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83 Cards in this Set
- Front
- Back
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The endocrine system exerts its effects via chemical messengers called _______________________.
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hormones
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What are the three processes the endocrine system plays a key role in regulating?
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• Metabolism
• Growth & development • Reproduction |
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_________ glands secrete products directly into the fluid that surrounds each cell while ________ glands secrete products into ducts that carry the secretions to the outside of the body, into body cavities, or into the lumen of an organ
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Endocrine - directly...
Exocrine - into ducts... |
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Which of the following statements regarding hormones is false?
A. Hormones are molecules that are formed in endocrine tissue and secreted into the fluid that surrounds each cell. B. Large amounts of hormones are usually required to exert their effects on target cells. C. Hormones play a role in regulating the functions of most of the body’s cells. D. Hormones are carried by blood from the organ that produces them to another part of the body where they exert their effects. |
B
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Hormones may be classified by all of the following except:
A. type of target cell. B. solubility. C. location of effect. D. chemical structure. |
A. Type of target cell
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True or false?
Hormones exert their effects by binding to specific receptors either on the surface of the target cell or within the target cell. |
True
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List three general effects of hormones on target cells.
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• Altering the rate of metabolic reactions
• Stimulating the synthesis of new molecules • Changing the permeability of the target cell’s plasma membrane • Stimulating the transport of a substance into or out of a target cell • Causing contraction or relaxation of muscle cells |
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How quickly and intensely a target cell responds to a hormone depends on the:
A. amount of hormone in the bloodstream. B. number of hormone receptors on the target cell. C. effects o fother hormones. D. All of the above |
D. all of the above
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List the three types of stimuli that control hormone secretion.
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• Other hormones
• Ions and other molecules • Nerve impulses |
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The thyroid gland regulates the body’s:
A. metabolic rate. B. growth. C. development. D. All of the above |
D. All of the above
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The majority of the thyroid gland consists of tiny spherical sacs called:
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thyroid follicules
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List the hormones produced by the thyroid gland.
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• Triiodothyronine (T3)
• Thyroxine or tetraiodothyronine(T4) • Calcitonin |
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True or false?
The thyroid gland secretes approximately 20 times more T3 than T4. |
F
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T3 and T4 help to regulate all of the following except:
A. calcium levels. B. basal metabolic rate. C. growth and development. D. cellular metabolism. |
A. calcium levels
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List the two endocrine organs (other than the thyroid gland) that help to regulate thyroid hormone secretion.
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Hypothalamus and pituitary gland
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Hypothyroidism is an endocrine disorder in which the production of thyroid hormone is ________________.
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diminished
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Signs and symptoms are absent or minimal in subclinical, or mild, hypothyroidism, which is defined as:
A. slightly increased serum TSH concentration with normal thyroid hormone levels. B. slightly increased serum TSH concentration and increased thyroid hormone levels. C. slightly decreased serum TSH concentration with normal thyroid hormone levels. D. Slightly decreased serum TSH concentration with increased thyroid hormone levels. |
A. slightly increased serum TSH concentration with normal thyroid hormone levels.
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Primary hypothyroidism involves a disorder of the _______________, whereas central hypothyroidism is due to disorders of the ________________.
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thyroid gland; hypothalamic-pituitary axis
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The NHANES III and the Colorado Thyroid Disease Prevalence Study determined the prevalence of hypothyroidism among the US populations they studied to be ____ and ____, respectively, with the majority of cases classified as subclinical hypothyroidism.
A. 13%; 18% B. 12.5%; 15.9% C. 4.6%; 9.5% D. 4.1%; 6.3% |
C. 4.6%; 9.5%
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What is the most common cause of primary hypothyroidism in the United States?
A. Postpartum thyroiditis B. Hashimoto’s thyroiditis C. Thyroid surgery D. Infiltrative diseases |
B. Hashimoto’s thyroiditis
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Which of the following is not a typical clinical feature of hypothyroidism?
A. Cold intolerance B. Slow heart rate C. Dry skin D. Diarrhea |
D. Diarrhea
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List the four areas of the body where the characteristic “puffiness” seen in hypothyroidism occurs.
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• Face (especially around the eyes)
• Hands • Ankles • Feet |
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In hypothyroidism, levels of _________ are reduced.
