Thyroid Hormone System

Question 1

What is the center of a thyroid cell that synthesizes and secretes thyroid hormone?

Answer 1

the colloid

Question 2

What is the protein that holds the iodide molecules with in the thyroid hormone?

Answer 2

thyroglobulin

Question 3

What enzyme oxidizes iodide to iodine in the body?

Answer 3

thyroid peroxidase

Question 4

Does T3 act like a hydrophilic or a steroid messenger?

Answer 4

It acts like a steroid messenger!

Question 5

What is the FIRST test for thyroid issues?

Answer 5

TSH!

Question 6

What does high TSH tell us?

Answer 6

High TSH = hypOthyroid

Question 7

What does low TSH tell us?

Answer 7

low TSH= hyperthyroid

Question 8

What test do you administer to find out if the thyroid disorder is autoimmune?

Answer 8

Anti-Thyroid antibodies

Question 9

What is TSI?

Answer 9

Thyroid stimulating immunoglobin…looking for hyperthyroidism

Question 10

Is a radioactive iodide scan showing anatomy or function?

Answer 10

Anatomy: can see hot and cold spots of iodine uptake

Question 11

What are levels of T4 and T3 like during hyperthyroidism?

Answer 11

High levels of T4 and T3

Question 12

What are TSH levels with hyperthyroidism?

Answer 12

Low TSH (unless it’s a VERY rare TSH producing tumor)

Question 13

What is the ONLY situation for proptosis?

Answer 13

Graves disease

Question 14

Which thyroid condition are goiters MOSTLY associated with? What is the exception?

Answer 14

Mostly hyperthyroid with the exception of high TSH causing a goiter in hypothyroidism

Question 15

Which thyroid condition is associated with vasodilation?

Answer 15

hyperthyroid, excess blood flow and heat. (Vasoconstriction for hypo, poor blood flow and cold intolerance)

Question 16

Antibodies (Thyroid Stimulating Immunoglobulin) activate the TSH receptor… high Uptake and diffuse and large scan

Answer 16

Graves Disease

Question 17

Areas of the thyroid escape TSH control. Patchty iodine uptake

Answer 17

multi nodular goiter

Question 18

An area with a mutation in the TSH receptor. High uptake in only one area

Answer 18

hot nodule

Question 19

An inflammed gland releasing stored hormone. No uptake!What is the mechanism for thyroiditis? Iodine uptake?

Answer 19

thyroiditis

Question 20

No uptake of Iodine, no mechanism. Just hyperthyroidism, maybe prescribed by a doctor?

Answer 20

Exogenous T4, T3

Question 21

What has a high diffuse uptake on the iodide scan and enlarged thyroid gland, but is very rare?

Answer 21

TSH-producing tumor

Question 22

What do eye muscles become infiltrated with in graves eye disease?

Answer 22

mucopolysaccarides, lymphocytes, and excess fat

Question 23

What disease has the result of FIBROTIC and scarred eye muscles accompanied with blurred vision?

Answer 23

Graves eye disease (you got that wrong on the quiz. idiot!)

Question 24

Does smoking have an effect on graves eye disease?

Answer 24

yes, smoking causes it to become worse

Question 25

What are the three main treatments for hyperthyroidism?

Answer 25

1.Radio-active iodine (usually become hypothyroid before Dr can adjust back 2. Anti-Thyroid drugs (inhibit synthesis of T3 from T4) (side effects present) 3. Surgery (w/ a GOOD physician)

Question 26

What can each of these individually cause? Autoimmune destruction (hasimoto thyroiditis), congenital defects in hormone synthesis, iodine deficiency, radioactive iodine/surgery, anti-thyroid drugs.

Answer 26

Primary Hypothyroidism!!

Question 27

Where is a secondary hypothyroidism caused?

Answer 27

The pituitary

Question 28

Where is a tertiary hypothyroid problem caused?

Answer 28

The hypothalamus

Question 29

What are T4/T3 levels and TSH levels with a thyroid effect? (primary)

Answer 29

low T3/T4 and high TSH

Question 30

What are the T4/T3 levels and TSH levels with a pituitary effect? (secondary)

Answer 30

low T3/T4 and low TSH

Question 31

What are the T4/T3 levels and TSH levels in a hypothalamic defect? (tertiary)

Answer 31

low T3/T4 low TSH

Question 32

Are the results of hypothyroidism reversible?

Answer 32

Yes, if caught and treated in time

Question 33

What is the hypothalamus condition, caused with no intervention as a child, results in short stature and no bone growth?

Answer 33

Cretinism

Question 34

What is the only named treatment for hypothyroidism?

Answer 34

Thyroxine! (give as T4 and the body will synthesize to T3 as needed)

Question 35

Would you expect a goiter with hypothyroidism due to pituitary insufficiency? (secondary hypothyroidism)

Answer 35

NO! The only goiter associated with hypothyroidism is due to high TSH. With a secondary hypothyroidism we would have no TSH.