Endo Passmedicine Flashcards
Skin manifestations of hypothyroidism
Dry coarse scalp hair and loss of lateral aspect of the eyebrows
Dry cold yellow skin
Non pitting edema of face and hands
Xanthomas
Eczema
Skin manifestations of hyperthyroidism
Scalp hair thinning
Thyroid acropachy ( clubbing)
Pretibial myxedema ( erythematous edematous lesions above the lateral malleoli )
Increased sweating
MOA of sulphonylureas
Stimulates pancreatic beta cells to release insulin and reduced the hepatic clearance of insulin
MOA of DPP-4 inhibitors
Inhibits a key enzyme ‘DPP4’ involved in breakdown of GLP- 1 prolonging the action of GLP 1 and increasing inculin secretion and reducing glucagon secretion
MOA of SGLT 2 inhibitors
Inhibits Na/glu co transported in PCT preventing glucose reabsorption and causing glucose excretion in urine.
MOA of biguanides( Metformin)
Reduces hepatic gouconeogenesis
Increases peripheral uptake of glucose
Reduces carbohydrate absorption in gut
MOA of thiazolidinones
Upregulation of insulin responsive genes leading to increase in insulin receptors at the surface of the cell
Which drug cannot be used for urinary incontinence in elderly frail woman?
Oxybutynin as it causes confusion , delirium and impairment in daily functioning.
Which drug cannot be used for urinary incontinence in elderly frail woman?
Oxybutynin as it causes confusion , delirium and impairment in daily functioning.
Treatment of urge incontinence?
Urge incontinence is due to detrusor muscle hyperactivity
Tx :-
1.Bladder retraining
2.Antimuscarinics/Anticholinergics: Oxybutynin , Tolperidone, Darifiniacin
(Avioid Oxybutynin in frail elderly)
3.Mirabegron(beta 3 agonist) : to use if anticholinergic side effects are a concer.
Treatment of stress incontinence?
1.pelvic floor exercises : kegels atleast 8 contractions 3 times a day for 3 months
2.Surgery : retropibic midurethral tape procedures
Types of MODY and featured
MODY 1 : HNF 4 alpha gene mutation
MODY 2 : Glukokinase
MODY 3 : HNF 1 alpha
MODY 5 : HNF 1 beta
MODY 1 and 3 : responsive to sulphonylureas
MODY 2 : doesn’t require treatment
MODY 5 : associated with renal cysts , uterine abnormalities , gout and develops later than other forms .