A. HDL B. LDL C. total cholesterol D. triglycerides |
A. HDL
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Briefly define myxedema coma.
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Myxedema coma is a medical emergency in which the body’s metabolism slows to the point that it starts to shut down.
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Define hyperthyroidism and thyrotoxicosis.
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• Hyperthyroidism: condition in which the thyroid gland produces too much thyroid hormone
• Thyrotoxicosis: state of thyroid hormone excess |
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The most common cause of hyperthyroidism, ____________________, typically occurs between 20 and 50 years of age. Among the elderly, _______________________ is more common.
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• Graves disease
• Toxic nodular goiter |
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Match each cause of hyperthyroidism with the appropriate description.
A. Toxic nodular goiter B. Thyroiditis C. Thyrotoxicosis factitia D. Graves disease ____ Results from excessive doses of thyroid hormone ____ Inflammation of the thyroid causes leakage of stored thyroid hormone ____ A single nodule in the thyroid that is producing too much thyroid hormone ____ An autoimmune disorder in which the thyroid is stimulated to enlarge and overproduce thyroid hormone |
C
B A D |
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Which of the following is not a typical clinical feature of hyperthyroidism?
A. Tachycardia B. Warm, moist skin C. Cold intolerance D. Insomnia |
C. Cold intolerance
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True or false?
Goiters are common in hypothyroidism, but occur rarely in hyperthyroidism. |
False
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Pretibial myxedema, a complication of advanced hyperthyroidism, is a:
A. condition involving inflammation of the eyes and tissues around the eyes. B. lumpy reddish thickening of the skin on the shins. C. condition in which the incorporation of calcium by the bones is impaired. D. life-threatening, sudden intensification of hyperthyroidism symptoms. |
B. lumpy reddish thickening of the skin on the shins.
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List three clinical features of thyroid storm.
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•High fever
•Tachycardia •Vomiting and diarrhea •Agitation •Delirium •Seizures •Coma |
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List four components of the diagnostic evaluation for hypothyroidism.
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• Medical and family history
• Patient’s symptoms and risk factors • Physical examination • Blood tests for TSH and the free T4 or free T4 index |
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List eight symptoms of hypothyroidism.
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• Weakness
• Fatigue • Sleepiness • Cold intolerance • Dry skin • Constipation • Joint pains • Muscle cramps • Mental impairment • Depression • Menstrual disturbances • Infertility • Weight gain |
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List six signs that might be observed during a physical examination that may indicate hypothyroidism.
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• Cool, dry skin
• Puffy face, hands, and feet • Diffuse alopecia • Bradycardia • Goiter or nonpalpable thyroid gland • Peripheral edema • Hoarseness, slow speech • Delayed relaxation of deep tendon reflexes • Carpal tunnel syndrome |
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A risk factor for hypothyroidism is:
A. older age. B. female gender. C. surgery or radiotherapy affecting the thyroid gland. D. All of the above |
D. All of the above
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Which of the following assays is the primary test used to diagnose hypothyroidism?
A. Free T4 B. Antithyroid antibodies C. Thyroid-stimulating hormone(TSH) D. Thyrotropin-releasing hormone (TRH) |
C. Thyroid-stimulating hormone(TSH)
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The normal serum level for TSH is:
A. 100 – 200 mIU/L. B. 0.4–4.0 mIU/L. C. 2.0–8.0 mIU/L. D. 0.4 – 4.0 mcg/dL. |
B. 0.4–4.0 mIU/L.
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True or false?
A diagnosis of autoimmune thyroiditis can be made by measuring antithyroid antibodies. |
True
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Match each type of thyroid assessment with its description.
A. Thyroid scan B. Thyroid ultrasound C. FNA biopsy ____ Procedure in which a thin needle is placed into a thyroid nodule and a specimen is withdrawn and examined microscopically ____ Examination that uses radioactive iodine to check for thyroid carcinoma or other thyroid gland growths ____ Noninvasive technique that uses sound waves to form a two- dimensional image of the thyroid |
C
A B |
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The primary goal of treatment for hypothyroidism is to restore the _______________ state.
