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Systems Exam IV (L)
The Thyroid Gland
37
Medical
Graduate
04/26/2009

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Cards

Term
What are the general effects of thyroid hormone?
Definition

Increases oxygen utilization

Increases energy expenditure

Increases heat production

Term
What is the structure of the thyroid?
Definition
Glandular with many follicles filled with colloid.
Term
What is the main component of colloid?
Definition
Predominately made up of the protein thyroglobulin
Term
What is the purpose of Thyroglobulin?
Definition
It serves at the backbone for the thyroid hormones, which are iodinated derivates of tyrosine.
Term

1. What is the dietary intake of Iodide daily?

2. How much Iodide does the thyroid store?

3. How much does Iodide does the thyroid take up daily?

Definition

1. 400 μg

2. 8000 μg

3. 80 μg

Term
What is the Wolf-Chaikoff Effect?
Definition
If iodide intake exceeds 2mg/day, excess iodide in the thyroid inhibits the iodide trap and hormone synthesis.
Term
How does the thyroid retain iodine?
Definition
By conjugating it to tyrosines on thyroglobulin.
Term
What are the two major thyroid hormones that are synthesized from thyroglobulin?
Definition
T3 and T4
Term
How does iodide transport across the basolateral membrane of the thyroid follicular cell?
Definition
By the Na+/I- symporter
Term
What is the Iodide Trap?
Definition
The coupling of transported iodide to thyroglobuin in the lumen of the thyroid which traps the iodide within the gland
Term
How does iodide exit the follicular cell of the tyroid?
Definition
Via the anion exchanger, Pendrin in a secretory vesicle with Thyroid Peroxidase.
Term
What is the purpose of Thyroid Peroxidase (TPO)?
Definition
In the presence of H2O2 it converts Iodide into Iodine. It also catalyzes the coupling of iodine to certain tyrosines on secreted thyroglobulin.
Term
T/F: When Iodide is limiting, T3 production is favored over T4.
Definition
True
Term

1. How are T3 and T4 stored?

2. How are they released?

Definition

1. Stored as a colloid in the lumen formed by follicular cells.

2. Colloid is endocytosed into the follicular cell. Lysosomes release the hormone from the colloid and T3 and T4 transit the basal membrane into the circulatory system.

Term
What is the major binding protein for thyroid hormones?
Definition
Thyroxine-Binding Globulin (TBG). Most T3 and T4 are bound to proteins in the circulation.
Term
What is the activity of the thyroid hormones from greatest to least?
Definition

T3>T4>rT3

 

Only FREE T3 and T4 are active.

Term
Where does the conversion of T4 to T3 occur?
Definition
In the peripheral tissues
Term
Where do T3 and T4 bind in the cell?
Definition

After passive diffusion into the cell, most T4 is converted into T3 and binds to Thyroid Hormone Receptor (TR)

.

Term
What is bound to Thyroid Binding Receptor (TR) when T3 and T4 are unavailable?
Definition
Thyroid Regulatory Elements (TRE) which repress gene expression downstream from the receptor.
Term
What are the structures of TR?
Definition
Homodimer or Heterodimer of TR and RXR
Term
What is the hormonal regulation of thyroid hormones?
Definition

Hypothalamus: TRH

Anterior Pituitary: TSH

Term
What does TSH receptor activation result in?
Definition

Thyroglobulin and Peroxidase Synthesis

Iodide Trapping

T3 and T4 synthesis

colloid endocytosis

T3, T4 release

Thyroid Gland development

Term
How does TSH deficiency affect thyroid size?
Definition
It decreases it.
Term
What is the feedback for thyroid hormones?
Definition

T3 and T4 inhibit TSH and TRH release

TSH inhibits TRH release

Term

What cells are targeted with thyroid hormones?

What are their actions?

Definition

Almost all cells

They regulate normal growth, development and metabolism

Term
What is the effect of thyroid hormone on basal metabolic rate?
Definition
It increases it
Term
What is the effect of thyroid hormones on fat metabolism?
Definition
It increases it increasing the concentration of fatty acids in the plasma.
Term
Thyroid Hormone levels are _________ related to cholesterol and triglyceride levels
Definition
Inversely. Hypothyroidism (low T3, T4) correlates with increased plasma cholesterol.
Term

What is a goiter?

How does size of gland reflect functioning?

Definition
An enlargement of the thyroid. Presence of the thyroid does not reflect function.
Term
What is the effect of a iodine deficiency?
Definition
Causes a decrease in thyroid hormone. When it is severe, the individual will be hypothyroid with goiter.
Term
What is Euthyroid?
Definition
If iodine deficiency is not extreme, the tyroid will increase iodine trapping in order to maintain normal T4 serum levels.
Term
What is the pathphysiology with Grave's Disease?
Definition
This is a hyperthyroidism caused by abnormal antibodies binding and stimulating TSH receptors in the thyroid gland increasing synthesis and secretion of thyroid hormones.
Term

What are the symptoms with Hypothyroidsm in children?

Treatment?

Definition

Respiratory Distress Syndrome, Poor Feeding, Hoarse Cry, Retarded Bone Age

 

Replacement therapy of hormone

Term

What are the symptoms with Hypothyroidsm in adults?

Treatment?

Definition

Decreased basal metabolic rate, hypothermia, reduced cold tolerance, reduced cardiac output, hypertensive

 

Replacement therapy

Term
What are some causes of Adult Hypothyroidism?
Definition

Gland destruction

Autoimmune disease

Iodine deficiency

Thyroiditis

Term
What is Hashimoto's Thyroiditis?
Definition
Autoimmune antibodies target TPO and TG causing hypothyroidism.
Term
What are the symptoms of hyperthyroidism (Grave's Disease)?
Definition
Increased basal metabolic rate, heat production, heat intolerance, nervousness, palpitations
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