thyroid stuff
whats that thing causes autoimmune stimulation of tsh receptors?
graves disease
whats that thing that causes autoimmune destruction of the thyroid
hashimotos thyroiditis
A patient with severe pancreatitis develops bruising around the umbilicus. This eponym, the "Cullen sign," indicates this severe underlying complication
What is retroperitoneal hemorrhage (from severe necrotizing disease)?
Overdose of acetaminophen can lead to this severe adverse drug reaction.
What is hepatotoxicity?
3 parts
How old is Dr. Gluck?
What is my middle name?
who is the best pearls group?
20 years younger than whatever age he is
bruno
The Breakfast Club!
what are the values for tsh and t4/t3 for primary and secondary hypothyroidism?
primary-> high tsh low free t4
secondary-> low tsh, low free f4
what are the values for tsh t4/t3 for hyperthyroidism
Secreted by G cells in the stomach, this hormone stimulates gastric acid secretion.
What is gastrin?
This hormone from the duodenum stimulates pancreatic bicarbonate secretion to neutralize stomach acid.
What is secretin?
what hypersensitivty is hasimotos?
type 2 and type 4
what hypersensitivity is graves disease?
type 2
Clinical signs of this type of motor neuron lesion include spasticity, hyperreflexia, and a positive Babinski sign.
What is an Upper Motor Neuron (UMN) lesion?
This drug treats Myasthenia Gravis by reversibly inhibiting acetylcholinesterase, increasing the amount of acetylcholine in the synaptic cleft.
What is pyridostigmine?
explain how hashimotos occurs
1. Autoimmune Attack
Immune System Misidentifies: The body's immune system, which is normally tasked with fighting off foreign invaders like bacteria and viruses, mistakenly recognizes the cells of the thyroid gland as a threat.
Antibody Production: The immune system produces specific antibodies, primarily Thyroid Peroxidase (TPO) antibodies and Thyroglobulin (Tg) antibodies, that target the thyroid tissue.
Inflammation and Damage: These antibodies and white blood cells (lymphocytes) build up in the thyroid gland, causing chronic inflammation (thyroiditis). Over time, this immune attack damages and destroys the thyroid's hormone-producing cells.
Resulting Hypothyroidism: As the thyroid is progressively damaged, it loses its ability to produce sufficient thyroid hormones (T3 and T4), leading to an underactive thyroid, or hypothyroidism
explain how graves disease occurs
1. The Role of Thyroid-Stimulating Antibodies
The key to Graves' disease is the production of a specific type of antibody by the immune system, primarily called Thyroid-Stimulating Immunoglobulin (TSI), which is a type of TSH Receptor Antibody (TRAb).
Mimicking TSH: Normally, the pituitary gland in the brain releases Thyroid-Stimulating Hormone (TSH), which tells the thyroid gland how much thyroid hormone (T3 and T4) to produce.
The Misfire: In Graves' disease, the TSI antibodies are structurally similar enough to TSH that they bind to the TSH receptors on the thyroid cells.
Continuous Stimulation: Unlike TSH, which is regulated, the TSI antibodies constantly stimulate the thyroid gland to produce and release excessive amounts of thyroid hormones.
This constant, unregulated stimulation forces the thyroid to work overtime, resulting in hyperthyroidism.
2. The Result: Hyperthyroidism
The high levels of thyroid hormones speed up the body's metabolism, leading to common symptoms like:
Rapid or irregular heartbeat (palpitations)
Unintentional weight loss
Nervousness, anxiety, and irritability
Heat intolerance and increased sweating
Enlargement of the thyroid gland (goiter)
This is the antidote for organophosphate poisoning that only addresses the life-threatening muscarinic effects (e.g., bronchospasm, bronchorrhea, bradycardia) but does not reverse the skeletal muscle paralysis
What is atropine?
This hormone, secreted by D cells, is the primary inhibitory signal for acid secretion, acting on G cells, ECL cells, and parietal cells.
Somatostatin
explain the HPT axis
Hypothamuluis->releases TRH->senses low levels of thryoid hormones in the blood and releases TRH
Anterior pituitary gland-> release TSH->thyrotropin->stimulates anterior pituitary to release TSH.
Thyroid gland-> releases t3/t4->travels to the cells in the body to regulat basal metabolic rate
Negative feedback loops occurs and high t3/t4 levels go back to the hypothalamus and anterior pituitary gland for inihibition of trh and tsh.
whats something that can mimic a thyroid storm and what happens?
pheochromocytoma->neuroendocrine tumor of the adrenal medulla that results the excessive production of norepi and sometimes epi
This specific class of antibiotics is relatively contraindicated in Myasthenia Gravis patients because it can precipitate a myasthenic crisis by inhibiting the presynaptic release of acetylcholine.
What are aminoglycosides?
Where do brocas and wercnickes aphasia occur in the brain?
brocas-> posterior inferior frontal gyrus
Wernickes-> posterior superior temporal gyrus of the dominant hemisphere