Chapter 32: Thyroid and Related Disorders
In adults, about how much water is needed daily?
1 mL/kcal
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An example of a goitrogen is
Brussels sprouts
Graves' disease is an autoimmune disease in which the thyroid is diffusely enlarged (goiter) and overactive, producing an excessive amount of thyroid hormones. It is the most common cause of hyperthyroidism (overactive thyroid) in the United States. What is the primary target of circulating autoantibodies in this disease?
Thyrotropin-releasing hormone (TRH) receptors
Hypothalamus
Tiny, cone-shaped structure located in the lower center of the brain that communicates between the nervous and endocrine systems
The most common endocrine-related chronic disease appears to be
diabetes mellitus.
Polycystic ovarian syndrome is characterized by
insulin resistance.
Sweat contains
small amounts of sodium
About how many days can adults live without water in moderate weather?
10 days
Thirst is an adequate guide for fluid intake for a(n)
25 year old woman
Selenium deficiency, inadequate protein, excess carbohydrates, chronic illness, and stress (high cortisol levels) can all impact what thyroid metabolic process?
5'-deiodinase conversion of T4 to T3
The normal range of pH for the body is
7.35 to 7.45.
Thyroid-stimulating hormone
A hormone released by the pituitary gland that stimulates release of thyroxine
Thyroid-binding globulin
A protein that transports thyroid hormones through the blood
A rare primary adrenal insufficiency in which insufficient levels of steroid hormones are produced despite adequate levels of the hormone ACTH is known as:
Addison's disease.
Costisol
Adrenal hormone that raises blood glucose when it drops too low
Tyrosine
An amino acid required for the synthesis of thyroid hormone
Graves disease
Autoimmune disease that causes an enlarged thyroid gland and overproduction of thyroid hormones
Hashimotos thyroiditis
Autoimmune disorder that results in hypothyroidism
Which of the following is a cation in solution
Calcium
Goitrogen
Cyanic plant foods such as cauliflower and broccoli that exert antithyroid activity through inhibition of TPO
Polycystic ovary syndrome (PCOS) is characterized by which of the following biochemical and endocrine abnormalities?
Elevated testosterone, insulin resistance, and impaired glucose tolerance
The oxidation of which of these yields the most metabolic water?
Fat
Thyroid health has been shown to be impacted by the elimination of which foods?
Gluten
Bulging eyes, a diffusely enlarged thyroid (goiter), heat intolerance, difficulty sleeping, and anxiety are typical symptoms of which autoimmune disease in the thyroid?
Graves' disease
Iodine deficiency is often a culprit in thyroid disorders. However, in which of these thyroid conditions may supplementing with iodine exacerbate the condition?
Hashimoto's thyroiditis
Low energy, cold hands and feet, fatigue, hypercholesterolemia, muscle pain, depression, and a positive test result for thyroid peroxidase antibodies could all be indicative of what condition?
Hashimoto's thyroiditis
More than half of the detected cases of underactive thyroid are caused by an autoimmune disorder in which the immune system attacks and destroys thyroid gland tissue called
Hashimoto's thyroiditis
Thyrotropin-releasing hormone
Hormone secreted by the hypothalamus that stimulates the release of thyroid stimulating hormone
Decreased TSH levels combined with normal to high T4 or T3 levels may be suggestive of
Hyperthyroidism.
Schmidts syndrome
Hypothyroidism associated with other disorders such as Addisons disease
Some plant foods (cauliflower, broccoli, cabbage) exert antithyroid activity through what mechanism?
Inhibiting thyroid peroxidase
Before 1960, reports surfaced that soy formula-fed infants were developing hypothyroidism. The addition of what supplement to these formulas ameliorated this problem?
Iodine
Cretinism
Iodine deficiency disease that adversely affects cognitive development in children
Which of these organs regulates acid-base balance?
Kidneys and lungs
Which of the following is an anion in solution?
Lactate
__________ reduces the conversion of T4 to T3
Lipoic acid
Although some T3 is produced in the thyroid, approximately 80% to 85% is generated outside the thyroid in which organs?
Liver and kidneys
Pituitary gland
Master gland of the endocrine system located at the base of the brain
Addisons disease
Primary adrenal insufficiency disease
Calcitonin
Produced by the thyroid and controls blood calcium level
Dietary intervention is a key therapeutic tool in managing patients with thyroid disease. In the absence of nutritional deficiencies, what is the main goal of nutritional support?
Reducing antithyroidal antibodies
Which of these is NOT a product of the thyroid?
Reverse T3 (rT3)
Individuals deficient in what supplement can help support the deiodination of T4 to T3? uestion 9: Instead of "deficient individuals," please change to "individuals deficient in _____.
Selenium
Thyroid gland
Small, butterfly shaped gland found just below the Adams apple
A variation in thyroid function related to an increased risk of heart disease would be evidenced by
TSH greater than 4 mU/L
Maintaining thyroid hormone function throughout the aging process appears to be an important hallmark of healthy aging. What characteristic is an indicator of thyroid health in centenarians?
The absence of circulating thyroid autoantibodies
Which of these is NOT required for the production of thyroxine (T4) and triiodothyronine (T3)?
Thyroid-binding globulin (TBG)
More than 90% of people with autoimmune thyroid disease have a genetic defect affecting their ability to metabolize what?
Vitamin D
Sodium balance is regulated
aldosterone
ABG stands for
arterial blood gas.
Thyroid heath in some adults can be improved by increasing the conversion of T4 to T3. This can be accomplished by:
correcting zinc deficiencies with zinc glycinate or zinc citrate.
Cushing's syndrome is indicated by high levels of
cortisol
Under normal conditions, the amount of sodium excreted is ___ the amount ingested
equal to
A severe systemic illness that causes decreased peripheral conversion of T4 to T3, an increased conversion of T3 to the inactive rT3, and decreased binding of thyroid hormones is known as:
euthyroid sick syndrome.
Individuals with TSH values of _________ have an increased risk of developing overt hypothyroidism.
greater than 2 mU/L
Greater than the minimum requirement for potassium is recommended because of the possible protective effect of potassium against
hypertension.
Characteristics of chronic adrenal stress do NOT include:
increased sensitivity to thyroid hormones.
Botanical preparations have been found in animal studies to influence thyroid activity. Commiphora mukul (guggulsterones from guggul extract) has strong thyroid stimulatory action, demonstrated by:
increasing TPO activity.
Potassium is primarily found in the ___ fluid
intracellular
Water within cells is ___ water
intracellular
Excessive acid loss (e.g., during gastric suctioning) can cause
metabolic alkalosis
The higher the total body water content, the higher
muscle mass
Insensible water loss can be described as
nonmeasurable water loss
The measure of osmotically active particles per liter of soulution is
osmolarity
Extracellular water includes
plasma and lymph
Primary intracellular buffers include
proteins and phosphates.
Increased ventilation and elimination of carbon dioxide can cause
respiratory alkalosis
The predominant cation in extracellular fluid is
sodium
Infants need more water than adults because
their kidneys have a limited ability to handle the renal solute load
Ninety percent of iodine in the body is organically bound to
thyroglobulin (Tg)
The major secretory product of the thyroid gland is
thyroid-stimulating hormone (TSH)
Calcitonin is produced by the
thyroid.
Cushing's syndrome is characterized by weight gain, easy bruising, depression, muscle loss, and weakness. It is caused by:
too much cortisol remaining in the bloodstream over a long period.
The most predominant and active form of thyroid hormone that the body can use is
triiodothyronine (T3)
