Endocrine

Question 1

Examples of SGLT-2 Inhibitors

-When are they used?
-Side effects

Answer 1

Drugs ending in FLOZIN

Increase urinary glucose excretion

-Added to T2DM treatment if any HF/CVD or risk of these
-Side effects;

1) Euglycemic DKA
2) UTIs (increase urinary glucose)
3) Fourneiers gangrene/lower limb amputations

Question 2

Example of DDP4 inhibitors?

-Side effects

Answer 2

Drugs ending in GLIPTIN
eg SITAGLIPTIN

Side effects;

1)URTI and headaches
2) skin reactions such as SJS
3) Pancreatitis

Do not cause weight gain which is beneficial

Question 3

Examples of Sulfonylureas?

Side effects

Answer 3

Gliclazide as an example also glibenclamide, glyburide

Directly stimulate release of insulin from pancreas

Side effects:

1)Hypoglycaemia
2) Weight gain
3) Avoid in severe renal failure

Question 4

Examples of GLP-1 mimetics?

Answer 4

Exenatide, Ozempic, Liragluide, semaglutide

Mimic incretin hormone which reduces gastric emptying, stimulating insulin secretion and inhibiting glucagon secretion

Cause weight loss and nausea and vomiting
Have been linked to pancreatitis

Question 5

Primary action of metformin?

Answer 5

Decreases hepatic gluconeogenesis and increases peripheral insulin sensitivity

Question 6

Treatment of prolactinoma?

Answer 6

Bromocriptine

Question 7

Causes of raised prolactin?

Answer 7

Pregnancy
Prolactinoma
Physiological
MetocloPramide and DomPeridone
Prochlorperazine
PCOS
Primary hypothyroidism

Question 8

What is a rare complication of untreated hypothyroidism?
Presentation?
Treatment?

Answer 8

Myxoedema coma
Typically presents with confusion and hypothermia as well as pitting oedema and reduced resp drive

Treatment involves:
-IV thyroid replacement
-IVF
-IV corticosteroids
-Electrolyte imbalance correction

Question 9

How do you manage primary hyperalosteronism?

Answer 9

If bilateral lesions on adrenal glands: Spironolactone

If unilateral lesion: adrenalectaomy