endo p 337 - 340 Flashcards
which multiple endocrine neoplasia is associated with marfanoid habitus?
MEN2B
name of the drug that sensitizes Ca2+ sensing receptor (CaSR) in parathyroid gland?
cinacalcet
how does cinacalcet change the level of PTH?
dec PTH
clinical application of cinacalcet?
hypercalcemia due to hyperparathyroidism
name of the synthetic analog of aldosterone with little glucocorticoid effects?
fludrocortisone
what is the clinical application of fludrocortisone?
mineralocorticoid replacement in primary adrenal insufficiency
name 3 side effects of fludrocortisone
edema, exacerbation of heart failure, hyperpigmentation
3Ps for MEN1?
Parathyroid tumors Pituitary tumors (prolactin or GH) Pancreatic endocrine tumors (Zollinger Ellison syndrome, insulinomas, VIPomas, glucagonomas)
what gene is associated with MEN1?
MEN1 gene (menin, tumor suppressor)
what MEN is associated with RET gene
MEN2A and MEN2B
What does RET gene code for?
receptor tyrosine kinase
symptoms of VIPomas?
WDHA
Watery Diarrhea, Hypokalemia, and Achlorhydria
what path is associated with dermatitis (necrolytic migratory erythema), diabetes, DVT, and depression?
glucagonoma (also associated with MEN1)
2Ps of MEN 2A?
Parathyroid hyperplasia
Pheochromocytoma
1P of MEN 2B?
Pheochromocytoma
what MEN is associated with medullary thyroid carcinoma?
MEN2A, 2B
which MEN is associated with mucosal neuromas (oral/intestinal ganglioneuromatosis)
MEN 2B
unique side effect of methimazole?
aplasia cutis
what drug blocks the reabsorption of glucose in PCT?
SGLT-2 inhibitors (canagliflozin)
name of the enzyme that propylthiouracil blocks
5’ deiodinase, thyroid peroxidase
name of the enzyme that methimazole blocks
thyroid peroxidase
side effects of propylthiouracil?
skin rash, agranulocytosis, aplastic anemia, hepatotoxicity
name of the enzyme that propylthiouracil blocks
5’ deiodinase, thyroid peroxidase
name of the enzyme that methimazole blocks
thyroid peroxidase
side effects of propylthiouracil?
skin rash, agranulocytosis, aplastic anemia, hepatotoxicity
activation of what gene increases insulin sensitivity and levels of adiponectin?
PPAR-gamma
what gene activation leads to HDL synthesis?
PPAR-alpha
name of the drug that dec both gastric emptying and glucagon
pramlintide (amylin analog)
drug that dec postprandial hyperglycemia
acarbose, miglitol (alpha glucosidase inhibitors)
name 5 drugs that inc insulin and dec glucagon release
GLP-1 analog
- exenatide
- liraglutide
DPP-4 inhibitors
- linagliptin
- saxagliptin
- sitagliptin
name two 1st generation sulfonylureas
chlorpropamide, tolbutamide
name three 2nd generation sulfonylureas
glimepiride, glipizide, glyburide
what is the mech of sulfonylureas?
close K+ channel of beta cell –> cell depolarizes –> insulin release via Ca2+ influx
name the general side effect of sulfonylureas
risk of hypoglycemia in renal failure
side effects of 1st generation sulfonylureas (chlorpamide, tolbutamide)?
disulfiram like effects, SIADH
other drugs that lead to disulfiram like effects
metronidazole, griseofulvin, procarbazine, some cephalosporin
what are the drugs that bind to PPAR-gamma nuclear transcription regulator to inc insulin sensitivity?
glitazones/thiazolidinediones
- pioglitazone
- rosiglitazone
what is metformin contraindicated with
renal insufficiency
name 2 long acting insulin
detemir, glargine
intermediate acting insulin?
NPH (twice a day)
name 3 short acting insulin
aspart, glulisine, lispro
what is the treatment strategy for type 1 DM?
low carb diet, insulin replacement
treatment strategy for type 2 DM?
dietary modification, exercise for weight loss, oral agents
what are the 2 roles of genes activated by PPAR-gamma
- fatty acid storage
2. glucose metabolism
clinical application of somatostatin (octreotide)
acromegaly, carcinoid syndrome, gastrinoma, glucagonoma, esophageal varices
name 3 ADH antagonists (V2 blockers)
conivaptan, tolvaptan, demeclocycline
what drug is used for central DI?
desmopressin acetate
what drug is used for Turner syndrome?
GH
DOC to control uterine hemorrhage?
oxytocin
if glucocorticoids are suddenly stopped after the chronic usage, what is the consequence?
adrenal insufficiency
name 2 targets inhibited by glucocorticoids
phospholipase A2, transcription factor NF-KB
what is triamcinolone?
glucocorticoids