C27- Endocrine system 2

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Questions and Answers

Thyroid hormones are derived from the amino acid phenylalanine.

False (B)

The main function of the thyroid gland is the synthesis and storage of thyroid hormone.

True (A)

Thyroid stimulating hormone (TSH) is produced by the thyroid gland itself.

False (B)

Colloid makes up approximately 30% of the mass of the thyroid gland and contains thyroglobulin.

<p>True (A)</p>
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The apical surface of the follicular cell is responsible for hormone release into the bloodstream.

<p>False (B)</p>
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Iodine, required for thyroid hormone synthesis, is obtained from the circulation.

<p>True (A)</p>
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Parafollicular or C cells in the thyroid gland produce thyroid hormones.

<p>False (B)</p>
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Thyroid hormones play a role exclusively in energy storage.

<p>False (B)</p>
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The secretion of thyroid hormones is regulated by thyrotropin-releasing hormone (TRH).

<p>True (A)</p>
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Lymphocytes are the only type of cells found in the thyroid gland.

<p>False (B)</p>
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The human chorionic gonadotropin (hCG) does not bind to the TSH receptor and has no effect on thyroid function.

<p>False (B)</p>
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Thyroid hormones T3 and T4 are synthesized from diiodotyrosine and triiodotyrosine through a series of coupling reactions.

<p>False (B)</p>
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The primary action of TSH is to regulate the uptake of nutrients and promote cell apoptosis in thyroid cells.

<p>False (B)</p>
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The process of iodide oxidation is primarily facilitated by the enzyme iodine oxidase.

<p>False (B)</p>
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About 3/4 of the iodinated tyrosine in thyroglobulin is converted to thyroid hormones.

<p>False (B)</p>
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Iodide is transported into the follicular cell via a sodium/iodide symporter that moves two Na+ ions for each iodide molecule.

<p>True (A)</p>
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The thyroid gland can store sufficient thyroid hormones to meet physiological demands for approximately 6 months.

<p>False (B)</p>
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Thyroid hormone receptors are located exclusively in the nucleus of the cell.

<p>False (B)</p>
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Reverse T3 (RT3) is synthesized from the coupling of diiodotyrosine and monoiodotyrosine, which is believed to be functionally significant in humans.

<p>False (B)</p>
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The Wolff-Chaikoff effect refers to increased organification of iodine when plasma iodide levels are elevated.

<p>False (B)</p>
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Thyroxine and triiodothyronine bind poorly with intracellular proteins compared to thyroxine-binding globulin.

<p>True (A)</p>
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TSH is primarily stimulated by T3 in a feedback regulation.

<p>False (B)</p>
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Thyroglobulin molecules can contain up to 30 thyroxine molecules and a few triiodothyronine molecules.

<p>True (A)</p>
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Thyroid hormones have no significant effect on cholesterol synthesis.

<p>False (B)</p>
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The conversion of iodide ions to an oxidized form of iodine is an early effect of TSH binding to its receptor.

<p>True (A)</p>
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Hypothyroidism can result from reduced responsiveness of tissues to thyroid hormones, a condition known as thyroid hormone resistance.

<p>True (A)</p>
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Epinephrine-induced glycogenolysis and insulin-induced glycogen synthesis are facilitated by thyroid hormones.

<p>True (A)</p>
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In adults, excess thyroid hormone levels can decrease the risk of osteoporosis.

<p>False (B)</p>
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The main proteins that thyroxine binds to in the blood are synthesized by the spleen.

<p>False (B)</p>
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Thyroid hormone is essential for bone development and affects osteoclast and osteoblast activity.

<p>True (A)</p>
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Hyperthyroidism is characterized by decreased basal metabolism and an underactive autonomic nervous system.

<p>False (B)</p>
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Graves disease is an autoimmune condition that results from TSH receptor stimulation by immunoglobulin G.

<p>True (A)</p>
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The thyroid-resistant state is marked by low levels of TSH despite high circulating free thyroid hormone levels.

<p>False (B)</p>
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Exophthalmos occurs in approximately 40%–50% of patients with hyperthyroidism but is not related to Graves disease.

<p>False (B)</p>
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Toxic adenoma is one of the common causes of hyperthyroidism, along with Graves disease.

<p>True (A)</p>
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The incidence of Graves disease peaks in the aged population and is statistically equal among men and women.

<p>False (B)</p>
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TSH producing tumors of the pituitary can result in hyperthyroidism.

<p>True (A)</p>
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Hyaluronate accumulation in extraocular tissues is linked to the pathogenesis of exophthalmos.

