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Endo Repro > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Biguanides MOA

Treats what? Names?

A

incr AMPK -> incr skeletal m uptake and decr gluconeogenesis (liver)

T2DM, Metformin

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2
Q

Biguanides ADR and CI

Treats what? Names?

A

ADR: gut stuff/B12 def, CI: renal and liver dysfuction/EtOH/acidosis

T2DM, Metformin

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3
Q

Thiazolidinediones MOA

Treats what? Names?

A

Direct: incr PPAR -> decr FFA -> incr peripheral insulin sens
Indirect: incr skeletal m uptake, decr gluconeogenesis (liver)

T2DM, Pio- or rosi- glitazone

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4
Q

Thiazolidnediones ADR and CI

Treats what? Names

A

ADR: LE edema, CHF, weight gain, decr bone density
CI: CHF, incr bladder cancer, severe liver dysfunciton

T2DM, pio- or rosi- glitazone

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5
Q

Secretagogues MOA

Treats what? Names?

A

bind SUR1 and close K channel -> incr Ca -> insulin secretion

T2DM, sulfonylurea, meglitinides

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6
Q

Sulfonylurea ADR

what kind of T2DM treatment is this? what are names?

A

hypoglycemia, weight gain

secretagogues, gli- or gly- + -ide

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7
Q

meglitinides ADR

what kind of T2DM treatment is this? what are names

A

hypoglycemia and weight gain to lesser extent as compared to sulfonylurea

secretagogues, some other letter + -ide

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8
Q

Incretins MOA (2 kinds)

Treats? Names?

A

DPP4 antagonists: DPP4 normally degrades GLP-1 and GIP
GLP-1 agonists

T2DM, DPP4 antag = -gliptin, GLP-1 ag = -tide

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9
Q

DPP4 antagonist ADR and CI

what type of T2DM treatment is it?

A

ADR: nausea, HA
CI: CKD

incretins

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10
Q

GLP-1 agonists ADR and CI

what type of T2DM treatment is it?

A

ADR: nausea, diarrhea, constipation
CI: Hx medullary thyorid cancer, GFR <30

incretins

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11
Q

alpha glucosidase inhibitor MOA

Treats? Names?

A

inhibit last step of carb digestion at brush border

T2DM, acarbose, miglitol

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12
Q

alpha glucosidase inhibitor ADR and CI

Treats? Names?

A

ADR: diarrhea, farty, bloat, abd pain
CI: liver and renal disease, IBD

T2DM, acarbose, miglitiol

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13
Q

SGLT2 inhibitor MOA

Treats? Names

A

inhibits in PCT, incr glucose loss through urine

T2DM, -flozin

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14
Q

SGLT2 inhibitor ADR and CI

Treats? Names?

A

ADR: polyuria, UTI, vaginal candidiasis, dehydration
CI: CKD

T2DM, - flozin

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15
Q

Amylinomimetics MOA and ADR

Treats? Names?

A

MOA: incr satiety and suppress glucagon
ADR: nausea

T2DM, pramlintide

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16
Q

Bile acid sequestrants ADR

Treats? Names?

A

GI

T2DM, colesevetam

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17
Q

D2R agonists MOA

Treats? Names?

A

incr insulin sens

T2DM, bromocriptine

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18
Q

D2R agonists ADR and CI

Treats? Names?

A

ADR: nausea, HA
CI: nursing, pregnant

T2DM, bromocriptine

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19
Q

Basal Insulin Names and Type

A

glargine, detemir
long-acting

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20
Q

what does basal insulin control

A

long-acting, fasting glycemic control

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21
Q

neutral protamine hagedorn type

A

intermediate-acting insulin

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22
Q

bolus (prandial) insulin names and type

A

lispro, aspart, glulisine
rapid-acting (every meal)

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23
Q

what does bolus/prandial insulin control?

A

post-prandial glycemic control

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24
Q

regular insulin type and uses

A

short acting
grazing, feeding tubes, peritoneal dialysis

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25
Q

combo pre-mixed insulin

actually GIVEN at same time, not same as giving multiple Rx to a T1DM for different kinds of control

A

NPH +
regular or rapid-acting insulin

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26
Q

How do you treat T2DM retinopathy?

break down by each symptom

names?

A

macular edema: VEGF inhibitors
prolif blood vessels: panretinal anticoag

VEGF: bevacizumab, ranibizumab, aflibercept

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27
Q

how do you treat T2DM neuropathy?

names?

A

antidepressants
topical anesthetic
anticonvulsants
foot care

antidepress = duloxetine, amitriptyline
anticonvulsant = pregabalin

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28
Q

Treat craniopharyngioma?

A

surgery or radiation

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29
Q

Treat pituitary adenomas in hypo-pit?

A

relieve mass effect (surg/radiation) and replace deficient hormones

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30
Q

what is exception to treating pit adenomas in hyper-pit

A

trans-sphenoidal surgery in all but PRLoma

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31
Q

How do you treat PRLoma?

A

DA agonists
cabergoline, bromocriptine

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32
Q

How do you treat DKA?

A
  • replace fluids and electrolytes, correct hyperglycemia/metabolic acidosis
  • treat precipitating cause (give insulin)
  • prevent recurrence
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33
Q

What is DKA lab triad?

