Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Medicine > Endo & Metabolic Disorders > Flashcards

Endo & Metabolic Disorders Flashcards

1
Q

Dx diabetes

A

random gluc > 200 WITH SYMPTOMS
2 fasting gluc > 126
HbA1c > 6.5% – recheck once to confirm
2 hour post oral gluc challenge > 200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

secondary prevention is…

A

minimizing impact of disease already occurred

preventing recurrences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Target BP, HbA1c, lipid levels to prevent symptoms and complications in diabetic?

A

BP v140/90
A1c v7%
just give a statin (unless hx myopathy, liver fail w synthetic deficiency, child bearing age (teratogenic)) no lipid target anymore

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

vaccs for diabetic?

A

flu annually
pneumovax 23 valent pneumococcal strep pneumo
booster prevnar 13 at age 65 if pnumovax > 5yo
can offer Hep B…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

if monofilament exam is negative but a potentially undiagnosed diabetic or known diabetic still complains of peripheral nerve sensory changes (eg burning) what is a good next physical exam to perform?

A

vibratory sense (lost early)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

prediabetic fasting glucose range is …

A

100-125

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what treatment do you recommend for pre-diabetic? (fasting gluc 100-125)?

A

diet/exercise

5-7% weight loss prevents diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

in a prediabetic, how much weight loss is typically necessary to prevent diabetes?

A

5-7% of body weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how does lifestyle change /diet / exercise treat diabetes?

A

inc insulin sns

dec hepatic gluc production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how much A1c dec can be achieved w diet/weight loss?

A

depends on dedication, starting point, but
1-2% avg
5-6% possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

another name for metformin

A

biguanides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how does metformin (biguanides) work?

A

inc insu sns

dec hep gluconeogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how much A1c reduction expected w metformin (biguanides) ?

A

1-2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how does metformin (biguanides) affect weight?

A

weight neutral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

is metformin (biguanides) expensive?

A

nope. cheap.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

does metformin cause hypoglycemia?

A

no
inc insu sns
dec hep gluconeogenesis
–diabetic drugs that cause hypoglycemia typically increase insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

name 3 side effects of metformin (biguanides)

A

GI nausea, loose stool
B12 malabsorption (see GI SEs)
lactic acidosis
(CI renal insuff – Cr >1.4 F, >1.5 M, CrCl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

5 CIs to metformin (biguanides)

A

renal insufficiency Cr >1.4 F, >1.5 M, CrCl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

sulfonylurea MOA

A

inc insulin secretion… by blocking ATP gated K+ channels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

expected A1c dec with sulfonylurea

A

1-2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

is the OA for sulfunylureas fast or slow?

A

rapid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

3 disavantages of sulfonylurea use

A

weight gain
hypoglycemia
loss of efficacy over time
(sulfonylureas inc insu sec by blocking ATP gated K+ channels)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

how do ATP gated K+ channels work in pancreatic beta cells

A

when open, K+ can leak out, keeping membrane polarized. With inc ATP, channels close, no leak, depolarize, release insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