<p>True (A)</p>
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Individuals with thyroid ophthalmopathy often do not have any form of hyperthyroidism.

<p>False (B)</p>
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Excess iodine intake is a rare cause of hyperthyroidism.

<p>False (B)</p>
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Flashcards

Thyroid gland

The thyroid gland is a butterfly-shaped endocrine gland located in the neck. It produces and secretes thyroid hormones, which are essential for regulating metabolism, growth, and development.

Thyroid hormones

Thyroid hormones are essential for maintaining energy balance and regulating energy expenditure.

TSH (Thyroid-Stimulating Hormone)

Thyroid hormones are produced by the thyroid gland in response to stimulation by thyroid-stimulating hormone (TSH).

TRH (Thyrotropin-Releasing Hormone)

TSH is regulated by thyrotropin-releasing hormone (TRH) produced by the hypothalamus.

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Iodine

Iodine is an essential nutrient for the synthesis of thyroid hormones.

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Thyroid follicle

Thyroid follicles are the functional units of the thyroid gland. They are spherical structures composed of follicular cells surrounding a central cavity filled with colloid.

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Colloid

Colloid is a protein-rich fluid that fills the thyroid follicles and contains thyroglobulin, the precursor to thyroid hormones.

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Thyroglobulin (Tg)

Thyroglobulin (Tg) is a protein found in colloid. It's the precursor to thyroid hormones.

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Apical surface of follicular cells

The apical surface of follicular cells faces the follicular lumen and is responsible for thyroid hormone synthesis.

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Basolateral surface of follicular cells

The basolateral surface of follicular cells faces the interstitium and is responsible for releasing thyroid hormones into the bloodstream.

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Megalin-Thyroglobulin Complex

A complex formed by the proteins Megalin and Thyroglobulin, released into the blood after being transported across the follicular cell.

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Transcytosis

A process where a substance is enclosed in a vesicle and transported across a cell.

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Thyroglobulin Digestion

The breakdown of Thyroglobulin, releasing thyroid hormones (T3 and T4) into the blood.

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Deiodinase

An enzyme that removes iodine from monoiodotyrosine and diiodotyrosine, making it available for reuse.

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Wolff-Chaikoff Effect

The process where the thyroid gland regulates its own iodine uptake and metabolism.

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Thyroid Hormone-Binding Proteins

Plasma proteins that bind to thyroid hormones, slowing their release into the tissues.

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Triiodothyronine (T3)

The active form of thyroid hormone, responsible for most of its effects.

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Thyroid Hormone Receptor

A protein receptor that binds to T3 and triggers gene transcription.

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Hypothyroidism

A condition caused by insufficient thyroid hormone production or action.

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Thyroid Hormone Resistance

A rare condition where tissues are less responsive to thyroid hormones.

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Thyroid-resistant state

A state where the body's cells are resistant to the effects of thyroid hormone, leading to high levels of free thyroid hormone in the blood and normal or elevated levels of TSH.

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Graves disease

An autoimmune condition where the body produces antibodies that stimulate the TSH receptor, leading to excessive thyroid hormone production.

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Goiter

Enlargement of the thyroid gland, often associated with thyroid dysfunction.

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Exophthalmos

Protruding eyes, a characteristic symptom of Graves disease.

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Compensatory mechanism

A compensatory mechanism in thyroid-resistant state where the body tries to maintain normal thyroid function by increasing T3, T4, and TSH levels.

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Toxic nodular goiter

A type of hyperthyroidism where multiple nodules on the thyroid gland become overactive, leading to excessive thyroid hormone production.

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Thyroiditis

An autoimmune response in which the body's immune system attacks the thyroid gland, leading to thyroid dysfunction.

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TSH-producing tumor

A tumor in the pituitary gland that produces TSH, leading to hyperthyroidism.

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TSH-like antibodies

Antibodies that mimic TSH and bind to the TSH receptor, leading to continuous stimulation and excess thyroid hormone production.

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Hypothalamic-pituitary-thyroid (HPT) axis

A process that ensures thyroid hormone production and release remain balanced. It involves communication between the hypothalamus, pituitary gland, and thyroid gland.

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Thyrotropin-releasing hormone (TRH)

A tripeptide hormone synthesized in the hypothalamus and released by nerve terminals in the median eminence. It travels to the anterior pituitary via the portal capillary plexus.

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Thyroid-stimulating hormone (TSH)

A glycoprotein hormone synthesized and released by the anterior pituitary gland. It acts on the thyroid gland to stimulate thyroid hormone synthesis and release.

