Endocrine

Question 1

Drug for Growth Hormone Hypersecretion and S/E

Answer 1

Octreotide
analog of somatostatin inhibit secretion of GH from anterior pituitary

S/E
GI disturbance Nausea Vomiting
Abdominal Cramps Flatuence Steatorrhoea
Gallstones
Postprandial hyperglycemia

Question 2

Drug for Deficiency Growth Hormone

Answer 2

Somatropin
Hypothroyidism
converstion of T4 to T3
Peripheral edem-retention of sodium phosphate and potassium
Papilledema- Visual Changes
Intracranial hypertension- Headache
Imapired glucose tolerance- glucose goes up can’t go down

Question 3

What is Disease for GH deficiency

Answer 3

Dwarfism

Question 4

What are the diseases for GH hypersecretion

Answer 4

Acromegaly
Enlargement of facial structure hands feet osteoarthritic vertebral changes

Gigantism
very tall, enlargment of facial structures hands and feet

Question 5

Treatment of Acromegaly and giantism and S/E

Answer 5

Pegvisomant

Growth Hormone receptor blocker
inhibit function of growth hormone

Elevate liver enzyme
Infection
Flu syndrome
Nausea and diarrhoea

Question 6

Cortisol Aldosterone effect

Answer 6

Glucocorticoid effect
decreased uptake and utilization of glucose
increased gluconeogensis
increased blood glucose level
increased catabolism of protein
increased lipolysis
maintenance of cardiovascular function by potentiation of noradrenaline effects

Mineralocorticoid effect
act on distal tubule to enhance na+ reabsorption and increased K+/H+ secretion

Question 7

Symptoms of ACTH insufficiency and Addison’s disease

Answer 7

Hypoglycemia fatigue weight loss due to decreased blood glucose
Intolerance to stress because potentiation effect on noradrenaline is lost
Hypotension reabosrption of sodium in kidney is decreased

Question 8

Deficiency ACTH Treatment S/E

Answer 8

Hydrocortisone (identical to cortisol)

Redistribution of fat and muscle wasting
moon face 
buffalo hump
increased abdominal hump
thin arm and legs
thinning of skin
Hyperglycemia 
Hypertension
Growth suppression in children
Osteoporosis
increased susceptibility to infection
Peptic ulcer
Cataracts

Question 9

Treatment of Addison’s disease

Answer 9

Hydrocortisone + Fludrocortisone (an analog of aldosterone)

Redistribution of fat and muscle wasting
moon face 
buffalo hump
increased abdominal hump
thin arm and legs
thinning of skin
Hyperglycemia 
Hypertension
Growth suppression in children
Osteoporosis
increased susceptibility to infection
Peptic ulcer
Cataracts

Question 10

What are the diseases for hypersecretion of Adrenal hormones

Answer 10

Cushing’s syndrome
-overproduction of cortisol and aldosterone

Hyperaldosteronism (overproduction of aldosterone

Question 11

Treatment of hypersecretion adrenal hormone and their S/E

Answer 11

Trilostane

Metyrapone

SE hypotension
Nausea and vomiting
Headache and dizziness
Rash

Question 12

Prolactin Effect +

Answer 12

Lactation
Reducing production of activities of gonadotrophins
lack of ovulation

Question 13

Hypersecretion of prolactin Symptoms

Answer 13

Galactorrhea
Hypogonadism
Amenorrhea

Question 14

Treatment of Hypersecretion of prolactin and S/E

Answer 14

Dopamine receptor antagonist
Bromocriptine
Cabergoline -longer half life and higher selectivity

Postural Hypotension
Constipation
Nausea and vomiting
Dizziness

Question 15

Secretion of oxytocin and physiologic effect

Answer 15

Sucking by infant at the nipple is relayed by spinal nerves to the hypothalamus. Nerves in posterior pituitary gland are simulated which oxytocin is secreted

Elicit milk ejection in lactating women

Question 16

Control of ADH and effects

Answer 16

increased plasma osmolarity
decreased blood volume
increased blood pressure
V1 receptor in blood vessel vascular smooth muscle
vasoconstriction increased blood pressure
V2 epithelial cells in distal tubule and collecting duct
increased membrane permeability to water (more water is absorbed)
decreased plasma osmolarity
increased blood volume
increased blood pressure

Question 17

Deficiency of ADH name and pathophysiology

Answer 17

Diabetes Insipidus
kidney can’t reabsorb water
continuous production of copious amount of hypotonic urine

Question 18

Treatment of ADH insufficiency and S/E

Answer 18

vasopressin or desmopressin
given by injection
nasal spray

Vasopressin and Desmopressin
Fluid retention
headache
Nausea

Vasopressin only (desmopressin is less selective to V1 receptors in smooth muscle)
spasm of coronary artery agina
abdominal cramps and uterine cramps

Question 19

Effects of Growth hormone and somatostatin

Answer 19

increased uptake of amino acid into cells and protein synthesis
increased glucose uptake initially then decreased glucose uptake after several hours
decreased lipolysis initially then increased lipolysis after seceral hours

Somatostatin
increased uptake of phosphate into bone
increased DNA and RNA synthesis in bone
increased bone growth