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WorksheetsPathophysiology Exam III - THYROID
Total questions: 74
Worksheet time: 43mins
Thyroxine
T4
T3
Prohormone
Active hormone
Triiodothyronine
T4
T3
Prohormone
Active hormone
T/F T3 and T4 are formed from the combination of iodinated tyrosine
True
False
Adequate levels of thyroid hormones are necessary in infants for
Normal CNS development
Skeletal growth and maturation
Normal function of multiple organ systems
Adequate levels of thyroid hormones are necessary in children for
Normal CNS development
Skeletal growth and maturation
Normal function of multiple organ systems
Adequate levels of thyroid hormones are necessary in adults for
Normal CNS development
Skeletal growth and maturation
Normal function of multiple organ systems
T/F the thyroid is highly vascular and has one of the lowest rates of blow flow per gram of tissue of any organ
True
False
The thyroid consists of
Two lateral lobes
Central isthmus
One lateral lobe
Three lateral lobes
T/F an irregular thyroid is firm, reddish brown, and located in the front of the trachea
True
False
Normal plasma level of T4
0.08ug/dL
8ug/dL
12ug/dL
0.15ug/dL
0.22ug/dL
Normal plasma level of T3
0.08ug/dL
8ug/dL
12ug/dL
0.15ug/dL
0.22ug/dL
T/F both T3 and T4 are bound to plasma proteins, including albumin, transthyretin, and thyroxine-binding globulin
True
False
Biologic half-life of T4
4-5 days
6-7 days
12 hours
24 hours
9-10 days
Biologic half-life of T3
4-5 days
6-7 days
12 hours
24 hours
9-10 days
(1) is (2) more potent than (3) on a molar basis
(1) T3
(2) 3-5 times
(3) T4
(1) T4
(2) 3-5 times
(3) T3
(1) T3
(2) 2-3 times
(3) T4
(1) T4
(2) 2-3 times
(3) T3
(1) T3
(2) 2x
(3) T4
About (1) of circulating T3 derives from the peripheral conversion of T4 to T3, with the remaining (2) derived from thyroid secretion
(1) 90%
(2) 10%
(1) 80%
(2) 20%
(1) 20%
(2) 80%
(1) 70%
(2) 23%
Three major thyroidal antigens include
Thyroglobulin [Tg]
Thyroidal peroxidase [TPO]
TSH receptor
TSH receptor autoantibody [TSH-R [stim] Ab [TSI]]
Hyperthyroidism is most commonly
Overproduction of thyroid hormones
Lack of expression of thyroid hormones
Due to Graves Diseas
Due to Hashimoto
Transient* hyperthyroidism
Hashimoto
Graves
Inherited primary immunodeficiency disease [PIDD] which increases the body's susceptibility to infections caused by certain bacteria and fungi
Chronic Granulatomatous Disease [GCD]
Hypothyroidism
Transient* hyperthyroidism
Graves disease
Hashimoto thyroiditis
Smooth and uniformly enlarged
Diffuse goiter
Nodular goiter
Caused by one or more nodules within the gland
Diffuse goiter
Nodular goiter
In nodular goiter, the nodules may be
Solid
Filled with fluid
Partly fluid and partly solid
Thyroid nodules are common
Smooth and uniformly enlarged
T/F hyperthyroidism resulting from Graves disease is characterized by an increased serum TSH level
True
False
TSH-secreting pituitary adenomas
Secondary hyperthyroidism
Secondary hypothyroidism
Tertiary hyperthyroidism
Tertiary hypothyroidism
Primary hyperthytroidism
Hypothalamic disease with excessive TRH production
Secondary hyperthyroidism
Secondary hypothyroidism
Tertiary hyperthyroidism
Tertiary hypothyroidism
Primary hyperthytroidism
High or high normal plasma TSH level
Secondary hyperthyroidism
Secondary hypothyroidism
Tertiary hyperthyroidism
Tertiary hypothyroidism
Primary hyperthytroidism
Most common cause of hyperthyroidism among individuals in their third and fourth decades
Chronic Granulatomatous Disease [GCD]
Hypothyroidism
Transient* hyperthyroidism
Graves disease
Hashimoto thyroiditis
T/F graves disease is only apparent among individuals in their third and fourth decades
True
False
Characteristics of Graves disease
Thyroid gland is symmetrically enlarged
Thyroid gland is asymmetrically enlarged
Vascularity increased
Vascularity decreased
Gland may double or triple in weight
T/F in graves disease, the follicular and endothelial cells are columnar in appearance and increased in number and size
True
False
Which is true among follicular endothelial cells of graves disease?
Follicles are large and dispersed
Follicles are small and dispersed
Follicles are small and closely packed
Colloid is scanty
Colloid is enlarged
T/F becuase serum levels of TSI correlate poorly with graves disease severity, its presence is not helpful diagnostically
True
False
T/F a genetic contribution to the development of Graves disease is possible
True
False
Patients may later develop hypothyroidism from graves disease for which of the following reasons?
