Endocrinology

Question 1

MOA of thiazoledinedione

Answer 1

acts as an agonist. binds to PPAR gamma to reduce insulin resistance and increaasesensitivity

Side effects:
Weight gain, Deranged LFTs, Fluid retantion,

Question 2

MOA of antidiabetics

Answer 2

Biguanides (Sensitizer) - inhibits glucose production in liver and increases sensitivity of muscles to insulin

Meglitinide (Secretagogue) - Binds to ATP dependent K channels on pancreatic beta cells to increase insulin secretion

DPP 4 inhibitors - Bind to DPP4 receptors to inhibit the action of DPP4 on incretin. The result is increased action of GLP1 and GIP leading to increased insulin and reduced glucagon from pancreas.

SGLT2 inhibitros - binds to this receptor in the kidney to prevent reabsorption of glucose from the kidney.

Thiazolidinediones - Binds to PPR gamma intranuclear receptors esp in fat cells to increase sensitivity to insulin

Question 3

what are the components of MEN 1 and what condition is often associated with MEN 1

Answer 3

P - Pancreas (Insulinoma/gastrinoma)
P - Hyperparathyroidism
P - Pituitary

Zollinger ellison syndrome is associated with MEN 1

Question 4

what is trastuzumab

Answer 4

monoclonal antibody against HER receptors in HER +ve breast Ca.

also called Herceptin

Question 5

Autoimmune polyendocrinopathy syndrome

Answer 5

An association of addison’s disease with other endocrine deficiencies.

Two types
- APS Type 2 - most common. Addison’s disease + Type 1 DM/Autimmune thyroid disease

• APS Type 1 - Autosomal recessive inheritance. mutation in AIRE gene on chromosome 21.
  2 out of 3 of the following:
  Addison’s disease
  Chronic mucocutaneous candidiasis
  Hypoparathyroidism