Thyroid/Antithyroid Drugs

Question 1

What cells make T3/T4?

Answer 1

Follicular cells

Question 2

What cells make calcitonin?

Answer 2

Parafollicular cells

Question 3

What is the name of the transporter that take Na and iodide into the follicular cell on the basolateral membrane?

Answer 3

NIS

Question 4

What is the name of the transporter that take iodide and brings it into the lumen of the follicular cell?

Answer 4

Pendrin

Question 5

What turns iodide into iodine?

Answer 5

TPO

Question 6

What brings MITs and DITs into the follicular cell on the apical membrane?

Answer 6

Megalin

Question 7

What breaks down MITs and DITs in the follicular cells so iodide can be used again?

Answer 7

Intercellular deiodinase

Question 8

What binds to T3/T4 to be transported in the blood?

Answer 8

Thyroid binding globulin (TBG)

Question 9

What turns T4 into T3?

Answer 9

Peripheral deiodinase

Question 10

Stimulation of what receptor on basilar membrane causes production of T3/T4 and follicular cell reproduction?

Answer 10

Stimulation of TSH receptor

Question 11

What actions do thyroid hormone cause to heart, respiration’s, protein synthesis, body weight, blood glucose, bone and nervous tissue? What does it do to Na/K pumps?

Answer 11

positive chronotropic and inotropic effect
Increases respiration’s
Increases protein synthesis
Decreases weight
Increases BGL
Increases bone growth
Increases nervous tissue growth

Increases the number of Na/K pumps in the body

Question 12

Pt with little to no nervous tissue can cause what? What can it lead to?

Answer 12

Cretinism

Lead to mental retardation

Question 13

Why are the Sx of a pt w/ hypothyroidism(6)?

Answer 13

Cretinism
Cold intolerance
weight gain
Lethargic
Constipation
Goiter
Myxedema

Question 14

What is myxedema? What condition is it associated with?

Answer 14

Coma caused by respiratory acidosis

Question 15

What are the Sx of a pt w/ hyperthyroidism(7)?

Answer 15

Heat intolerance
Weight loss
Tachycardia
Diarrhea
Exophthalmos
Goiter
Increased BGL

Question 16

What is exophthalmos? How is it caused?

Answer 16

Bulging eyes

Immune system attacks muscles and CT behind eye causing inflammation

Question 17

How is goiter caused in hyperthyroidism? Hypothyroidism?

Answer 17

Hyperthyroidism-increase is TSI levels

Hypothyroidism-increase in TSH d/t feedback from low T3/T4

Question 18

What deficiency can often cause goiter?

Answer 18

Iodine deficiency

Question 19

What is the number 1 cause of hypothyroidism? What does it attack?

Answer 19

Hashimotos disease

Antibodies attack TPO and thyroglobulin

Question 20

What edible substances can cause hypothyroidism?

Answer 20

Cabbage

Question 21

How can tumors cause hypothyroidism?

Answer 21

Tumors can steal nutrients for TSH production

Question 22

What can cause damage to follicular cells?

Answer 22

X-rays

Iodine deficiency

Question 23

What is the number 1 cause for hyperthyroidism? How is it caused?

Answer 23

Graves’ disease

TSI stimulates TSH receptors to keep increasing T3/T4 w/o a negative feedback response

Question 24

Where does a primary thyroid malfunction occur?

Answer 24

In the thyroid gland itself

Question 25

What does a pituitary malfunction occur?

Answer 25

In the anterior pituitary

Question 26

Where does a hypothalamic malfunction occur?

Answer 26

In the hypothalamus

Question 27

What is armour thyroid from? What type of thyroid hormones does it contain?

Answer 27

Porcine-derived Contains both T3/T4

Question 28

What is the goal for TSH levels when a pt is on HRT? How big of a dose of T3/T4 should be given to lower TSH levels?

Answer 28

Goal is to have TSH levels at lower end of normal range Give largest dose of T3/T4 to decrease TSH levels

Question 29

What is euthyroidism?

Answer 29

Thyroid levels are in normal range

Question 30

When on HRT, when should medication be taken, why?

Answer 30

Before breakfast because the food makes HRT less absorbed

Question 31

Out of T3 and T4, which medication has a quicker onset and shorter duration?

Answer 31

T3

Question 32

What is a black box warning for HRT? Why?

Answer 32

Contraindicated for pt w/ obesity Can lead to HF

Question 33

When must a pt be taking insulin w/ their thyroid medication?

Answer 33

When taking synthroid

Question 34

What are the 3 forms of Tx for hyperthyroidism?

Answer 34

Anti thyroid drugs Radiation Surgical removal

Question 35

Why should a pt taking thyroid drugs, take the medication once daily in the morning?

Answer 35

Decrease chances of insomnia

Question 36

What Sx should be reported for a pt on thyroid medication(2)?

Answer 36

Chest pain | Heart palpitations

Question 37

How long does it take for therapeutic effects to occur when taking thyroid medication?

Answer 37

Several weeks (3-4wks)

Question 38

What must be done with HRT dosage to keep TSH levels at lower end of normal range?

Answer 38

Adjust dosage every 4 weeks

Question 39

What must DM pt taking thyroid medication do to their hypoglycemic medication?

Answer 39

Increase dosage

Question 40

What can happen to the baby if a mother is experiencing hypothyroidism while pregnant?

Answer 40

Cretinism(mental retardation)

Question 41

What should antithyroid medications be given w/? What time of day?

Answer 41

Food Same time each day

Question 42

True or false: you can stop taking antithyroid medications abruptly?

Answer 42

False

Question 43

What decreases the effectiveness of antithyroid medications? What are some examples?

Answer 43

Eating foods high in iodine Seafood Soy sauce Tofu Iodized salt