Hyperthyroidism and Graves' Disease

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39 Questions

Which gland primarily secretes steroid hormones?

Adrenal cortex, Kidney, Gonads

What is the main function of the endocrine system in postnatal growth?

all of the above

Which of the following is NOT a peptide hormone?

Testosterone

Where does the isthmus of the thyroid gland lie?

Overlying the 2nd and 3rd rings of the trachea

Which gland secretes amines such as epinephrine?

Adrenal medulla

Where are peptide hormones released from?

All of the above

Which of the following is a common cause of hyperthyroidism in children?

A and D

In Graves' disease, which antibodies bind to the TSH receptor?

TSH receptor antibodies

What is the preferred adrenergic blocking agent for the treatment of hyperthyroidism?

Atenolol

Which condition can resemble hyperthyroidism clinically but differs in thyroid function studies?

Severe anemia

What is the treatment of choice when medical therapy fails in hyperthyroidism?

Surgery

Which of the following clinical features is associated with thyroid storm?

Profuse diaphoresis

What is an important investigation necessary to confirm the diagnosis of hyperthyroidism?

Serum T3 and T4 levels

What condition does Graves' disease result in?

Hyperthyroidism

What is the peak incidence age group for Graves' disease?

11-15 years old

What investigation confirms the diagnosis of Graves' disease?

TSH-receptor autoantibodies (TSIs)

Which treatment modality is preferred during pregnancy and for nursing mothers in hyperthyroidism?

Propylthiouracil(PTU)

Which of the following is a primary function of the thyroid gland?

Regulating the amount of circulating calcium

What is the main hormone secreted by the thyroid gland?

Thyroxine

Which hormone encourages thyroid cell growth and differentiation, increases iodine uptake, and stimulates the release of T3 and T4?

Thyroid-stimulating hormone (TSH)

What is the effect of increased circulating levels of thyroid hormone on TSH release and TRH production?

Decreases TSH release but increases TRH production

Which of the following is a function of thyroid hormone in the Central Nervous System (CNS)?

All of the above

What is a common clinical manifestation of congenital hypothyroidism in infants?

Hoarse cry and hypotonia

What is a common respiratory difficulty associated with congenital hypothyroidism?

Apneic episodes

'Excessive sleep, hypotonia, and coarse facies' are symptoms associated with which condition?

(T3) Hypothyroidism

What can be inferred from a roentgenograph of skeletal for a newborn with congenital hypothyroidism?

Delayed osseous development

What is the treatment of choice for congenital hypothyroidism?

Replacement therapy with sodium-L-thyroxine, orally for life

What condition is almost always due to autoimmune overproduction of T3 and T4 in children?

Graves' disease – hyperthyroidism

What is the peak age group for presentation of type 1 diabetes mellitus?

5-7 years of age and at puberty

Which genetic syndrome is associated with type 1 diabetes mellitus?

Down syndrome and klinfelter

What component is regarded as a part of the multifactorial disorder of type 1 diabetes mellitus?

Genetic and environmental components

Which factor is NOT listed as an environmental factor associated with type 1 diabetes mellitus?

Bacterial infections

What defines prediabetes?

Impaired fasting glucose (IFG) level of 100-125 mg/dL

What is the role of insulin in reducing blood glucose levels?

Slows the breakdown of fat to triglycerides and free fatty acids and Stimulates fat storage

Which clinical presentation is the most common for childhood type 1 diabetes?

Classic new onset

At what blood glucose level does diabetic ketoacidosis (DKA) occur?

>300 mg/dl

'DKA is a pediatric emergency' refers to which characteristic of DKA?

Altered consciousness

'Soluble insulin is given subcutaneously at a dose of 0.5-1units/kg /day 3 times daily' refers to which phase of treatment?

'Initial phase'

'Total dose given twice daily using about 75% of the daily insulin dose as 2/3rd at breakfast and 1/3rd at dinner' describes which phase of treatment?

'Maintenance phase'

Study Notes

Endocrine System

  • The adrenal gland primarily secretes steroid hormones.
  • The main function of the endocrine system in postnatal growth is to regulate growth and development.

Thyroid Gland

  • The isthmus of the thyroid gland lies between the two lobes.
  • The thyroid gland secretes amines such as epinephrine.
  • Peptide hormones are released from the thyroid gland.
  • Thyroid storm is a clinical feature associated with hyperthyroidism.
  • An important investigation necessary to confirm the diagnosis of hyperthyroidism is thyroid function studies.
  • Graves' disease results in hyperthyroidism.
  • The peak incidence age group for Graves' disease is 20-40 years.
  • Thyroid scintigraphy confirms the diagnosis of Graves' disease.
  • The treatment of choice when medical therapy fails in hyperthyroidism is surgery.
  • Thyroid hormone increases the breakdown of nutrients to produce energy.
  • Thyroid hormone stimulates the release of T3 and T4.
  • Increased circulating levels of thyroid hormone decrease TSH release and TRH production.
  • Thyroid hormone plays a role in the development and maintenance of the CNS.

Congenital Hypothyroidism

  • A common clinical manifestation of congenital hypothyroidism in infants is excessive sleep, hypotonia, and coarse facies.
  • A common respiratory difficulty associated with congenital hypothyroidism is respiratory distress.
  • A roentgenograph of skeletal for a newborn with congenital hypothyroidism reveals delayed bone age.
  • The treatment of choice for congenital hypothyroidism is hormone replacement therapy.

Diabetes Mellitus

  • Type 1 diabetes mellitus is almost always due to autoimmune overproduction of T3 and T4 in children.
  • The peak age group for presentation of type 1 diabetes mellitus is 10-14 years.
  • Down syndrome is a genetic syndrome associated with type 1 diabetes mellitus.
  • Genetic susceptibility is a component of the multifactorial disorder of type 1 diabetes mellitus.
  • Vitamin D deficiency is not an environmental factor associated with type 1 diabetes mellitus.
  • Prediabetes is defined as a fasting blood glucose level of 100-125 mg/dL.
  • Insulin plays a role in reducing blood glucose levels by facilitating glucose uptake in cells.
  • The most common clinical presentation for childhood type 1 diabetes is polyuria and polydipsia.
  • Diabetic ketoacidosis (DKA) occurs at a blood glucose level of 250 mg/dL.
  • DKA is a pediatric emergency due to its rapid progression and potential for mortality.
  • Soluble insulin is given subcutaneously at a dose of 0.5-1 units/kg/day 3 times daily in the initial phase of treatment.
  • Total dose is given twice daily using about 75% of the daily insulin dose as 2/3rd at breakfast and 1/3rd at dinner in the maintenance phase of treatment.

Test your knowledge about hyperthyroidism, including its causes and the autoimmune disorder known as Graves' disease. Learn about the factors contributing to hyperthyroidism and its peak incidence age group.

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