Usmle 1 Thyroid Hormone

  1. Thyroid Hormone Mech
    • • TRH (Hypothalamus)
    •   →→ TSH (Pituitary)
    •   →→→ Thyroid Gland
    •   →→→ →T3/T4

    • Thyroid hormone is required for growth and differentiation in utero

  2. Thyroid Hormone Deficiency
    • • Cretinism
    •   Poor differentiation
    •     Eyes don’t know where to go
    •   Mother & baby both hypothyroid
    •   Mother’s T3/T4 last for at least 1 month of the babies life
    •       Deficiency can not be noticed until the 2nd month of life
    •       If it is deficient, Brain is at danger because it is still growing 
    •         Retardation
  3. Thyroid Composition
    • T3/T4 are made from tyrosine and the have a nuclear membrane receptor

    • • T3/T4 is responsible for the BMR
    •    Basal Metabolic Rate
    •   Therefore, it ALLOWS various functions to speed up

    • • Permissive action
    •   Lets other processes to their job
    •   IF there is a deficiency everything will “shut down

    • • The Thyroid Gland always concentrates Iodine
    •   Therefore, needs a ATPase b/c it is going against a gradient
  4. Thyroid Synthesis
    • • Tyrosine → MIT/DIT + colloid
    •      monoiodotyrosine (MIT)
    •     diiodotyrosine (DIT)
    •   = Thyroglobulin →
    •   Peroxidase = 20%T3/80%T4
    •   T3 is the biologically active form
    •   T4 is changed to T3 by deiodinase from the liver
  5. Thyroid hormone storage
    • rT3

    • Often elevated when sick
  6. Thyroid Diagnose
    • • SIGNAL
    •   : Organ
    •   : Pituitary
    •   : Hypothalamus
  7. Thyroid Hormone Disorders: 
    Hyperthyroidism
    • • Grave’s Disease 
    •    autoimmune
    •    < 50 y/o TSH antibody

    • • Plummer’s Syndrome:
    •    toxic multinodular goiter
    •    > 50 y/o 
    •    one area hot (iodine takeup)

    • • Tx: propanolol
    •    Propylthiouracil-
    •       blocks peroxidation
    •    Methimazole-
    •       block peroxidation
    •    I-131
    •       destroy the tissue
    •    Thyroxine-
    •       replacement
  8. Thyroid Hormone Disorders: 
    Hypothyroidism
    MCC: Iodine deficiency

    • • Cretinism
    •    Mom and fetus
    •    hypo

    • • Hashimoto’s disease
    •   Autoimmune disease

    • • DeQuarvain’s disease
    •    Virus (painful)
    •    self limiting

    • • Lymphocytic thyroiditis 
    •    postpartum 

    • • Riedel’s Struma
    •    capsule cancer 
    •    woody

    • • Tx:
    •    Thyroxine (T-4) 
    •    L-Thyronine (T-3)
Author
docbrito
ID
362264
Card Set
Usmle 1 Thyroid Hormone
Description
Updated