Endocrinology Flashcards
What dosing do you use when starting someone on basal/bolus insulin?
Total daily insulin: 0.3-0.5 u/kg
Split dose into 50% basal 50% bolus
Spread bolus dose over 3 meals
How often is denosumab given?
Every 6 months SC injection (Prolia)
RANKL inhibitor
Name 2 bisphosphonates
- Alendronate (weekly tablet)
- Zoledronic acid (annual infusion)
How doe SIADH cause hyponatremia?
↑ ADH secretion → addiction aquaporin-2 canals in the distal convoluted tubules and collecting ducts → increased water reabsorption → decreased serum osmolality and increased urine osmolality
Where is glucagon produced?
Alpha cells of the pancreas
What is the function of glucagon?
Stimulate glycogenolysis and glyconeogenesis
Decreases fatty acid synthesis
Promotes lipolysis
Which two hormones are incretins?
Glucagon-like peptide (GLP-1) and gastric inhibitory peptide (GIP)
What is the function of incretins?
Stimulate a decrease in BSL
- Inhibit glucagon release*
- Reduce gastric emptying*
- Stimulate insulin release*
What does dipeptidyl peptidase-4 do?
Inactivates incretins
Incretins stimulate a decrease in BSL
What is the mechanism of propylthiouracil?
Blocks thyroid hormone synthesis (inhibits thyroperoxidase - TPO)
Inhibits peripheral conversion of T4 to T3
What is the mechanism of carbimazole?
Prohormone to methimazole
Methimazole blocks thyroid hormone synthesis (inhibits thyroperoxidase - TPO)
Why do people with adrenal insufficiency have hyperpigmentation?
Melanocyte-stimulating hormone is cleaved from the same precursor peptide as ACTH
What are the macrovascular complications of diabetes?
- Peripheral vascular disease (atherosclerosis)
- Ischaemic heart disease
- Stroke
What electrolyte disturbance is characteristic of hyperaldosteronism (Conn syndrome)?
Hypokalaemic metabolic alkalosis
Why does acromegaly cause insulin resistance?
Increased GH → IGF-1 synthesis → binds to insulin receptors → glucose tolerance
