hard questions endo part 2

Question 1

2 mechanisms of t2dm

Answer 1

RESISTANCE AND LESS PRODUCTION (beta cell fialure)

Question 2

3 methods of measuring glucose?

Answer 2

HB1AC, ORAL GLUCOSE TOLERANCE, FASTING GLUCOSE

Question 3

how can adiposity lead to insulin resistance

Answer 3

ADIPOSE RELEASES PROINFLAMMATORYH CYTOKINES

Question 4

3 other factors affecting pathophysiology of t2dm

Answer 4

DIET GENES, UTERINE AND ADULT ENVIRONMENT, PRESECE OF FATTY ACID

Question 5

what is the hallmark of t2dm on the insulin clamp?

Answer 5

loss of first phase insulin release

Question 6

what is the firstline methodof diagnosing t2dm?

Answer 6

HBA1C OVER 48

Question 7

what is a hyperosmolar hyperglycaemic state? what causes it?

Answer 7

DEHYDRATION DUE TO TRYING TO PEE OUT GLUCOSE. DANGEROUS, RENAL FAILURE, EXTREME HYPERGLYCAEMIA, ALTERED MENTAL STATE.
PRECEDED BY INFECTION OR MI

Question 8

2 roles of metformin

Answer 8

sensitizes insulin receptors and lowers hgo

Question 9

what is the role of pioglitazone?

Answer 9

insulin sensitiser

Question 10

2 side effects of pioglitzasone

Answer 10

peripheral weight gain
hepaitits
heart failure

Question 11

what is glp and when is it secreted?

Answer 11

GUT HORMONE SECRETED IN RESPONSE TO NUTIENTS IN GUT BY L CELLS
CAUSES FULLNESS AND DTIMULATES INSULIN

Question 12

roleof SGL2 inhibitors in diabetes?

Answer 12

inhibit the glucose transpeort in pct so more is peed out. IMPROVE MICROALBUMINURIA, IMPROVE CKDM WEIGHT LOSS, LOWER CVD RISK

Question 13

what 2 things increase diabetes complications?

Answer 13

hypertension and high glucose

Question 14

what is seen in background retinopathy?

Answer 14

small haemorrhages

cheese coloured exudates

Question 15

what is seen in preproliferative retinopathy

Answer 15

cotton wool spots and haemorrahge

Question 16

how is each of the follwing treated?
background retinopathy
preproliferative
proliferative 
diabetic maculopathy

Answer 16

watchful waiting
panretianl photocoagulation
panretinal photocoagulation
anti vegf injections, grid photocoagulation

Question 17

3 signs of diabetic nephrophathy

Answer 17

microalbuminuria
hypertension
deranged gfr

Question 18

classification of microalbuminuria, proteinuria, nephropathy?

Answer 18

micro - <2.5
protein > 30
nephropathy >3000 mg/24h

Question 19

what happens to the renin angiotensin system in t2dm

Answer 19

it is in overdrive

Question 20

4 ways of managing diabetic nephropathy?

Answer 20

tighter glycaemic control
ace/arb
stop smoking
SGLT-2 inhibitor if T2DM

Question 21

How is diabetic foot with ulceration treated?

Answer 21

MDT DIABETES FOOT CLININC 
OFFLOADING 
REVASCULARISATION 
ABS 
ORTHOPEDIC FOOTWARE
AMPUTTION

Question 22

what is seen in mononeuropathy?

Answer 22

SUDDEN MOTOR LOSS - WRIST/FOOT DROP, CN PALSY (3RD NERVE)

Question 23

what is seen in autonomic neuropathy

Answer 23

GI; DELAYED GASTRIC EMPTYING (EFFETS ON INSULIN RELEASE), CONSTIPATION
CV: POSTURAL HYPOTENSION, SUDDEN CARDIAC DEATH