Endocrine

Question 1

Where do you find GLUT 1

Answer 1

Widely distributed

Question 2

Where do you find GLUT 2?

Answer 2

Mainly found in beta cells

Question 3

Where are GLUT3 found

Answer 3

Found in the brain

Question 4

Where is GLUT4 found?

Answer 4

Muscle and fat cells

Question 5

Where is GLUT5 found?

Answer 5

In the sperm

Question 6

How much reabsorption of glucose does SGLT2 do in the proximal convoluted tubule?

Answer 6

90%

Question 7

Why are diabetic people’s urine very sugary?

Answer 7

The high content of glucose in filtrate super saturates SGLT2 & SGLT1 causing residual glucose to be urinated

Question 8

What is a common cause for Cushing syndrome?

Answer 8

Cancer growth of pituitary gland

Long term use of steroids then sudden lowering of treatment

Question 9

What is a common cause of Addison’s disease

Answer 9

ACTH resistance or loss of adrenal mass

Question 10

What causes Graves’ disease?

Answer 10

Autoimmune Thyroid receptor T cells binding to TRH receptors

Question 11

What causes aldosterone to be released

Answer 11

Low blood pressure

Question 12

What does aldosterone do

Answer 12

Aldosterone causes ENaC transporters to be added into the cortical collecting duct causing sodium reabsorption and potassium excretion. Also increases water reabsorption

Question 13

Which enzyme converts progesterone into pregnenolone

Answer 13

stAR - Steroidogenic acute regulatory protein

Question 14

Why do people with type 2 diabetes risk developing blindness

Answer 14

While suffering diabetes, blood vessels receive damage from high sugar in blood. These vessels deteriorate leading to ischaemia of eye causing VEGF to be released.

VEGF caused formation of small weak blood vessels which burst easily. Bursting can lead to blood covering retina causing blindness

Question 15

Why do people with type 1 diabetes suffer from DKA

Answer 15

No insulin leads to fat and muscle not taking sugar. Causes production of fatty based carbohydrates leading to ketone over production.

Ketones are acidic and cause metabolic acidosis

Question 16

Which enzyme produces aldosterone

Answer 16

Aldosterone synthase

Question 17

What is used to supplement hypopituitaryism

Answer 17

Hormonal replacement therapy using hormones such as;

Flurocortisone
Hydrocortisone

Question 18

What is the result of too much growth hormone production

Answer 18

Acromegaly

Question 19

What is a complication associated with an enlarged pituitary adenoma

Answer 19

Compression of optic tract causing bitemporal hemianopia

Question 20

What is given to treat diabetes insipidus

Answer 20

Desmopressin

Question 21

What are the 2 types of diabetes insipidus

Answer 21

Cranial caused by a lack of vasopressin production

Nephrotic caused by resistance to vasopressin in collecting duct

Question 22

How would you test for diabetes insipidus type?

Answer 22

Water deprivation test. Deprive patient of fluid for 8 hours and measure patient urine every 2 - 4 hours.

Then give desmopressin and observe urine.

If patient urine similarity changes then it’s cranial

Question 23

How to test for Adrenal insufficiency

Answer 23

SynACTHen test.

Give patient some ACTH and observe how much cortisol increases.

If patient cortisol increases it suggests an issue with pituitary gland. If no increase observed it suggest adrenal insufficiency

Question 24

Why is hyponatreamia (low sodium) dangerous and most common cause

Answer 24

Low sodium due to water misbalance where patient loses a lot of water

Hypovolemia - vomiting or Diarrhoea, diuretic excess

Euvolemia - hypothyroidism, pain, diabetes insipidus, glucocorticoid deficient

Hypervolemia - cardiac failure, acute chronic renal failure

Question 25

What happens to the brain if there is too little sodium or too much sodium?

Answer 25

Too little = Cerebral Oedema

Too much = osmotic demyelination

Question 26

Treatment for severe hyponatraemia

Answer 26

I.V hypertonic 3% saline

Question 27

common cause of hypernatraemia (Too much sodium)

Answer 27

Loss of excess water due to diabetes insipidus or osmotic diuretic from diabetes

Question 28

How to treat hypernatraemia

Answer 28

IV 5% Dextrose

Question 29

How is calcium absorbed in the body

Answer 29

Calcium absorbed in GI tract, kidneys and bone.

Question 30

What positively and negatively controls calcium absorption?

Answer 30

PTH - increases calcium absorption in bone, intestinal and kidney.

Calcitonin opposes PTH by reducing bone reabsorption and inhibiting kidney calcium reabsorption

Biphosphates - inhibit osteoclasts reducing bone reabsorptioni

Question 31

Symptoms associated with hypercalcaemia

Answer 31

Bradycardia, decreased concentration, polyuria, pancreatitis, nausea, bone pain

Question 32

What molecule carries fat into mitochondria for beta oxidation

Answer 32

Carnitine which goes through Carnitine Palmitoyl Transferase

Question 33

Where do the superior, middle and inferior adrenal arteries arise from?

Answer 33

Superior - inferior phrenic

Middle - Aorta

Inferior - renal artery

Question 34

What main set of genes causes type 1 diabetes

Answer 34

Mutation in HLA genes.

Beta cells no longer get recognised at own cells resulting in autoimmunity

Commonly observed with coeliac disease

Question 35

What are common signs of Cushing disease

Answer 35

Buffalo hump, purple straie on abdomen, easy brushing, thin peripheral limbs, significant fat in abdomen

Question 36

What is the fasting and fed blood glucose of someone who is diabetic

Answer 36

Fast - >=7 mmol/l

Fed - >= 11.1 mmol/l

Question 37

What test is given to identify someone with diabetes?

Answer 37

75g Oral Glucose Tolerance Test (OGTT)

Question 38

Why is hyperglycaemia bad for blood vessels

Answer 38

Glucose normally goes through the pyol pathway to be converted into sorbitol

Too much glucose goes through the sorbitol pathway causing excessive ROS production and increases AGE production leading to damaged blood vessels

Question 39

What is HbA1c

Answer 39

It’s haemoglobin that has been bound to a glucose molecule. >48 mmol/mol is diabetic

Question 40

How is Cushing syndrome tested?

Answer 40

Dexamethasone test is given. In a normal patient, Dex would cause low cortisol but in Cushing no change is observed