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TSH Receptor

A protein located on the basolateral membrane of thyroid follicular epithelial cells. TSH binds to this receptor to initiate thyroid hormone production.

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Iodide Uptake

The process by which iodide ions (I-) are transported into the cytosol of the thyroid follicular cell. This process involves a sodium/iodide (Na+/I-) symporter, which moves two Na+ ions with each I- ion.

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Na+/I- Symporter

A protein involved in transporting and concentrating iodide in the thyroid epithelial cell. It uses the energy from the Na+ gradient to transport I- into the cell.

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Thyroid Peroxidase (TPO)

An enzyme that catalyzes the oxidation of iodide and its incorporation into tyrosine residues of thyroglobulin.

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Organification of Thyroglobulin

The process of combining iodide with thyroglobulin. It occurs in the colloid of thyroid follicles and is a crucial step in thyroid hormone synthesis.

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Thyroid Hormone Release

A process where thyroglobulin bound to thyroid hormones is taken up by the thyroid cells and digested to release T3 (triiodothyronine) and T4 (thyroxine) into the bloodstream.

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Study Notes

Thyroid Gland: Structure, Function, and Disorders

  • Thyroid hormones (T3, T4) regulate energy homeostasis and cell metabolism, crucial for development and maturation. Deficiencies cause severe mental retardation in infants.
  • Thyroid hormones are derived from tyrosine and produced by the thyroid gland. Production is stimulated by TSH from the anterior pituitary, which is itself regulated by TRH.
  • Dietary iodine is also essential for thyroid hormone production.
  • The thyroid gland's functional unit is the thyroid follicle, composed of follicular cells surrounding a colloid-filled cavity. Colloid contains thyroglobulin (Tg).
  • Follicular cells are polarized: the apical side faces the colloid, where thyroglobulin iodination occurs, and the basolateral side faces the circulation for hormone release.
  • TSH regulates nutrient uptake and intracellular transport of proteins involved in thyroid hormone synthesis and release. This includes proteins like Na+/I- symporter, Tg, TPO (thyroid peroxidase), and thyroid hormones themselves.
  • TSH also stimulates gene transcription of these proteins.
  • Iodide is actively transported into follicular cells by the Na+/I− symporter. This process requires energy and is crucial for thyroid hormone production.
  • Iodide is subsequently oxidized and incorporated into tyrosine residues within thyroglobulin.

Thyroid Hormone Synthesis

  • Thyroid hormones are synthesized by the organification of thyroglobulin. Iodine is incorporated by thyroid peroxidase.
  • Iodinated tyrosine molecules (monoiodotyrosine, diiodotyrosine) couple to form T4 (thyroxine) and smaller amounts of T3 (triiodothyronine).
  • Tg containing hormones are stored in the colloid. The thyroid gland stores sufficient hormones for several months.
  • Thyroid hormone release is triggered by endocytosis of colloid into the follicular cell. Lysosomal digestion frees T3 and T4.

Thyroid Hormone Transport and Action

  • More than 99% of T4 and T3 bind to plasma proteins (primarily thyroxine-binding globulin). This slow, controlled release of hormones to tissues is important.
  • T4 is converted to the more active T3 intracellularly.
  • Thyroid hormone receptors are found within virtually all tissues. T3 binds to these receptors, activating nuclear transcription of many genes, including those for metabolic enzymes. This results in increased oxygen consumption, fatty acid oxidation, and protein synthesis.
  • Thyroid hormones also regulate various organ-specific functions.

Effects on Various Organs

  • Bone: Essential for bone growth and development.
  • Cardiovascular: Increases cardiac output and blood volume, decreases systemic resistance.
  • Adipose tissue: Regulates lipolysis (breaking down fats).
  • Liver: Regulates triglyceride and cholesterol metabolism.
  • Pituitary: Regulates pituitary hormone synthesis.
  • Brain: Crucial roles in myelination, cell differentiation, migration, and signaling.
  • Reproductive function: Essential for folliculogenesis, granulosa cell survival, spermatogenesis, fertilization, placental function, and gestation.

Thyroid Disorders

  • Hypothyroidism: Insufficient thyroid hormone action, may result from primary or secondary causes. Severe cases in infancy can cause cretinism.
  • Hyperthyroidism: Excessive thyroid hormone production. Causes include Graves' disease (autoimmune), toxic nodular goiter, and toxic adenoma.
  • Wolff-Chaikoff effect: High plasma iodide levels inhibit the organic binding of iodine within the thyroid.
  • Graves' disease: An autoimmune condition causing excess thyroid hormone production due to antibodies mimicking TSH. Often characterized by exophthalmos (protruding eyes).

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