name one CI to sulfonylurea use

A

sulfa allergy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
TZDs antidiabetes drugs stand for
thiazolidinidiones = glitazones
26
another word for glitazones
thiazolidinidiones = TZDs | antidiabetes drugs
27
how do thiazolidinidiones (TZDs, glitazones) work?
increase insulin sns
28
how much A1c dec expected with TZDs
0.5-1.5%
29
what is the advantage of TZDs
better lipid profile...
30
4 SEs of TZDs
fluid retention / weight gain bone fractures (osteopenia) bladder cancer MI with rosiglitazone (Avandia)
31
give an example of a TZD
pioglitazone (Actos)
32
2 CIs to TZD use
- symptomatic (stage III or IV) CHF -- TZDs cause fluid retention - hx bladder cancer -- TZDs cause bladder cancer
33
mechanism of alpha-glucosidase inhibitors
dec GI absorption of sugars eg in tx of DM
34
give an example of an a-glucosidase inhibitor
acarbose | dec GI absorb of sugars eg in tx of DM
35
expected A1c dec w a-glucosidase inhib
.5-.8
36
how do a-glucosidase inhib affect weight
weight neutral
37
how do TZDs (glitazones) affect weight?
weight gain | fluid retention, inc insulin sns
38
1 SE | 2 inconveniences ofacarbose
``` GI disturb (a-glucosidase inhib... mech = dec GI absorb of sugars...) 3x/day dosing expensive ```
39
MOA meglitinides
inc insu sec | short acting, prandial use
40
1 example of a meglitinide
repaglinide (Pranding, Starlix)
41
pearl: use meglitinide if...
sulfa allergy prevents sulfonylurea use
42
2 SEs | 2 inconveniences of meglitinides
weight gain hypoglycemia tid dosing expensive
43
are meglitinides fast or slow OA
rapid acting
44
expected A1c dec w meglitinide
.5-1.5
45
``` expected A1c dec w diet/exercise metformin (biguanide) sulfonylureas TZDs (pioglitazone/Actos) a-glucosidase inhib (acarbose) meglitinides (repaglinide/Prandin/Starlix) ```
``` diet/exercise 1-2 metformin (biguanide) 1-2 sulfonylureas 1-2 TZDs (pioglitazone/Actos) .5-1.4 a-glucosidase inhib (acarbose) .5-.8 meglitinides (repaglinide/Prandin/Starlix) .5-1.5 ```
46
this class of antidiabetics is commonly combined with insulin
sulfonylureas
47
this class of antidiabetics is commonly used if healthier diet is unaffordable or impossible for some reason, can't dec carb intake
a-glucosidase inhib (e.g. acarbose)
48
this class of antidiabetics consists of short-acting insulin secretagogues
metglinides (eg repaglinide/Prandin/Starlix)
49
what does DPP-4 stand for
dipeptidyl peptidase 4
50
what does DPP-4 do?
--| incretins (GLP-1, GIP), which inhibit glucagon release and stimulate insulin release so active DPP-4 reduces incretin inhibition of glucagon release so active DPP-4 leads to more glucagon, less insulin, HIGHER blood glucose
51
name 2 incretins and how they affect insulin and blood glucose levels
``` GLP1, GIP --| glucagon release --> insulin release --| gastric emptying ^ blood glucose ```
52
Expected A1c reduction with gliptin / DPP-4I
.5-.8%
53
how do gliptins / DPP-4Is affect weight
weight neutral (other diabetic drugs that ^insulin more powerfully cause weight gain and hypoglycemia... think gliptins/DPP-4Is are just milder in effect)
54
T/F hypoglycemia is a concern with gliptins/DPP-4Is
Fish other drugs that ^ insulin (insulin, suflonylureas, meglitinides) do cause weight gain and risk hypoglycemia... however I think gliptins/DPP-4Is are milder in effect (A1c red .5-.8) and they are weight neutral with rare risk of hypoglycemia
55
3 SEs and 2 other disadvantages of gliptins/DPP-4Is
- GI nausea/diarrhea (incretins GLP1 and GIP delay gastric emptying... GI effects) - Headache (goes with nausea/diarrhea?) - Pancreatitis - long term safety not established - expensive
56
CI to DPP-4/gliptin use
hx pancreatitis SEs of DPP-4/gliptins include - GI nausea/diarrhea (incretins GLP1 and GIP delay gastric emptying... GI effects) - Headache (goes with nausea/diarrhea?) - Pancreatitis
57
expected A1c dec w insulin
1.5-3.5
58
2 SEs 3 inconveniences of insulin therapy
- weight gain - hypoglycemia - multiple daily injections - monitoring - long acting forms expensive
59
exogenous insulin OA fast or slow?
rapid
60
T/F no dose limit w insulin therapy
T
61
name 2 GLP-1 agonists
exenatide Byetta | liraglutide
62
how do GLP1 agonists work
^insulin v glucagon v gastric emptying v blood glucose
63
A1c red w GLP1 agonist
.5 to 1.0
64
exenatide liraglutide examples of what drug class
GLP1 agonists | tx DM
65
1 SE | 3 other disadvantages of GLP1 agonists
GI SEs injections multiple daily long term safety unknown expensive
66
CI to GLP1 agonist therapy
gastroparesis | GLP1 delays gastric emptying
67