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euthyroid
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Match the category of thyroid hormone replacement therapy with the individual agents.
A. Natural B. Synthetic ____ Liotrix ____ Desiccated thyroid ____ Levothyroxine ____ Liothyronine |
B
A B B |
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Which of the following statements about desiccated thyroid tablets is true?
A. Desiccated thyroid was the first available thyroid hormone replacement preparation. B. Desiccated thyroid may be antigenic in sensitive individuals. C. The potency and composition of desiccated thyroid tablets can vary among batches. D. All of the above |
D. All of the above
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Match the descriptions of each synthetic thyroid hormone replacement therapy with the correct agent.
A. Chemically stable, uniformly potent, non-antigenic, and relatively inexpensive T4 replacement agent B. Combination of T3 and T4 C. Higher cost and higher incidence of cardiac effects ____ Liotrix ____ Synthroid ____ Liothyronine |
B
A C |
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The recommended full dose of Synthroid in healthy adult patients is approximately:
A. 25 μg/day. B. 1.7μg/kg/day. C. 100 to 125 μg/kg/day. D. None of the above |
B. 1.7μg/kg/day.
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Following initiation of thyroid hormone replacement therapy, TSH levels should be measured after:
A. 6 days. B. 6 weeks. C. 6 months. D. 12 months. |
B. 6 weeks.
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List the two factors that can affect thyroid hormone absorption.
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• Malabsorptive states
• Drug interactions |
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List four drugs that interfere with the absorption of levothyroxine.
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• Cholestyramine
• Iron (ferrous sulfate) • Sucralfate • Calcium carbonate • Antacids containing aluminum or magnesium • Simethicone |
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True or false?
During pregnancy, many patients with hypothyroidism require a decreased dosage of thyroid hormone replacement therapy. |
False
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Therapy with T4 sometimes unmasks symptoms of _______________, especially in the elderly.
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cardiac disease
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List the three methods that are used to diagnose hyperthyroidism.
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• Patient’s medical history
• Physical examination • Laboratory tests |
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List three symptoms of hyperthyroidism.
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• Excessive weight loss with increased appetite
• Heat intolerance • Increased sweating • Nervousness or jitteriness • Itching • Irritability • Insomnia • Memory loss • Poor attention span • Shortness of breath • Difficulty in swallowing • Frequent bowel movements • Frequent urination • Muscle weakness • Changes in the menstrual cycle • Loss of libido • First trimester miscarriage in pregnant women |
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All of the following are risk factors for the development of hyperthyroidism except:
A. smoking. B. obesity. C. childbirth. D. life events such as divorce or job loss. |
B. obesity.
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List three components of the physical examination to diagnose hyperthyroidism.
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• Measuring weight, blood pressure, and Listening to the heart through a stethoscope to detect arrhythmias
• Palpation of the thyroid • Asking the patient to swallow • Listening to the thyroid through a stethoscope • Checking for muscle weakness or wasting • Checking the patient’s skin for red, scaly areas |
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List one of the most common signs of Graves ophthalmology.
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• Bulging of the eyeballs beyond the eyelids
• Swelling around the eyeballs |
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What is the primary test used to diagnose hyperthyroidism?
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sensitive assay of TSH level
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List three tests used to diagnose hyperthyroidism.
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• Sensitive assay of TSH level
• Free thyroxine (T4) level • Free triiodothyronine (T3) level • Radioactive iodine uptake (RAIU) • Antibody assays |
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True or false?
A diagnosis of Graves disease can typically be made based on an elevated T4 level. |
False
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The ____________ test is a measurement of how much iodine the thyroid can collect.
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RAIU
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______________ are performed primarily to monitor pregnant women with Graves disease to predict hyperthyroidism in an infant.
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Antibody assays
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List the treatment goals of hyperthyroidism.
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• Restore the euthyroid state by reducing the amount of thyroid hormone produced
• Modulate the effect of the excess thyroid hormone on the body |
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List the most commonly used treatments for hyperthyroidism.
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• Antithyroid drugs
• Radioactive iodine therapy • Surgery |
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List the two antithyroid drugs approved for the treatment of hyperthyroidism in the United States.
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• Propylthiouracil(PTU)
• Methimazole |
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True or false?
Antithyroid drugs may be used to prepare a patient for radioactive iodine therapy or surgery. |
True
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The antithyroid drug ________ is recommended for pregnant women with hyperthyroidism because _________ has been associated with rare congenital abnormalities.
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propylthiouracil (PTU); methimazole
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What is the most serious potential complication of treatment with antithyroid drugs?
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agranulocytosis (acute condition in which the number of granulocytes (type of white blood cell) is severely reduced; may result in infected ulcers in the throat, intestinal tract, other mucous membranes, and skin)
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In addition to antithyroid drugs, __________ and _______ are two other drug types sometimes used in the treatment of hyperthyroidism.
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beta-blockers; iodides
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Most thyroid specialists in the United States consider the treatment of choice for hyperthyroidism caused by the excess production of thyroid hormone to be:
A. antithyroid drugs. B. radioactive iodine. C. surgery. D. thyroid hormone replacement therapy. |
B. radioactive iodine.
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Radioactive iodine is administered by:
A. oral capsule. B. subcutaneous injection. C. intravenous infusion. D. surgical implantation. |
A. oral capsule.
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Radioactive iodine that is not absorbed by the thyroid leaves the body primarily through the __________.
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urine
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Radioactive iodine is never given to a patient who is _______ or _______.
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pregnant or breastfeeding
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Surgery to remove most of the thyroid gland is not often performed in the United States unless ________ is suspected.
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cancer
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The rate of serious complications of thyroidectomy is less than:
A. 1%. B. 4%. C. 7%. D. 9%. |
A. 1%.
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True or false?
Synthroid is made up of synthetic T₃, which is identical to T₃ produced in the human thyroid gland. |
False - it's T₄
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Which of the following best describes the mechanism of action for thyroid hormone replacement therapy?
A. Stimulation of the pituitary gland to release TSH B. Control of DNA transcription and protein synthesis in the cell nucleus C. Stimulation of the hypothalamus to release TRH D. All of the above |
B. Control of DNA transcription and protein synthesis in the cell
nucleus |
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Absorption of Synthroid can be (increased/decreased) by malabsorption syndromes, dietary fiber, age, and certain foods and drugs. (choose one)
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decreased
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List three indications for Synthroid.
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• Replacement or supplemental therapy in congenital or acquired hypothyroidism of any etiology, except transient hypothyroidism during the recovery phase of subacute thyroiditis
• Treatment or prevention of various types of euthyroid goiters. • Adjunctive therapy to surgery and radioiodine therapy for management of thyrotropin-dependent well-differentiated thyroid cancer |
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Match the patient population to the recommendation for the initial dose of Synthroid. (More than one answer may apply.)
A. Adults and children in whom growth and puberty are complete B. Most patients>50 years old or patients<50 years old with underlying cardiac disease C. Elderly patients with cardiac disease D. Patients with severe hypothyroidism ____ 12.5 to 25 mcg/day ____ 25 to 50 mcg/day ____ Full replacement dose (ie, approximately 1.7 mcg/kg/day) |
C,D
B A |
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Synthroid is supplied as round, color-coded, scored tablets in _____ different strengths.
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12
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Which of the following is a warning in the Synthroid product labeling?
A. Synthroid should not be used for the treatment of infertility unless the condition is associated with hypothyroidism. B. Chronic use of Synthroid can cause increased bone resorption and decreased bone mineral density. C. Caution should be used when Synthroid is administered to patients with cardiovascular disorders. D. All of the above |
A. Synthroid should not be used for the treatment of infertility unless the condition is associated with hypothyroidism.
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True or false?
Regardless of the indication for use, careful dosage titration of Synthroid is necessary to avoid the consequences of over- or undertreatment. |
True
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Which of the following drugs can interact with Synthroid to increase hepatic metabolism, resulting in hypothyroidism?
A. Carbamazepine B. Amiodarone C. Cholestyramine D. All of the above |
A. Carbamazepine
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Adverse reactions associated with Synthroid are primarily symptoms of ________ related to therapeutic overdosage.
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hyperthyroidism
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Symptoms of Synthroid overdosage can include:
A. symptoms of hyperthyroidism. B. confusion. C. disorientation. D. All of the above |
D. All of the above
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