Thyroid ablation by surgery
Thyroid ablation by 131I radiation treatment
Autoimmune thyroiditis, leading to thyroid destruction
Myxedema, leading to thyroid destruction
Development of antibodies that block TSH stimulation
Untreated hyperthyroidism may decompensated into which of the following?
Thyroid storm
Autoimmune thytoiditis
Myxedema
Hypothyroidism
Transient* hyperthyroidism
Tachycardia, fever, agitation, nausea, vomiting, diarrhea, and restlessness or psychosis are symptoms of which of the following?
Thyroid storm
Autoimmune thytoiditis
Myxedema
Hypothyroidism
Transient* hyperthyroidism
Abnormally low serum T4 and T3 levels
Thyroid storm
Hyperthyroidism
Myxedema
Hypothyroidism
Transient* hyperthyroidism
Severely advanced hypothyroidism
Thyroid storm
Hashimoto thyroiditis
Myxedema
Goiter
Transient* hyperthyroidism
Serum TSH level is the most sensitive test for early
Thyroid storm
Hyperthyroidism
Myxedema
Hypothyroidism
Transient* hyperthyroidism
In frank hypothyroidism, serum TSH levels show
Elevations of serum TSH
Reductions of serum TSH
Normal serum TSH
Abnormal serum TSH - can be elevated or reduced
Thyroid failure
Primary hypothyroidism
Secondary hypothyroidism
Central hypothyroidism
Myxedema
In central hypothyroidism, serum TSH levels show
Elevations of serum TSH
Reductions of serum TSH
Normal serum TSH
Abnormal serum TSH - can be elevated or reduced
Gland is diffusely enlarged, firm, rubbery, and nodular in the early stages and the gland becomes smaller as the disease progresses
Thyroid storm
Hashimoto thyroiditis
Myxedema
Goiter
Transient* hyperthyroidism
Destruction of thyroid follicles and lymphocytic infiltration with lymphoid follicles
Thyroid storm
Hashimoto thyroiditis
Myxedema
Goiter
Transient* hyperthyroidism
As Hashimoto thyroiditis progresses, there is
An increasing amount of fibrosis
A decreasing amount of fibrosis
T/F serum levels of antibodies correlate with the severity of the hypothyroidism and their presence is helpful in diagnosis
True
False
High antibody titers
Hashimoto thyroiditis
Elderly
Graves disease
Myxedema
Transient* hyperthyroidism
Moderate antibody titers
Hashimoto thyroiditis
Elderly
Graves disease
Myxedema
Transient* hyperthyroidism
Low antibody titers
Hashimoto thyroiditis
Elderly
Graves disease
Myxedema
Transient* hyperthyroidism
Hypothyroidism
Pitting
Nonpitting
Promotes sodium and water retention
Inhibits sodium and water retention
Carotenemia
May occur in hyperthyroidism
May occur in hypothyroidism
Hepatic conversion of carotene to Vitamin A
Hepatic conversion of carotene to Vitamin C
Carotene accumulates in the bloodstream and skin
Myxedema coma may caused by severe untreated
Hyperthyroidism
Hypothyroidism
Diffuse thyroid enlargement most commonly results from prolonged stimulation by TSH
Thyroid storm
Hashimoto thyroiditis
Myxedema
Goiter
Transient* hyperthyroidism
Stimulation by TSH in goiter may be a result of
Hypothyroidism
Hyperthyroidism
May occur in a clinically euthyroid patient
T/F goitrogens are factors that promote thyroid hormone synthesis
True
False
Most patients remain clinically euthyroid in goiter due to (1) of TSH production
Increase
Decrease
Goiter has a progressive (1) in serum T4 and progressive (2) in serum TSH
(1) rise
(2) fall
(1) fall
(2) rise
(1) fall
(2) fall
(1) rise
(2) rise
Autonomous mutlinodular goiter
Iodine deficiency
Iodine abundance
Nontoxic
Toxic
Subclinical thyroid dysfunction
Low TSH levels
High TSH levels
Normal circulating T4 and T3 levels
Abnormal circulating T4 and T3 levels
Normal circulating T4 and abnormal T3 levels
Subclinical hypothyroidism
Elevated TSH level
More common among men
More common among women
Individuals older than 65
Individuals older than 40
Subclinical hyperthyroidism
Elevated TSH level
Low TSH level
Normal circulating thyroid hormone levels
Individuals older than 65
Abnormal circulating thyroid hormone levels
Hyperthyroidism diseases
Transient* hyperthyroidism
Chronic granulomatous disease
Graves disease
Thyroid storm
Hashimoto thyroiditis
Hypothyroidism diseases
Transient* hyperthyroidism
Chronic granulomatous disease
Graves disease
Goiter
Hashimoto thyroiditis
Coupling of MIT + DIT
T3
rT3
T4
Coupling of DIT + DIT
T3
rT3
T4
Deiodinase II produces
T3
rT3
T4
T2
Deiodinase III produces
T3
rT3
T4
T2
Active
T3
rT3
T4
T2
Inactive
T3
rT3
T4
T2
T/F rT3 and T3 have the same structure
True
False
1
Colloid
Follicular cells
Stroma
2
Colloid
Follicular cells
Stroma
3
Colloid
Follicular cells
Stroma
