Extra Clinical in Endocrine

Question 1

What is the action of sulfonylureas?

Answer 1

displacing the binding of ADP-Mg2+ from the SUR subunit (closing the KATP channel)

Question 2

Give some examples of sulfonylureas.

Answer 2

Tolbutamide, glibenclamide, glipizide

Question 3

Undesirable effects of sulfonylureas?

Answer 3

weight gain

may cause hypoglycaemia

Question 4

How do glinides work?

Answer 4

bind to SUR at distinct site close to Katp channel

Question 5

Which two hormones are released from the small intestine causing enhanced insulin resistance?

Answer 5

GLP-1 and GIP

Question 6

Which cells are GIP1 and GIP released from?

Answer 6

L cells in ileum and colon

K cells in jejenum/duodenum

Question 7

Mechanism of incretin analogues?

Answer 7

mimic action of GLP-1 but are longer lasting

Question 8

Desirable effects in incretin analogues?

Answer 8

reduce hepatic fat accumulation

weight loss

Question 9

How are incretin analogyes administered?

Answer 9

subcutaneously, twice a day

Question 10

Adverse effects of incretin analogues?

Answer 10

hypoglycaemia
nausea
pancreatitis (rare)

Question 11

What are gliptins?

Answer 11

Competitive DPP 4 inhibitors

Question 12

Do gliptins/DPP4 inhibitors cause hypoglycaemia?

Answer 12

no

Question 13

What is DPP-4?

Answer 13

an enzyme that terminated the actions of GLP-1 and GIP

Question 14

What is acarbose?

Answer 14

alpha-glucosidase inhibitor

Question 15

What is alpha-glucosidase?

Answer 15

an enzyme that breaks down starch and disaccharides into glucose

Question 16

In who is acarbose used?

Answer 16

T2DM patients inadequately controlled by other drugs

Question 17

Where do the adverse effects of acarbose occur?

Answer 17

GI tract

Question 18

What is metformin?

Answer 18

biguanine

Question 19

What is the mechanism of metformin?

Answer 19

reduced hepatic gluconeogenesis, increases glucose uptake by skeletal muscle, reduces carb absorption, increased fatty acid oxidation

Question 20

What do glitazones do?

Answer 20

Enhance action of insulin at target tissues

Question 21

What is dapagliflozin

Answer 21

Sodium-glucose cotransporter inhibitor

Question 22

Who is tertiary hyperparathyroidism most commonly seen in?

Answer 22

patients with chronic renal failure

Question 23

How do steroids cause osteoporosis?

Answer 23

by blocking production of interleukin

Question 24

Name two antithyroid drugs.

Answer 24

carbimazole and PTU

Question 25

Which antithyroid drug can be used in preg?

Answer 25

PTU

Question 26

What is the most worrying adverse effect of carbimazole?

Answer 26

agranulocytosis

Question 27

Name two macrovascular complications of diabetes.

Answer 27

Heart disease, stroke

Question 28

Name three microvascular complications of diabetes.

Answer 28

retinopathy, nephropathy, neuropathy

Question 29

Give some complications of Turner’s.

Answer 29

CVS - coarctation of aorta, bicuspid aortic valve, hypoplastic left heart
GI Bleed due to vascular malformation, increased risk of IBD
Also lymphoedema, hypothyroid, ototis medial, scoliosis, renal problems