pramlintide (Simlin) MOA
``` (amylin mimetic) slows gastric emptying promotes satiety -decreases post prandial glucose rise also --| glucagon secretion ```
68
what does amylin do
cosecreted with insulin slows gastric emptying promotes satiety inhibits glucagon release
69
what peptide hormone that is cosecreted with insulin is also deficient in diabetics?
amylin - slows gastric emptying - promotes satiety - inhibits glucagon release
70
which antidiabetic drug is an amylin mimetic?
pramlintide (Simlin) | prAMLINtide (siMLIN)
71
expected A1c dec w pramlintide
.5-1.0
72
what is the commercial name for pramlintide
Simlin
73
what is the generic name for Simlin
pramlintide
74
how does pramlintide (Simlin) affect weight?
weight loss | amylin mimetic -- slows gastric emptying, promotes early satiety
75
2 SEs | 4 inconveniences of pramlintide
``` GI upset hypoglycemia tid injections expensive long term safety not known only approved if also taking insulin ```
76
1 CI for pramlintide
gastroparesis | amylin mimetic -- slows gastric emptying
77
-agliflozin suffix is what kind of drug
SGLT2 inhibitor | aGLiflozin sGLt2
78
name 2 SGLT2 inhibitors
dapagliflozin | canagliflozin
79
how do SGLT2Is treat DM
^ renal excretion of glucose
80
expected A1c dec w SGLT2I
.5-.7
81
3 advantages of canagliflozin & dapagliflozin use to tx DM
(SGLT2Is) weight loss v BP rare hypoglycemia
82
T/F hypoglycemia is a common SE of canagliflozin and dapagliflozin use
Fish | SGLT2Is rarely assoc w hypoglycemia
83
4 SEs of canagliflozin and dapagliflozin use
``` (SGLT2Is) UTI vulvovag candidiasis dehydration DKA ```
84
2 CIs to canagliflozin & dapagliflozin use to tx DM
(SGLT2Is) eGFR v60 mL/min active bladder cancer (don't want to feed it?)
85
this drug is often used to combat weight gain of insulin
pramlintide (Simlin) | -amylin mimetic, v gastric emptying, ^ satiety
86
these drugs treat DM via inducing kidney diuresis of glucose
dapagliflozin | canaglifloizin (SGLT2Is)
87
2 most notable aspects of bulimic dental erosion
short teeth | gaps between teeth
88
how do anorexia and bulimia differ in respect to menstrual effects?
anorexia - amenorrhea | bulimia - dysmenorrhea
89
literary name for obesity hypoventilation sydrome
Pickwickian syndrome | Pickwick was a fat boy in a Dickens novel who would fall asleep with his finger on the doorbell
90
Pickwickian syndrome
Obesity hypoventilation syndrome severely overweight people fail to breathe rapidly enough or deeply enough, resulting in low blood oxygen levels and high blood carbon dioxide (CO2) levels
91
lipid goals for prevention of CAD from obesity
total CH v200 HDL ^40 LDL v100 primary prevention, v40-60 secondary prev.
92
glyburide is what class of drug
sulfonylurea | stims panc beta islet cell to release insulin by blocking ATP gated K+ channels
93
3 categories for etiology of DKA
all have to do with insulin defic / resist and/or glucagon excess: T1DM T2DM -extreme stress (infection, CV emergency, trauma) -noncompliance KPD (Ketosis Prone Diabetes) -B islet cell dysfunction/depletion of reserve
94
what is the mechanism underlying DKA
no insulin, more glucagon gluconeogenesis ^ glycogenolysis ^ uptake by tissues v
95
how does stress cause DKA in T2DM
Cortisol, CCs, GH --| insulin action v GLUT4 peripheral glucose uptake ^ glycogen synth (glycogenesis)
96
Cortisol function
BIG FIB - BP ^ (upreg a1 for ^ epi sns) - Insulin resist (diabetogenic.. more gluc for brain) - Gluc ^ (gluconeogen, lipolysis, proteolysis) - Fibroblast activity (striae) - Inflammation and Immune response v (--| LTs, PGs, IL-2, WBC adhesion - neutrophilia, mast cell H release, eos) - Bone formation v (--| OB activity)
97
4 elements of Tx for DKA
- fluid replacement, stabilize CV status - K+ repletion (KCL) IMMEDIATELY if v5.3 (usually will be) - Insulin AFTER K+ repleted (don't want to drive K+ into cells and induce an arrhythmia) - Bicarb (NaHCO3) if arterial pH v6.9
98
2 complications of DKA
cerebral edema | non-cardiogenic pulm edema
99
diffuse toxic goiter =
graves disease
100
most common cause of hyperthyroidism
graves disease (diffuse toxic goiter)
101
Graves disease - alternative name - pathogenesis - epidemiology - common disease association - radioodide scan shows
diffuse toxic goiter AI thyroid-stimulating IgG binds TSH receptors younger women other AI disorders diffuse uptake -- every thyroid cell affected
102
multinodular toxic goiter =
plummer disease
103
diffuse toxic goiter = | multinodular toxic goiter =
graves disease | plummer disease

Medicine (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions