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Endo > Endo 1 > Flashcards

Endo 1 Flashcards

1
Q

DM can be caused by unopposed secretion of ___and ____. Also seen in patients on _____ therapy

A

GH and epinephrine

glucocorticoid (steroid diabetes).

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2
Q

DM- Osmotic damage: sorbitol accumulation in organs with ______ and ↓ or absent _________

A

aldose reductase

sorbitol dehydrogenase):

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3
Q

HbA1c ↓ in:

A

Conditions with ↑ destruction of existing RBCs

Beta thalassemia
Sickle cell disease and trait

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4
Q

HbA1c ↑ in:

A

Conditions with ↓ new RBC synthesis

Folate, iron, Vit B12 deficiency
Advanced diabetic nephropathy (↓ EPO production)

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5
Q

DM skin lesions:

A
  1. Skin tags
  2. Acanthosis nigricans
  3. Necrobiosis lipoidica diabeticorum
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6
Q

Elevated levels of ____ donot contribute to insulin resistance or acanthosis nigricans.

A

LDL

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7
Q

Insulin resistance mechanism:

A
  1. FFA activate serine threonine kinase → phosphorylate amino acids on beta chain of insulin RECEPTORS → inhibiting tyrosine phoshporylation
  2. ↑ TNF-a produced by adipocytes → activate serine threonine kinases
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8
Q

DPP-4 inhbitor: suffix

Adverse effects

A

gliptins

Mild urinary or respiratory infections, weight neutral.

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9
Q

Glitazones/ thiazolidinediones

A

Activate PPAR-gama (a nuclear receptor) - ↑ insulin sensitivity and levels of adiponectin
- regulation of glucose metabolism and fatty acid storage.

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10
Q

onset of action of Glitazones/ thiazolidinediones

A

Delayed onset of action (several weeks).

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11
Q

weight neutral anti diabetic

A

DPP-4 inhibitor

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12
Q

Weight gain antidiabetics

A

Insulin
Glitazones
Sulfonylureas

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13
Q

Pioglitazone adverse effect

A

Urinary bladder cancer (long term use)

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14
Q

SGLT2 inhibitors

A

HYPERKALEMIA
Glucosuria, UTis, vaginal yeast infections,
dehydration (orthostatic hypotension),
weight loss.
Not recommended if kidney function is impaired (↓efficacy with ↓ GFR).

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15
Q

Distinguish exogenous hyperthyroidism from endogenous hyperthyroidism by

A

using a combination of TSH receptor antibodies, radioactive iodine uptake, and/or measurement of thyroid blood flow on ultrasound

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16
Q

Rosiglitazone adverse effect

A

↑ risk of MI, cardiovascular death.

17
Q

Fludrocortisone adverse effects

A

Similar to glucocorticoids; also edema, exacerbation of heart failure, hyperpigmentation

18
Q

Agranulocytosis by methimazole by?

A
  1. Immune mediated (generation of antineutrophilic cytoplasmic antibodies ANCA)
  2. Direct bonemarrow toxicity (ROS formation)
19
Q

Drug induced agrannulocytosis initial manifestation :

A

Fever
Sore throat
Oral Ulcers

20
Q

Thyroid diverticulum arises from _____ and descends into _______

A

floor of primitive pharynx

neck

21
Q

Foramen cecum is normal remnant of ______

A

thyroglossal duct.

22
Q

Dermoid cyst presents as

A

midline neck mass that donot move with swallowing and tongue protrusion

23
Q

Paraganglioma is a ______

presents as:

D/D of?

A

neuroendocrine tumor that arises from extraadrenal, autonomic paraganglia (eg. carotid body paraganglia) due to abnormal migration of neural crest cells

Lateral neck mass

Thyroglossal duct cyst

24
Q

Respiratory failure and heart failure in DKA, How?

A

Acidosis → Shifts phosphate out into extracellular fluid → phosphaturia caused by osmotic diuresis → loss of ATP → Muscle weakness (respiratory failure) , Heart failure (↓ Contractility)

25
Q

Screening test for gestational diabetes?

Why?

A

OGT test

some insulin resistance is normal in pregnancy, so fasting glucose donot give idea about condition

26
Q

Effect of exercise on insulin treated state:

A

↑ insulin → impaired endogenous glucose production, ↑ Glucose uptake by skeletal muscles, no counter-regulator hormones released due to ↑ insulin → severe hypoglycemia

27
Q

Effect of epinephrine on insulin release:

A

↓ insulin production as alpha affect is dominated

Fight, flight response → ↑ plasma glucose

28
Q

Insulin lowers K+ by?

A

↑ activity of Na/K ATPase pump in skeletal muscles

29
Q

Liver glycogen is broken down by:

muscle glycogen is broken down by:

A

Glucagon

Ca and Exercise (Glucagon receptors are not present on skeletal muscles)

30
Q

Insuline → tyrosine phosphorylation → downstream steps are:

A

Phosphoinositide-3 kinase pathway:

  1. Vesicles containing GLUT4
  2. Glycogen, lipid, protein synthesis

RAS/MAP kinase pathway: Cell growth, DNA synthesis

31
Q

GHRH Analog

A

(tesamorelin) used to treat HIV-associated lipodystrophy

32
Q

Oxytocin modulates?

A

modulates fear, anxiety, social bonding, mood, and depression

33
Q

Prolactin is structurally homologous to:

A

Growth hormone

34
Q

Prolactin inhibits its own secretion by:

A

↑ dopamine synthesis and secretion from hypothalamus

35
Q

prolactin is eliminated:

A

Renal

↑ levels in renal failure

Endo (3 decks)

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