Notes in 07 Thyroid Function Tests

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Published	07/30/2024	TRH stimulates the production of TSH and {{c1::Prolactin}}
Published	07/30/2024	{{c1::Leptin::hormone}} regulates TRH
Published	07/30/2024	The {{c1::alpha}} subunit of TSH is the same sequence as LH, FSH, and hCG
Published	07/30/2024	The {{c1::beta}} subunit of TSH is for expression of hormonal activities
Published	07/30/2024	Iodide is reabsorbed in the follicular cells through the {{c1::iodide symporter (NIS)}} and {{c2::Na-K ATPase}}
Published	07/30/2024	[VR]1. Serum Iodide2. Follicular Cell Na-K ATPase Activity{{c1::B}}
Published	07/30/2024	Once iodide is trapped inside the follicular cells, it is transported through the follicular cells and across the apical membrane by {{c1::pendrin::tr…
Published	07/30/2024	{{c1::Thyroglobulin}}, a large glycoprotein molecule, is also secreted in the thyroid follicle which contains the amino acid {{c1::Tyrosine}} to which…
Published	07/30/2024	[QC] Secreted Hormone1. T32. T4{{c1::B}}
Published	07/30/2024	[QC] Potency1. T32. T4{{c1::A}}
Published	07/30/2024	Bloodstream contains {{c1::2-3 months::time frame}} supply of thyroid hormones
Published	07/30/2024	{{c1::75}}% of T4 and {{c1::70}}% of T3 will attach to Thyroxine Binding Globulin (TBG)The rest is bound to {{c2::albumin}} and {{c2::Transthyretin Bi…
Published	07/30/2024	{{c1::20}}% of T3 actually comes from the thyroid. The rest are from peripheral enzymatic conversion of about {{c2::50}}% of T4
Published	07/30/2024	{{c2::Reverse T3 (rT3)}} - Formed from deiodination of inner ring of T4, catalyzed by {{c1::5’ deiodinase}} and is metabolically {{c1::ina::ina/a…
Published	07/30/2024	[QC]1. T32. rT3{{c1::C... sorta}}
Published	07/30/2024	These 4 conditions cause the preferential conversion of T4 to rT3:{{c1::PregnancyFastingHepatic & Renal FailureBeta Blockers}}
Published	07/30/2024	[VR]1. Liver Cirrhosis2a. TBG2b. T4{{c1::B, A}}
Published	07/30/2024	[VR]1. Pregnancy2. TBG{{c1::A}}
Published	07/30/2024	{{c1::0.3}}% of T3 is unbound{{c1::0.03}}% of T4 is unbound
Published	07/30/2024	Normal Values: Thyroid Hormones Half-LifeT3: {{c1::18 Hours}}T4: {{c1::7 Days}}
Published	07/30/2024	[VR]1. Emotional Stress2. TRH and TSH{{c1::B. Euthyroid Sick Syndrome}}
Published	07/30/2024	[VR] Normal Thyroid1. Acute Thyroid Load2. TRH and TSH{{c1::B. Wolff-Chaikoff Effect::Also name the phenomenon}}
Published	07/30/2024	[VR] Abnormal Thyroid1. Acute Thyroid Load2. TRH and TSH{{c1::A. Joe-Basedow Effect::Name the effect as well}}
Published	07/30/2024	Normal Values: Serum T3{{c1::60-160}} ug/dL{{c1::0.9-2.46}} nmol/L
Published	07/30/2024	If ↑ T3, think of Graves' disease, {{c1::Toxic Nodular Goiter/Adenoma, and T3 Thyrotoxicosis::2}}
Published	07/30/2024	If ↓ T3, think of hyp{{c1::othyroidism, HOWEVER. Not really that useful because T3 is normal in 15-30% of px w/ hypo}}thyroidism
Published	07/30/2024	Normal Values: Serum T4{{c1::5-12.5}} ug/dL
Published	07/30/2024	In {{c1::Thyrotoxicosis}}, only either T3 or T4 is increased
Published	07/30/2024	{{c1::Low T3 and T4 Syndrome}} - Severe Nonthyroidal illness which is an adaptive response to reduce metabolic demands and conserve protein stores tho…
Published	07/30/2024	[VR]1. Protein Binding2. Serum T4{{c1::A. Euthyroid Hyperthyroxinemia}}
