Thyroid Flashcards

1
Q

which is greater, BMR or RMR?

A

RMR (includes a few more activities than BMR)

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2
Q

what are the biologically active forms of thyroid hormone?

A

thyroxine (T4) and triiodothyronine (T3)

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3
Q

where is TH stored? where is it synthesized?

A

as a precursor in the lumen of the thyroid follicles

synthesized in the follicular cells surrounding the follicle

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4
Q

what stimulates the release of TH?

A

TSH that is released from the anterior pituitary

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5
Q

what is TH stored with in the follicles?

A

it is associated with thyroglobulin in the colloid

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6
Q

what do the C cells do?

A

they secrete calcitonin

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7
Q

what are T3 and T4 synthesized from? which one is made more abundantly?

A

tyrosine and iodide
synthesized on thyroglobulin
T4 is made preferentially

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8
Q

how is iodide concentrated in the thyroid gland? how is it regulated?

A

by a 2Na/I symporter that uses the inward Na gradient

thyroid autoregulates according to its needs

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9
Q

describe the TH synthesis events that happen within the follicle.

A

thyroglobulin is produced and exocytosed into the follicle
iodide is pumped into the lumen and is oxidized to iodine
iodine replases H+ on benzine rings of tyrosine

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10
Q

what is organification?

A

binding of iodine moities sequentially onto thyroglobulin

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11
Q

what is the function of thyroid peroxidase?

A

substitutes I for H+ on tyrosine, catalyzes DIT (diiodotyrosine) dimerization forming T4

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12
Q

how is T3 formed?

A

a MIT (monoiodotyrosine) is coupled with a DIT (diiodotyrosine)

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13
Q

what happens to T3 and T4 after they are made in the lumen?

A

they remain bound to thyroglobulin in the follicle and then are endocytosed back into the follicle cell

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14
Q

what does TSH stimulate?

A

colloid proteolysis creating free T3 and T4 to enter the blood stream

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15
Q

what is reverse T3?

A

biologically inactive TH that is derived from T4 by peripheral diodinases

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16
Q

how does thyroid hormone travel in the blood?

A

mostly bound to thyroid binding globulin
some bound to transthyretin and albumin
0.03% is free

17
Q

what can free TH do that bound TH cannot?

A

it can enter target tissues and bind to TH receptors in the nucleus

18
Q

what is T4 referred to and why?

A

it is referred to as prohormone because it is converted to T3 to produce a more biologically active form

19
Q

how is hyperthyroidism treated?

A

with pharmacological agents that prevent T4>T3 conversion

20
Q

why is T4 used to treat hypothyroidism if it is less active?

A

because it has a longer half life and greater stability

21
Q

what does TH regulate? where?

A

metabolism of carbohydrates, proteins and lipids (increase basal metabolic rate)
in all tissues of the body

22
Q

describe the kinetics of THs

A

slow onsets and long duration of action

T3 acts 4X more rapidly than T4

23
Q

what hormones act synergistically with TH?

A

growth hormone and somatomedin

24
Q

in hypothyroidism, what is the impact on bone? what can excessive hormone therapy do?

A

bone age is less than chronological age

hormone tharapy can lead to bone loss

25
when is TH neccessary for the CNS?
during CNS development in perinatal period
26
what effect does TH have on bone?
promotes ossification and fusion of bone plates and bone maturation
27
what does TH deficiency in infants result in?
growth (can be fixed) and mental retardation (only fixed if caught quickly)
28
what does TH do to the cardiovascular system?
increases cardiac output
29
what does TH do metabolically?
increases O2 consumption, increases heat production, increases glucose absorption, glycogenolysis, gluconeogenesis, lypolysis and protein synthesis and degredation (catabolic and anabolic effects)
30
what is the effect of complete lack of TH secretion and extreme excess secretion on BMR?
lack- BMR falls 40-50% | excess- BMR rises 60-100% above normal
31
protein synthesis and degredation occur with TH action. which predominates?
degredation
32
in hypothyroidism, what two factors increase atherosclerosis risk?
decreased LDL receptor expression and cholesterol excretion in bile
33
what is the effect on the SNS in hyperthyroidism?
increased expression of beta adrenergic receptors leads to enhanced SNS sensitivity
34
what are the hypothalamic and pituitary releasing factors of thyroid hormone?
thyrotropin releasing hormone (TRH)-hypothalamus | thyroid stimulating hormone (TSH)- pituitary
35
how does TRH stimulate TSH release?
activates g protein linked to PLC> IP3 generation> increase in intracellular calcium (vesicular fusion)
36
how does TSH stimulate TH release?
g protein linked to adenylate cyclase> cAMP
37
what is the control mechanism of TH release
T3 (especially) and T4 exert negative feedback to the anterior pituitary and hypothalamus dopamine and somatostatin inhibit TSH release
38
how is thyroid disease diagnosed?
serum TSH levels elevated levels- hypothyroidism reduced levels- hyperthyroidism