Flashcards in Thyroid Gland disorders Deck (58)
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1
where is thyroid gland located
lies adjacent to trachea and immediately below larynx
2
hyperthyroidism is essentially
hyperactive thyroid gland
3
thyroid gland produces what hormones
T3 & T4 (thyroxine) called thyroid hormone together
4
essentially T3 & T4
increase metabloic rate
5
thyroid hormone is secreted in response to _______
thyroid stimulating hormone from anterior pituitary
6
Goiter is enlargement of
thyroid
7
causes of goiter could be from
hyper function or hypo function
8
endemic goiter
-iodine deficiency
-decrease in T3 & T4
-compensatory increase in TSH
-hyperplasia & hypertrophy causin goiter
9
Toxic goiter
-due to hypersecretion
-Nodular gland (associated with hypothyroidism)
10
Hyperthyroidism is due to
autoimmunity
11
85% of all hyperthyroidism is ____
Graves disease (so name is used interchangeably)
12
Graves disease is usually found in
young women (20-40yrs)
13
3 hallmark features of graves disease
-hyperthyroidism
-goiter
-expothalmos (protruding eyeballs)
14
Patho of graves disease
-antibodies target TSH receptors on target cell (abnormal thyroid stimulation)
-TSAbs(TS immunoglobulins) mimic TSh & bind to TSH receptors
-Increase in TH secretion
-increase in TH inhibits TSH secretion
-Causes decrease in TSH secretion
-TSabs avoid enzyme degradation (active longer, thyroid doesn't inhibit, enzymes dont break it down)
15
Thyrotoxicosis
-"thyroid storm"
-Syndrome of hyperthyroidism (IN UNDIAGONSED & UNTREATED CASES)
-precipitated by stress (emotional & physiologic) (eg. resp infection, DKA, thyroidectomy)
16
Mnfts of thyrotoxicosis
- excessive fever, severe cardiovascular & CNS problems
-Increase metabolism (alt pathways, protein & lipid catabolism) --- metabolizes all carbohydrates then moves to proteins & lipids (causes wt loss)
-General increase in metabolism-- increase in metabolic heat ---compensatory heat loss mechanisms--flushed skin & perspiration (if exercising heat already maxed of compensatory mechanisms)
-Intolerance to an increase in temp
-CV: angina, tachycardia, CHF (increase demand for energy, oxygen, waste removal & glucose --- Increase Heart rate & Cardiac output)
-CNS: delirium, agitation, irritability, insomnia (hot & miserable cannot sleep)
-increase mortality rate
17
Treatment of hyperthyroidism
producing hormone in excess want to suppress hormones:
1 of 3 options:
-antithyriod drugs (eg. tapazole decreses TH syntehsis): (have an increase in T3 and T4, have a drug that inhibits synthesis of, resolves problem does not irradiate cause which is autoimmunity)
-radioidine therapy:
(gets in thyroid & binds to thyroid omitting radiation which destroys local cells that secrete hormone)
-surgery: (difficult because dont know how much to remove)
18
Hypothyroidism
-primary (thyroid)
-secondary (pituitary)
-tertiary (hypothalamus)
-95% is primary - thyriod
19
Etiology of hypothyroidism
-autoimmunity
-radiation & surgery for hyperfunction
20
Hashimotos thyroditis is the most common
-hyposecretion state
-90% in middle age women (45yrs)
21
Hashimotos thyroiditis patho
-autoimmune destruction of gland
-infiltration of lymphocytes
-anti thyroid Abs block TSH binding (even competition for receptors)
-(deficiency of T3 & T4, will not produce thyroid hormone)
22
mnfts of hashimotos thyroiditis
-decreased body temp
-decrease in cardiac output (d/t less ATP)
-decrease in CNS function (d/t less ATP)
-weak muscle contraction (d/t less ATP)
-increase body weight (cells not able to utilize ingested nutrients)
-Hypometabolic state & myxedema
23
Treatment of hypothyroidism
Replacement therapy (T4 daily)
24
Adrenal glands
- 2 glands one in association with each kidney
-2 parts to gland cortex and medulla
25
Cortex secretes what 3 kinds of hormones
Cortex: (under pituitary control) (most endocrine disorders related to cortex) glucocorticoids (cheif CORTISOL), mineralocorticoids (cheif ALDOSTERONE),
androgens (cheif testosterone & dihydrotesterone (DHT)
26
Medulla
influenced by SNS
-secrese epinephrine & norepinephrine
27
ACTH is
Adrenocorticotropic hormone produced by anterior pituitary,
28
ACTH is
Adrenocorticotropic hormone produced by anterior pituitary, targets adrenal glands, adrenal cortex, ACTH facilitates the release of cortisol from adrenal cortex (regulates levels of steroid hormone cortisol)
29
Hyperfunction of Adrenal glands Etiology & Patho
-cortical tumor or hyperplasia ---increase in cortisol (acts negatively & suppresses ACTH), Low levels of ACTH
-Tumor or hyperplasia of anterior pituitary causes an increase in ACTH
-ectopic ACTH tumor (eg. in the lungs)
30