Term
| biosyntehsis of thyroid hormones |
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Definition
| IOdine ocms in via NA/I symporter, enters folciular cell and exits to colloid via pendrin. Iodien gets oxidized and iodiantoed and conjugated to form thyrglobulin which gets endocytosed form colloid to follicle, in the follicle it undergoes proteoloysis to t3 and t4 and is sent out of the cell. |
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Term
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Definition
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Term
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Definition
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Term
| emtaoblic clearnceo f thyroid hormones |
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Definition
| cyp3a icnreases t4 to t3 conversion. BLocked conversion shutns T4 into rt3 production. |
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Term
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Definition
| metabolzied by dieiodiantion adn deamination and removed in ruine and bile |
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Term
| T3 effect on epripehral tissue |
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Definition
| convert vfrom t4 to t3 in peripheral tissue, then b inds to TR which elads to dNa upregulation |
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Term
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Definition
| TRH form hypothaalmsu stimaultes TSH, TSH stimautles t4 and t3, also sitmaultes vascularity of thyroid. T3 adn t4 inhibit trh and tsh |
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Term
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Definition
| caused hypothyroidis with goiter ,due to elevated TSH |
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Term
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Definition
| amidioadrine is high in iodide.. |
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Term
| pregnancy and hypothyroidism |
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Definition
| increased TBg levels due to increased estrogen- causes ypothyroid |
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Term
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Definition
| identical to t4 , logn ahlflife, best choice |
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Definition
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Term
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Definition
| shrot half life, but acts faster than t4, but g |
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Term
| liothryonine adverse effects |
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Definition
| reater risk of cardiotoxicity. avoid in aptients iwth cardiac disease, |
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Term
| liothryonine preferred use |
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Definition
| best for short term supreession of tsh |
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Term
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Definition
| useless and more expensive, t4 and t3 together, |
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Term
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Definition
| from animal origin, hormoen amount ucntontrllable, may ahve antigenicity, and high risk of toxicity. |
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Term
| special problem in hypothyroid therapy |
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Definition
myxemeda with CAD, be cautious to avoid p rovoking arrythmais or MI.
Myxemeda |
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Term
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Definition
| a medical emergency, treat iwth large intravenous loading dose to saturate bindingg sites onTBG, since mxyemeda itself interefes with itnestinal absorptio nfo L-t4 |
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Term
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Definition
hypothyroid can lead to ifneritlity, sometimes used for inertility treatment.
nead to consideri ncresaing t4 dosage in hypothyroid women who are pregnant due to icnrteased TBg produc iton |
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Term
| sublcinial hypothyroidism treatment indciations |
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Definition
sublicianial hypothryoidism defined as elevated TSH and normal TV.
replacement therpay shoudl be ocnsidered for patients iwht TSH levels grater than 10. |