Published	07/30/2024	{{c1::Euthyroid Hyperthyroxinemia}} - Presence of increased serum T4 in association with normal TSH in an otherwise eurothyroid individual caused…
Published	07/30/2024	3 Causes of Increased Protein Binding of T4{{c1::EstrogenLiver DiseaseFamilial Dysalbuminemia}}
Published	07/30/2024	{{c1::T3 Uptake Tests}} - Method used to adjust the total T4 measurement for alterations in binding protein
Published	07/30/2024	Only order FT3 if concerned about {{c1::Hyperthyroidism}}
Published	07/30/2024	FT4 can be measured using {{c1::immunoassay}}
Published	07/30/2024	Why are there different levels of TSH in pregnancy?{{c1::Aside from the alpha subunit, the beta subunit of TSH is 40% similar to b-hCG}}
Published	07/30/2024	Assuming the HPT axis is intact, the most sensitive test for both hyper and hypothyroidism is serum {{c1::TSH}} using {{c1::radioimmunoassay::measurem…
Published	07/30/2024	Thyroid Fxn Test Fast Diagnosis!↓ TSH, ↓  FT3 +/- FT4?{{c1::Secondary/Central}} Hypothyroidism
Published	07/30/2024	Thyroid Fxn Test Fast Diagnosis!↑ TSH, ↓  FT3 +/- FT4?{{c1::Primary Hypothyroidism}}
Published	07/30/2024	Thyroid Fxn Test Fast Diagnosis!↓ TSH, Normal  FT3 +/- FT4?{{c1::Subclinical Hyperthyroidism}}
Published	07/30/2024	Thyroid Fxn Test Fast Diagnosis!↑ TSH, Normal FT3 +/- FT4?{{c1::Subclinical Hypothyroidism}}
Published	07/30/2024	Thyroid Fxn Test Fast Diagnosis!↓ TSH, ↑ FT3 +/- FT4?{{c1::Primary Hyperthyroidism}}
Published	07/30/2024	Thyroid Fxn Test Fast Diagnosis!↑ TSH, ↑ FT3 +/- FT4?{{c1::Secondary}} Hyperthyroidism
Published	07/30/2024	Patients with non-thyroidal illness tend to have {{c1::low or low normal}} TSH and {{c1::normal or low normal}} FT4, but {{c1::very low}} FT3 results …
Published	07/30/2024	What medications suppress TSH?{{c1::GlucagonOpioidsGlucocorticoidsDopamine::4}}
Published	07/30/2024	If you have a high suspicion for hypothyroidism, order {{c1::TSH, FT4::TFTs}}
Published	07/30/2024	If you have a high suspicion for hyperthyroidism, order {{c1::TSH, FT3, FT4::TFTs}}
Published	07/30/2024	If you have low suspicion for thyroid disease check the {{c1::TSH}} first only if the patient isn't acutely illIf low, check {{c2::FT3, FT4}}If normal…
Published	07/30/2024	Thyroglobulin is never routinely measured except for these Indications:{{c1::Monitoring Thyroid Malignancy Post-op and Carcinoma VariantsDx of th…
Published	07/30/2024	Most cases of thyrotoxicosis will have high thyroglobulinThyrotoxicosis Factitia will have {{c1::no}} thyroglobulin
Published	07/30/2024	Measurements of TBG may be helpful in patients who {{c1::have serum T4 and T3 levels that do not agree with other laboratory parameters of thyroid fun…
Published	07/30/2024	If you see {{c2::Antithyroglobulin (Tg) Ab, Anti-thyroid peroxidase (TPO) ab, Anti-TSH receptor (TR) Ab::antithyroid antibodies}}, think of {{c1::Hash…
Published	07/30/2024	If you see {{c2::just Anti-thyroid peroxidase (TPO) ab::antithyroid antibodies}}, think of {{c1::Atrophic Thyroiditis::disorder}}
Published	07/30/2024	If you see {{c2::just Anti-TSH receptor (TR) ab::antithyroid antibodies}}, think of {{c1::Graves' Disease and Thyroid dysfunction in newborns of mothe…
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