Endocrinology

Question 1

What is the most common side effect of metformin?

Answer 1

GI disturbance

Question 2

Which diabetic medication should be stopped in AKI?

Answer 2

Metformin

Question 3

Which class of T2DM drug is useful in bringing down glucose quickly?

Answer 3

Sulphonylureas
- glimepiride, gliclazide, glipizide

Question 4

Which T2DM drug is useful if insulin resistance is significant?

Answer 4

Pioglitazone

Question 5

Which class of T2DM drug is useful in cardiovascular risk?

Answer 5

SGLT2 inhibitors
- canagliflozin, dapagliflozin, empagliflozin

Question 6

SGLT2 inhibitors carry risk of what type of infection?

Answer 6

Urinary tract infection, thrush
- due to mode of action of increasing glucose excretion in urine

Question 7

Which class of T2DM medications are commonly used for weight loss?

Answer 7

GLP1 analogues
- liraglutide, semaglutide, exenatide

Question 8

Which class of T2DM drugs is useful in protecting kidneys if there is albumin or protein in the urine?

Answer 8

SGLT2 inhibitors
- canagliflozin, dapagliflozin, empagliflozin

Question 9

What is the recommended cut off HbA1c for diagnosing diabetes?

Answer 9

48mmol/mol

Question 10

When should we not utilise HbA1c testing for diabetes diagnosis?

Answer 10

Children, suspected type 1, pregnancy, acute illness, symptomatic for less than 2 months

Question 11

Which test is used for detecting microvascular kidney complications in diabetes?

Answer 11

ACR

Question 12

What is the upper limit of normal for ACR in men and women?

Answer 12

2.5mg/mmol men
3.5mg/mmol women

Question 13

When replacing insulin in DKA, which electrolyte is important to monitor?

Answer 13

Potassium
- Insulin decreases blood potassium

Question 14

What are the three main things to administer in a DKA patient?

Answer 14

Fluids + insulin + potassium

Question 15

Steroids can have what effect on blood glucose?

Answer 15

Increase

Question 16

Type 3c diabetes can be caused by what conditions?

Answer 16

Acute/chronic pancreatitis, pancreatic cancer, cystic fibrosis, haemochromatosis

Question 17

How may Cushing’s disease/syndrome lead to diabetes?

Answer 17

Elevated cortisol leads to increased insulin resistance

Question 18

Excessive growth hormone may lead to what effect on insulin?

Answer 18

Resistance

Question 19

Name 4 hormones that can increase insulin resistance/impede it’s secretion

Answer 19

Cortisol, adrenaline, thyroid, growth hormone

Question 20

What is target blood pressure for those with diabetes?

Answer 20

<140/90mmHg
- NB same as those without diabetes

Question 21

Which painkiller is first line in painful peripheral neuropathy in diabetics?

Answer 21

Amitriptyline
- note cannot use in glaucoma

Question 22

During puberty what do we usually need to do to insulin dosages?

Answer 22

Increase them
- due to increasing insulin resistance at puberty

Question 23

Alcohol does what to glucose levels?

Answer 23

Hypoglycaemia
- due to alcohol inhibiting the livers ability to regulate blood glucose

Question 24

How many grams of quick acting carbohydrate should we give to those who we suspect hypoglycaemia who are conscious and talking?

Answer 24

15-20g