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Term
| Drug induced hypothryoidism indicaitons |
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Definition
| stop depressatn drug, if it cant be stopped used t4. |
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Term
| Drug induced hypothryoidism indicaitons |
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Definition
| stop depressatn drug, if it cant be stopped used t4. |
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Term
| exopthalmos hyeprthyroidiism cause |
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Definition
| graves disease, autoantibodies activaito nof tsh-r on robital tissues |
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Term
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Definition
| drugs that inhibit production of thryorid hormones |
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Term
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Definition
| anionic inhiitor - drugs that block iodide updtake |
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Term
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Definition
| anionic inhiitor - drugs that block iodide updtake |
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Term
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Definition
| anionic inhiitor - drugs that block iodide updtake |
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Term
| b blockersi ntyroid therapy |
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Definition
| alter the tissue resposne to the excess thryorid |
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Term
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Definition
| destroy thyroid gland tissue |
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Term
| INBHITION OF HORMONE PRODUCTION: |
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Definition
NIS blocked by ANIONIC INHIBITORS
2. TPO blocked by iodides and thioamides.
proteolsysis blcoked by high iodide, peripehral conversion (from t4-t3 in peripheral tisuses) blcoked by beta blockers, coritocsterioids iodine contrasting agents, glucocoritcoids (dexamehasone). |
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Term
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Definition
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Term
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Definition
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Term
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Definition
| bind TPO , inhibit iodide incoporatio nand coupling |
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Term
| Which drug inbhits 5 prime deiodinase as an extra effect, blockign t4-t3 conversion |
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Definition
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Term
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Definition
| ptu blcoked 5 prime deiodinase, but MMi has a logner hlaf life. PTU is preferable in pregnancy, but it has hepatotoxicity |
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Term
| Thioamides duration of effect |
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Definition
| effect can take up to months to happen (becuase htyroid stores need to be depleted) |
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Term
| main toxicity of thioamides |
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Definition
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Term
| anionic inhbiitors major use |
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Definition
| samiodarone induced hyeprthyroidism |
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Term
| Perchlorate adverse effects |
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Definition
| is present in breast milk because is trnasportered via NIS (competitivei nbhiitor). potentially inhibiting newborns thyroid function |
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Term
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Definition
| blocks TPo, collodi resoprtio nvia endocytosis, and proteolosys of Tg. |
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Term
| Iodide treatment problems |
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Definition
| leaves tryoid loaded with iodide, so harder for RAI therapy and thioamide therapy |
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Term
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Definition
| reduce size and vascularity of htyroid gland prior to surgeyr or during thryotixc crisis |
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Term
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Definition
| sore throat mucous membrane irritaiotn ,rashes, and fetal goiter |
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Term
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Definition
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Term
| radioiodine contraindications |
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Definition
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Term
| radioiodinee adverse effecsdt |
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Definition
| low cancer risk ,nodular goiter, and hyperthyroidism |
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Term
| propanolo li nthyroid disorders |
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Definition
| blocks agaisnt cardiac arrythmias |
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Term
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Definition
| an antihyperentive that emilorates exopthalmos |
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Term
| mangement of grave's disease |
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Definition
useful in patients with milddisease, MMI or PTU adminmistered until disease remits . MMI preferred
for more serious disease thyroidectomy required, start with treating with antiithryoid agents unti euthoroid, and iodide to diminish vasularity. will require thyroid supplementaiton afterwards |
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Term
| radioactive iodine therpay i ngraves disease |
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Definition
| preferred treatment in patients over 21 years old. IF have heart d isease or sever thyrotoxicosis you getpretreated with MMI unti leuthyroid. Iodide eneeds to be avodiiedto ensuremaxmal uptake |
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Term
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Definition
| acclerate t4 breakdown by indcution of cyp3a hepatic cenzymes |
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Term
| bile acid sequestrants and thryoid |
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Definition
| rapidl ylweors t4 levels by increasing feccal exretion and itnerfering with t4 absoprtion |
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Term
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Definition
| sudden excaerbaiton of all symto0pomf of thrytoxicosis such as fever tachyc ardia, arrythmias, sweating ,tremor, vomitting, extreme weight loss |
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Term
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Definition
supportive care , fever contol with acetamipnohen not aspirin (aspiring wil lexacarcerbate symtpsom by dysplacing thryoxine from TBG.
anti thyroid therpay, then remove the acute precipitant |
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Term
| thyroid storm pharmacolical agents |
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Definition
anti thyroid therapy - blco k end orgna effects of hormone - propanolol
blcok syntehis and release of enw hormones- PTu, Iodide
Block peripehral activaito nof T4: dexamehasone (glucocorticoid)propanolol PTU. |
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Term
| opthalmopathy adn dermopathy treatmetn |
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Definition
opthalmopathy: treat htryoid disease, prednisosoen to reduce infalmmaiton.
dermopathy- corticosteroids. |
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Term
| thryotoxicosis during prengnacy |
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Definition
| RAI shoudl nto be used. USe PTU and subtotal thryoidectomy . |
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Term
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Definition
| due to meaterna lantibodies, suaully self limted and subsides, ma ytreat wth PTu |
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Term
| subclincial hyperthyroidism |
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Definition
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Term
| amidoarone indcud thr yoxcisos i types and treatment |
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Definition
type I - iodine induced, oftne due to udnaerlying disease ( e.g. m ult i nod ula rgoiter). treat with MMI or ptu
tYPE ii- inflammatory thryoiditis, without underlying thyroid idsesae, due to elakge of hormone itno circulat ion, responds best to glucocorticiods |
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Term
| NONTOXIC GOITER TREATMETN |
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Definition
thyroid enlargment without excess hormone production.
Caused by iodide deficieny, ingestio nof goitrogens , or hashimmotos.
Treat with proph administriaotn of iodide, elimination odf goitrogen or by adding suffiicent t4 to supress tsh stimulation |
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Term
| thyroid neoplasm treatment |
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Definition
| monitor until bostructs if beningn. If malignant total thryodectomy with postop RAI therpay and lfietime replacemant of l-t4 |
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Term
| SUmmary slide at end ifs very useful |
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Definition
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