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Med School: Semester 2 > Endocrine 1 > Flashcards

Endocrine 1 Flashcards

1
Q

What are the 3 big categories of insulin resistance? What are some examples?

A

a. making bad insulin
b. circulating insulin competition (receptors Abs, insulin Abs, inhibitors)
c. target tissue defects (receptor defect, post-receptor defect)

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2
Q

Tell me the following about DM1 and DM2:

a. age of onset
b. weight
c. HLA link
d. concordance
e. Islet Abs
f. C-peptide level
g. ketoacidosis

A

a. 30
b. low, high
c. yes, no
d. 50%, 100%
e. yes, no
f. low, normal
g. yes, no

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3
Q

Is insulin resistance due to a decrease in the number of receptors?

A

No.

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4
Q

Is insulin resistance due to a decrease in the number of receptors?

A

No.

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5
Q

What are two reasons for insulin resistance?

A

a. IR tyrosine kinase is impaired.

b. GLUT4 translocation/activation is impaired.

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6
Q

What are the three big signs of metabolic disease?

A

a. HTN
b. obesity
c. hyperlipidemia

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7
Q

What are the levels of hyperlipidemia in metabolic disease for HDL and triglycerides?

A

HDL 150

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8
Q

What are the differences between DKA and HHNC for the following:

a. serum glucose
b. pH
c. HCO3
d. osmolarity

A

a. >250, >600
b. 7.3
c. 20
d. variable, >=330

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9
Q

What are some causes of HHNC?

A

a. new DM2 dx
b. missed meds
c. infection
d. unknown

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10
Q

What are the Dx criteria for DM2?

A

a. A1c > 6.5%
b. fasting glucose >= 126
c. random glucose > 200 with symptoms
* all should be rechecked*

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11
Q

What are the Dx criteria for DM2?

A

a. A1c > 6.5%
b. fasting glucose >= 126
c. random glucose > 200 with symptoms
* all should be rechecked*

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12
Q

How can you treat retinopathy?

A

anti-VEGFs like ranibizumab.

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13
Q

What are the 4 acute complications to DM2?

A

a. hyperglycemia
b. DKA
c. HHNC
d. infection

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14
Q

What are the 3 microvascular complications of DM2?

A

a. retinopathy
b. neuropathy
c. nephropathy

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15
Q

what are the 3 macrovascular complications of DM2?

A

a. CVD
b. CAD
c. peripheral vascular disease

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16
Q

what are the 3 macrovascular complications of DM2?

A

a. CVD
b. CAD
c. peripheral vascular disease

17
Q

What releases glucagon?

A

alpha cells in the islets of langerhans.

18
Q

Where are ketones produced? What is the effect of insulin on this process?

A

Produced in the liver.

Insulin decreases ketone production.

19
Q

Where are ketones produced? What is the effect of insulin on this process?

A

Produced in the liver.

Insulin decreases ketone production.

20
Q

Insulin causes decreases in what 5 substrate concentrations?

A

a. glucose
b. ketones
c. K+
d. FAs
e. triglycerides

21
Q

Glucagon causes an increase in what 2 substrate concentrations?

A

a. glucose

b. ketones

22
Q

What do catecholamines do to serum FFA levels?

A

increase… the release FFAs into circulation.

23
Q

What 4 things do glucocorticoids do?

A

a. mobilize FFAs
b. GLUCONEOGENIC
c. increase ketone synthesis
d. decrease in peripheral glucose use

24
Q

What 5 things do growth hormones do?

A

a. mobilize FFAs
b. favor ketogenesis
c. increase hepatic glucose output
d. reduce peripheral glucose use
e. promote protein synthesis

25
Q

Where is GLUT4 found? Is it insulin responsive?

A

Found in skeletal muscle, heart, and adipose cells. It is insulin sensitive.

26
Q

Where is GLUT4 found? Is it insulin responsive?

A

Found in skeletal muscle, heart, and adipose cells. It is insulin sensitive.

27
Q

Where is GLUT1 highly concentrated?

A

brain(!) and endothelial cells.

28
Q

Where is GLUT2 found, and what is it’s major function?

A

Found in kidneys, liver, pancreatic beta-cells. It senses glucose levels in islets.

29
Q

What is special about GLUT5?

A

It has a high affinity for fructose.

30
Q

Where is GLUT3 found?

A

neurons and placenta.

31
Q

Where is GLUT3 found?

A

neurons and placenta.

32
Q

What are the two ways somebody can develop DM1? Gives examples?

A

a. Genes: HLA-linked

b. Environmental Insult: viral infection and/or damage to beta-cells.

33
Q

What is reduced in DKA, and what is increased?

A

Reduced: circulating insulin and its effects

Increased: glucagon, catecholamines, cortisol, growth hormone

34
Q

Can you hold the insulin of DM1 pts ever?

A

No. Never. Never. Never.

35
Q

What are the 5 I’s that precipitate DKA?

A

a. Infection
b. Insulin (missed)
c. Infarction
d. Ishcemia
e. Intoxication

Med School: Semester 2 (37 decks)

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