Deiodinase enzymes: D1 & D2? [1] D3 [1] Why is this important?

D1 & 2: convert **T4 -> T3 - activation** D3: D3 -> **inactivates** **T4 to rT3** Important because **another level of control** - expression of deiodonase enzymes: these enzymes will be up/down regulated at certain times to increase/decrease metabolism.

Hyperthyroidism: [] insulin turnover [] gluconeogenesis [] insulin secretion

**Increased** insulin turnover **Increased** gluconeogenesis **Reduced** insulin secretion

Hyperthyroidism: Effect on Nervous System? [3] Effect on skin [3] Effect on eyes? [1]

Hyperthyroidism: **Effect on Nervous System? [3]** * Increased risk of seizures * Nervousness/tremor. * Hyperphagia - increased hunger **Effect on skin [3]** * Warm and moist - due to vasodilation + heat loss. * 'Plumber's' nails. Or soft and crumbling nails - **acropachy** * Pretibial myxoedema inflammation over the tibia. **Effect on eyes? [1]** * Eyelid retraction and eyelid drag.

Hyperthyroidism Effect on GI tract? [4] Effect on bones? [3] Haematological effect [2] Effect on reproductive system [3]

Hyperthyroidism **Effect on GI tract? [4]** * Increased appetite * Weight loss * Increased gut motility * Increased liver enzymes - transaminitis. **Effect on bones? [3]** * * Accelerated osteoclast activity - to provide substrates for metabolism. * Hypercalcemia * **Osteoporosis** - in the long term. **Haematological effect [2]** * Pernicious anaemia - coincidental, autoimmune. * **B12 deficiency** **Effect on reproductive system [2]** * Periods stop (oligomenorrhoea) * Gynecomastia (man boobs) * Erectile dysfunction.

What are 3 risk factors for graves disease? [3]

**HLA status** - TH17 led autoimmune response Trigger: **infection, neck trauma, stress** **Female stress** - 1-2% of women. Because connected to X- chromosome.

What causes Toxic Multinodular Goitre? [1]

Somatic TSHR mutation: Thyroid always on

What is toxic adenoma? [1] How can you diagnose? [1] How do you treat? [1]

**One nodule** of T (where the tumour is) becomes **hyperactive** and the **rest of the gland becomes inactive**. Diagnosed by **ingesting iodine 123** and using gamma camera imaging - will see one area lit up by gamma emitting iodine- 123. Can **treat** with **iodine-131** - emits b-particles to destroy overactive nodules - used in toxic adenoma and thyroid cancer.

What findings would you find for thyrotoxicosis: - T4 / T3 [1] - TSH [1] What treatment would you find for thyrotoxicosis [3]

**Findings**: * Elevated T4 and T3 * Suppressed TSH * Technetium or iodine uptake scans **Treatment**: * Thionamide drugs: **Propylthiouracil; Carbimazole** * Radioactive Iodine I-131 * Thyroidectomy

Hypothyroidism effects on: Skin [2] CV [4] GI tract [3]

**Skin [1]** * myxoedema * Accumulation of hyaluronic action -> yellowing. Hair falls our and becomes thin. **CV [4]** * Stroke volume reduces * Cold/reduced circulation * Sinus bradykinin. * J-waves on ECG due to hypothermia. * LDL cholesterol rises. **GI tract [3]** * Reduced appetite * Constipation * Weight increases (fat - due to reduced metabolic rate - and fluid retention).

Causes of hypothyroidism? [4]

**Hashimoto's disease** **Endemic goitre** (Iodine deficiency) **Lithium** (toxic to thyroid) **Pendred's syndrome** (lack of PDS: improper synthesis of TH)

What causes cretinism?

Large goitres: Low levels iodine in diet + low levels of iodine produced in thyroid -> increasing TSH production -> stimulates growth of thyroid gland Causes mental retardation

Diagnosis [2] and Treatment of HypoT? [1]

**Diagnosis of hypothyroidism:** * High levels of TSH and low T4 in blood - biochemistry tests **Treatment**: * **Levothyroxine** - only treatment used In UK

[] is the first line anti-thyroid drug [] is the second line anti-thyroid drug.

**Carbimazole** is the first line anti-thyroid drug **Propylthiouracil** is the second line anti-thyroid drug.

Label A-D

A: Falciform ligament B: fundus of gall bladder C: stomach D: Ligamentum teres

Label A-F

A: IVC B: Cystic duct C: Cystic artery D: Ligamentum teres E: Ligamentum venosum

Label A & B [2]

A: Quadrate lobe B: Caudate lobe

Which of the following are the: SMA [1] Middle colic artery [1] Right colic artery [1] SMV [1] Jejunal arteries [1]

11 Superior mesenteric artery 2 Middle colic artery 3 Right colic artery 10 Superior mesenteric vein 13 Jejunal arteries

Name this pathology [1]

**Ascites**. Axial CT scan of the abdomen shows low density ascitic fluid surrounding the liver, spleen and stomach.

Label 1, 2, 3, 7, 8, 9 & 10

1 Left hepatic duct 2 Right hepatic duct 3 Cystic duct 7 Common hepatic duct 8 Common bile duct 9 Pancreatic duct 10 Greater duodenal papilla

Which thyroid pathology is depicted here? [1]

Hashimotos thyroiditis

Which thyroid pathology is depicted here? [1]

Graves disease

What is the name for this symptom of Graves disease? [1] What is this symptom usually associated with? [1]

Acropachy in association with thyroid ophthalmopathy

Name three reasons for hyperthyroidism [2]

Toxic multinodular goitre Graves Disease Toxic adenoma

Pendreds symptom is a cause of hypothyroidism. Which transporter is lacking in this disease? [1]

Lack of PDS

MET EOYS5 Flashcards

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