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Terms in this set (29)
What controls the activity of the thyroid gland (list two)?
The hypothalamus and the anterior pituitary gland
Thyroid hormones effect which functions in the cells (list three)?
- Cellular differentiation
- Cellular growth
- Cellular metabolism
Action of thyroid hormones include?
Increasing energy, producing heat and stimulating cardiac tissue
What is the function of follicular cells found inside the thyroid?
produce and store thyroid hormones which are thyroxine (t4) and triiodothyronine (T3)
What is the function of parafollicular cells (or C cells)?
They secrete calcitonin
Regulation of thyroid hormones rely on which feedback mechanism?
negative feedback mechanisms with the hypothalamus in control of stimulating or inhibiting their ultimate release
Which conditions, recognized by the hypothalamus, effect stimulation or inhibition of hormonal release?
cold, stress, or low levels of circulating hormone
How does the hypothalamus respond upon recognition of infrequent bodily conditions? (a total of 9 steps)
Responds by releasing TRH or thyrotropin releasing hormone, TRH then stimulates the glandular anterior pituitary to release TSH or thyroid-stimulating hormone. TSH then travels to the thyroid gland and stimulates the gland to uptake iodine so that they can synthesize and release T3 and T4 thyroid hormones
What is the most abundant circulating thyroid hormone? Derivatives of this hormone include which biologically active, potent molecule? [triiodothyronine OR TSH]
Thyroxine (T4) is the most abundant circulating thyroid hormone, conversion of T4 creates T3 or triiodothyronine. T3 is more biologically active making it more potent
Iodine is essential for the synthesis of which thyroid hormones?
Iodine is essential for the synthesis of both T3 and T4 hormones and these hormones are named based on how much iodine they contain
TSH and TRH levels are used in which applications? [Differentiation of primary, secondary and tertiary etiologies; testing for autoimmune antibodies]
TSH and TRH levels are used to differentiate primary, secondary and tertiary etiologies
Why are radioactive iodine uptake tests administered in clinical settings?
measures the ability of the gland to concentrate iodine from the blood to synthesize hormones
What are thyroid scans?
thyroid scans are used to detect nodules and their activity, with some nodules producing too much hormone and others not enough.
How is hypothyroidism treated? How is hyperthyroidism treated? What is the end goal, specifically give the nominal characterization?
Hypothyroidism is treated with thyroid replacement therapy. Hyperthyroidism is treated with antithyroid medication or gland removal as treatment. The end goal for both these extremes is to achieve a euthyroid or normal state of thyroid gland activity.
Hypothyroidism results in a decrease of which thyroid hormone? Is it congenital or acquired, both? Severity of the disease is based on what?
Decreased or absent amounts of thyroxine (T4). It can be congenital and acquired and severity of the disease is based on the degree and etiology of the deficiency.
Primary hypothyroidism is characterized how
is thyroid gland failure with insufficient hormone production.
What is cretinism? Can identification of this disorder at birth aid in an individual's recovery?
Cretinism is hypothyroidism at birth, newborns in the united states are screened for this condition because rapid identification and treatment dramatically improves long term outcomes.
What is Hashimoto's thyroiditis? Is it an autoimmune disorder? How prevalent is it in today's society? Is it a primary, secondary, or tertiary disorder?
Hashimoto's thyroiditis is the most common cause for primary hypothyroidism in the united states. It is an autoimmune disorder that attacks the thyroid gland causing inflammation and gland dysfunction
Why could an insufficient iodine intake prove dire to one's thyroid activity? Specifically reference goiter in your response.
The term goiter refers to an enlargement of the thyroid gland. A non-toxic goiter is an enlarged gland that does not produce thyroid hormones. Globally this is most commonly due to inadequate iodine in the diet.
Other potential causes of hypothyroidism include what?
A thyroidectomy and thyroid ablation meaning intentional destruction of part of the gland are also potential causes of hypothyroidism.
Secondary and Tertiary hypothyroidism is different that primary hypothyroidism. Why is this so? Specifically, detail where failure occurs.
Secondary hypothyroidism is pituitary gland failure such as from a pituitary adenoma. Tertiary hypothyroidism is failure of the hypothalamus, usually from a tumor or brain injury.
How could a physician or nurse recognize hypothyroidism (list 4)?
in adults includes weight gain, brittle hair, dry skin and cold intolerance with a low body temperature. The heart rate and GI motility will slow, patients will fell lethargic and the face is often puffy and expressionless referred to as a flat affect.
Why do these clinical manifestations occur?
What would a thyroid report show for someone with hypothyroidism?
Thyroid labs will show and elevated TSH and corresponding low levels of T3 and T4.
What is Myxedema? If left untreated, what can happen? What are the symptoms associated with Myxedema? How can we treat Myxedema?
Myxedema is a severe manifestation of hypothyroidism in adults that can progress to coma if left untreated. Signs and symptoms include a boggy, non-pitting, mucosa type edema usually periorbital meaning around the eyes which is caused by an accumulation of protein and other substances in connective tissue. This is not the same as pitting edema from fluid overload. Other manifestations of myxedema include bradycardia, hypothermia and severe lethargy. Treatment requires aggressive thyroid replacement therapy and cardiovascular support.
Grave's disease is the most common form of which thyroiditis? Is Grave's disease an autoimmune disorder? Which receptors are activated in Grave's disease? Which hormones are subsequently released upon receptor activation? Do thyroid nodules play a role in primary hyperthyroidism? If so, detail, anatomically, how such nodules lead to Plummer's disease.
Graves' disease is the most common form of primary hyperthyroidism. Primary meaning the problem is with the gland. Like Hashimotto's it is an autoimmune disorder but with graves' disease the antibodies activate TSH receptors in the gland, causing it to continuously release T3 and T4 into circulation. Another etiology for primary hyperthyroidism are thyroid nodules, either from thyroid cancer or benign nodules called Plummer's disease. Both of these are examples of a toxic goiter which describes an enlarged thyroid that is over active.
What causes secondary hyperthyroidism? What causes tertiary hyperthyroidism? Are these conditions rare?
Secondary hyperthyroidism is rare and usually due to pituitary adenoma that sends out too much TSH. Likewise tertiary hyperthyroidism is rare, such as a TRH secreting adenoma.
List the clinical manifestations of hyperthyroidism. What will thyroid labs reveal for an individual with hyperthyroidism? What are the treatment options?
include the classic feature of exophthalmos or a bulging appearance to the eyes caused by immunoglobulins inflaming the muscles around the eyes. Other manifestations are directly linked to excess thyroid hormones such as feeling jittery and hot with an intolerance for warm environments and increased heart rate and a sudden unexplained weight loss. Labs will reveal high levels of T3 and T4 with low levels of TSH. Treatment options include anti-thyroid drugs and or surgery to remove all or part of the gland depending on the etiology of the disorder and the severity of the symptoms.
Thyroid storm? When should this be done?
is an extreme manifestation of thyroid toxicosis, it is rare but is a potentially life threatening medical emergency usually precipitated by trauma or manipulation of the thyroid gland during surgery. With thyroid storm body temperatures get extremely high along with dangerously high heartrates leading to potential heart failure. Thyroid storm requires aggressive cardiovascular management to stabilize.
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