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Thyroid Function Flashcards

1
Q

What are the two types of cells in the thyroid gland?

A

Follicular and parafollicular

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2
Q

What thyroid hormones do follicular cells make and secrete?

A

T4 (L-thyroxine)

T3 (L-triiodothyronine)

rT3 (reverse T3 (biologically inactive))

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3
Q

Where are hormones stored in follicular cells?

A

Lumina of the follicle

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4
Q

What hormones do parafollicular cells secrete?

A

Calcitonin (involved in calcium regulation)

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5
Q

List the functions that thyroid hormones are involved in

A

Rate of O2 consumption

Growth

Sexual maturity

Protein and carbohydrate metabolism

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6
Q

TRH

A

Released by hypothalamus and stimulates anterior pituitary to secrete TSH

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7
Q

TSH

A

Regulates synthesis and release of the thyroid hormones

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8
Q

What regulates the secretion of TSH?

A

TRH

somatostatin: inhibitory factor

FT3 and FT4: stimulate hypothalamus to secrete somatostatin. Exert neg feedback to anterior pituitary to inhibit TSH secretion

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9
Q

H-P-T axis

A

The negative feedback loop of TRH and TSH

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10
Q

Thyroid hormones circulate the blood bound to what?

A

Thyroxine-binding globulin (TBG)

Thyroxine-binding prealbumin

Thyroxine-binding albumin

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11
Q

T/F:

Biologically inactive = physiologically active

A

TRUE

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12
Q

What is the function of TBG?

A

Principle carrier protein

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13
Q

FT3 and FT4 are physiologically ___

A

Active

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14
Q

T/F:

T3 is 4-5 times more metabolically potent than T4

A

TRUE

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15
Q

What is the most useful test for assessing thyroid function

A

TSH

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16
Q

Characteristics of hypothyroidism

A

TSH is minimally increased

FT4 stays within normal range

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17
Q

Characteristics of subclinical hyperthyroidism

A

TSH is low

FT4 is normal

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18
Q

T/F:

Up to 90% of thyroid hormone are protein bound

A

FALSE

MORE than 99.9% of thyroid protein are protein bound

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19
Q

T/F:

alteration in thyroid hormone binding proteins frequently lead to total T4 outside of normal range without representing true clinical thyroid dysfunction

A

TRUE

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20
Q

Thyroid produces approximately ___% of T3

A

20%

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21
Q

T3 contains 3 atoms of ___

A

Iodine

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22
Q

T/F:

FT4 makes up a large fraction of total thyroxine

A

FALSE

Small fraction because most are bound to thyroid carrier proteins

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23
Q

FT4 is the ___ ___ fraction of T4

A

Biologically active! It can enter the tissues.

24
Q

FT3 is elevated in ___

A

Hyperthyroidism

25
What can cause the leakage of Tg into the bloodstream
Destruction through autoimmune hypothyroidism OR Inflammation of the thyroid
26
In what condition do we see anti-Tg autoantibodies in 12%-30% of patients?
Grave’s disease
27
What antibody does this describe: Active, complement, and play an important role in the pathogenesis of hypothyroidism CHECK THIS NOTECARD BECAUSE THE SLIDE NEEDS TO BE FACT CHECKED
Thyroperoxidase antibody (TPO)
28
The production of this stimulating antibody can cause all forms of autoimmune thyrotoxicosis
Thyrotropin Receptor Antibody (TRAb)
29
Grave’s disease is the most common cause of ___
Hyperthyroidism
30
Hashimoto’s thyroiditis causes ___
Hypothyroidism
31
In Grave’s disease, ab are produced that are directed at ___ ____
TSH Receptor (TSHR)
32
In what condition can we observe the growth of the thyroid gland and goiter?
Grave’s Disease
33
In what condition to antibodies lead to decreased thyroid hormone production as the thyroid gland is being destroyed
Hashimoto’s thyroiditis
34
What does low Radioactive iodine uptake (RAIU) suggest?
Gland is metabolically inactive
35
What does high Radioactive iodine uptake (RAIU) suggest?
Gland is metabolically active and producing significant amounts of thyroid hormone
36
Why would we use a thyroid ultrasound?
To detect non-palpable nodules using high frequency sound waves
37
What is a fine needle aspiration (FNA) biopsy?
First step and most accurate tool in the evaluation of thyroid nodules in the absence of hyperthyroidism
38
How is hypothyroidism defined?
Low FT4 Normal-High TSH
39
List primary conditions of hypothyroidism
Hashimoto’s Treatment for toxic goiter Excessive Iodine Intake Subacute thyroiditis
40
What is a secondary condition of hypothyroidism
Hypopituitarism
41
What is a condition of tertiary hypothyroidism
Hypothalamic dysfunction
42
What is thyrotoxicosis?
Many findings that result when peripheral tissues are presented with, and respond to, and excess of thyroid hormone
43
What are potential causes of thyrotoxicosis?
Excessive thyroid hormone ingestion Leakage of stored thyroid hormone from thyroid follicles Excessive thyroid gland production of thyroid hormone
44
What are symptoms of Grave’s disease
Thyrotoxicosis, goiter, opthalamopathy, dermopathy (orange peel skin(
45
How do you treat thyroid disease associated with Grave’s?
1) Medication 2) Radioactive Iodine 3) Surgery
46
What causes a toxic adenoma?
Autonomously functioning thyroid tissue (no TSH needed)
47
What are treatment options for toxic adenoma / multinodular goiter
1) Surgery 2) Radioactive iodine 3) Thyroperoxidase inhibitor medications
48
T/F: Radioactive iodine often kills both the hyperactive nodule as well as functioning thyroid tissue
FALSE Tends to only kill hyperactive nodules, leaving behind functioning thyroid tissue
49
Amiodarone-Induced Thyroid Disease
A drug used to treat cardiac arrhythmias that that interfere with normal thyroid function
50
What are characteristics of amiodarone?
A drug that is fat soluble with a long half life of 50 days
51
Subacute thyroiditis
Conditions associated with inflammation of the thyroid gland, leakage of stored thyroid hormone, followed by repair of the gland
52
What is the most common form of subacute thyroiditis?
Postpartum thyroiditis (5-9% of women in postpartum)
53
TSH, T3, and FT4 in nonthyroidal illness and thyroid nodules
LOW TSH LOW T3 LOW FT4
54
T/F: Thyroid nodules are common and are often not thyroid cancer
TRUE
55
What is nonthyroidal illness or euthyroid sick syndrome?
Abnormalities in thyroid function tests without thyroid dysfunction (Often in hospitalized or critically ill patients)

Chem II (12 decks)

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