A

ketonemia
hyperglycemia
AG metabolic acidosis

34
Q

Type 1 APS symptoms

need 2/3 symptoms to Dx

what is another name for it? what is it assoc with?

A
  • hypoparathyroidism
  • chronic mucocutaneous candidiasis
  • adrenal insufficiency

whitaker, T1DM

35
Q

Type 2 APS symp

need 2/3 to dc

what is another name for it? what is it assoc w?

A
  • adrenal insufficiency
  • autoimmune thyroid disease
  • T1DM

schmidt, T1DM

36
Q

what does GH do

A

maintains BG in fasting state

37
Q

what does insulin do

A

maintains blood glucose in fed state

38
Q

how can you treat short stature

A

recomb IGF-1 (mecasermin, dep height velocity) or HGH (dep IGF-1 response)

39
Q

ocreotide MOA

treats?

A

somatostatin analog

acromegaly

40
Q

pegvisomant MOA

treats

A

mutated GH-r peptide (inhibits GH-r)

acromegaly

41
Q

cabergoline MOA

treats?

A

DA agonist

acromegaly (also PRLoma)

42
Q

leptin

A

adipokine, fat storage molecule

43
Q

laeral hypothalamus

A

hunger center

44
Q

ventromedial hypothalamus

A

fat center (lose = gain weight)

45
Q

phentermine MOA

A

Na dep NE transporter, decrease NE uptake, inhibit 5HT and DA reuptake

46
Q

phentermine ADR and CI

A

ADR: symp shit (dry mouth, palpitations)
CI: CVD, HTN, arrhythmias, hyperthyroid, glaucoma

47
Q

Phentermine/topiramate MOA

A

NE release in hypo decrease hunger

48
Q

phentermine/topiramate ADR and CI

A

ADR: symp stuff + brain stuff
CI: +kidney stones, MAOI

49
Q

Naltrexone/bupropion MOA

A

inhibit DA and NE reuptake (incre POMC)

50
Q

Naltrexone/bupropion ADR and CI

A

ADR: SI, nausea, HA, insomnia
CI: seizures, HTN, bulimia, chronic opiod use

51
Q

Liraglutide MOA

Use?

A

GLP-1 agonist

DM and prediabetes

52
Q

liraglutide ADR and CI

A

ADR: nausea, HA, angioedema
CI: MTC, MEN2, Hx pancreatitis

53
Q

Semaglutide MOA

Use

A

GLP-1 agonist

chronic weight management

54
Q

Semaglutide ADR and CI

A

ADR: nausea, HA, angioedema
CI: MTC, MEN2

55
Q

Gelesis MOA

Use

A

non-absorbent hydrogel

BMI 25-40 with lifestyle changes

56
Q

Gelesis ADR and CI

A

ADR: GI
CI: pregnant, allergies

57
Q

Setmelanotide MOA

uses

A

MC4 R agonist

obesity due to POMC, PCSK1, or LEPR def

58
Q

Pheochromocytoma triad

A
  • sustained/paroxysmal HTN
  • HA
  • generalized sweating
59
Q

treat pheochromocytoma

A

alpha then beta blockade, surgery

60
Q

MIBG test

A

utilizes Type 1 reuptake like NE, shows what cells are active in pheochromocytoma

61
Q

basal secretory rate of cortisol

A

9-12 mg/day

62
Q

treat adrenal insufficiency

A

GC: hydrocortisone
MC: fludrocortisone
androgen: DHEA

63
Q

ACTH-dep cushing syndrome specific symp

A

hyperpigmented skin, achne, hirsutism

64
Q

what can you use to treat chronic inflamm?

A

prednisone, methylprednisone

65
Q

treat hypoaldo

A

fludrocortisone

66
Q

meds to treat hyperaldo

A

1st line is mc inhibitors (spironolactone, epleronon)
then K sparing diuretics (amiloride, triamterene)

67
Q

where does sup thyroid a br from

A

external carotid

68
Q

where does inf thyroid a br from

A

thyrocervical trunk

69
Q

thyroid ima a br from

A

brachiocephalic a

70
Q

bisphosphonates moa

treat

A

antiresorptive

hypercalcemia

71
Q

cinacalcet moa

treat

A

calcimimetic

hypercalcemia

72
Q

treat acute/severe hypercalcemia

A

vol expand (lose Ca in urine)
give calcitonin/bisphosphonates
denosumab (RANKL inhibitor)

73
Q

treat hypocalcemia

A

iv ca or oral calcitriol
maintenance with oral ca and cholecalciferol

74
Q

DiGeorge symp

A

cardiac, abnormal facies, thymic aplasia, cleft palate, hypocalcemia

75
Q

treat hypothyroidism

A

levothyroxine

incr dose in pregnancy

76
Q

treat hyperthyroid with nuclear med

A

131-I, low dose graves (8-20), high dose toxic adenoma or Plummer (20-25)

77
Q

treat hyperthyroid

names

A

thionamides: inhibit iodine oxidation

methimazole, propylthiouracil

78
Q

MEN1

A

hyperparathyroid, ant pit tumor, pancreatic islet tumor

79
Q

MEN2A

A

MTC, hyperparathyroid, pheochromocytoma

80
Q

MEN2B

A

MTC, Hyperparathyroid, pheochromocytoma, mucosal neuromas, ganglioneuromas, marfanoid habitus

Endo Repro (1 decks)

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