High yield exam cram Flashcards
what is meant by catabolic metabolism?
larger molecules are broken down into smaller ones
What is meant by anabolic metabolism?
a larger molecule is made from smaller ones (e.g. storing)
What does autocrine mean?
Acts on the same cell it was released from
What does endocrine mean?
Acts on neighbouring cells
What does exocrine mean?
enters the bloodstream and acts on distant cells
What is meant by ‘neuroendocrine’?
neurons release hormones which enter the blood and travel to their target tissue
What is meant by ‘total plasma hormone’?
Free hormone + protein bound hormone
What connects the hypothalamus and the anterior pituitary?
capillary portal system
Which hormones are secreted by the posterior pituitary?
Vasopressin and oxytocin
Which part of the pituitary is an extension of neural tissue?
Posterior pituitary
Name the amine hormones
Catecholamines (adrenaline, dopamine)
Thyroid hormones
Name the steroid hormones
- Sex steroids
- HCG
- Corticosteroids
What are steroid hormones derived from?
cholesterol
What is a primary endocrine disorder?
disorder arising from a defect in the tissue that secretes that hormones
What is a secondary endocrine disorder?
too much/too little from the pituitary
What is a tertiary endocrine disorder?
Hypothalamic defect
What are the growth drivers in infancy (0-2)?
Nutrition and insulin
What are the growth drivers in childhood (3-11)?
Growth hormone and thyroxine
What are the growth drivers in puberty (12-18)?
Growth hormones and sex steroids
What is the first sign of puberty in girls?
breast budding (Tanner stage B2)
What is the first sign of puberty in boys?
testicular enlargement (Tanner stage G2)
What is the normal age of pubertal onset in boys?
9-14
(below 9 is precocious and above 14 is late)
What is the normal age of pubertal onset in girls?
8-13
(below 8 is precocious and above 13 is late)
Who is offered bariatric surgery?
a BMII ≥ 40
or
BMI ≥ 35 with 1 or more health problems that are likely to improve upon weight loss
which pancreatic cells produce glucagon?
alpha
which pancreatic cells produce insulin?
Beta
Which pancreatic cells produce somastatin?
D cells
What is c-peptide?
a by-product of insulin production
What effect does insulin have on the body?
causes cells to absorb glucose and use it as energy.
causes liver and muscle cells to take up glucose and store it.
What effect does glucagon have on the body?
causes the liver to break down glucose stores (glycogenolysis)
tells the liver to change fats and proteins into glucose (gluconeogenesis
What are the sick day rules for insulin?
Don’t ever stop insulin, check blood glucose levels more often.
When must the DVLA be informed with regards to diabetes?
if you have diabetes managed with medications
If on insulin and likely to be for >3 months
What are the rules regarding driving and long car journeys for those with diabetes?
BM must be checked before driving and every 2 hours whilst driving
Must not drive if BM <5
If BM falls below 5 while driving, you must wait for at least 45 minutes after your BM has surpassed 5mmol/L
What is a healthy, non-diabetic HBA1c?
<42
What is the target HBA1c in diabetics not on medications which carry a hypo risk?
48 or less
What is the target HBA1c in diabetics on medications which carry a hypo risk?
53
what causes T1DM?
Autoimmune destruction of the pancreas
What is MODY?
subset of T1DM occurring in older patients
How often to those with T1DM need to check fngerprick BM?
Finger prick a least 4x daily (before each meal and before bed)
How does c-peptide measure in T1DM?
Low
what causes T2DM?
peripheral tissues become insensitive to insulin (this is insulin resistance) & the pancreas loses its ability to secrete high levels of insulin
Explain the stepwise management of T2DM
Management is stepwise
Diet & exercise
Metformin
Dual therapy (metformin + 1 from table)
Triple therapy (metformin +2 from table)
What are the3 features of DKA
Ketoacidosis, dehydration, potassium imbalance
Which tests cane used to diagnose DKA?
- BM >11
- Ketones > 3
- pH < 7.3
What is the first line treatment of DKA?
Fluid
What must you be careful to avoid causing when treating DKA?
Cerebral oedema
What is the MOA of metformin?
Increases insulin sensitivity
Decreases glucose production by the liver
What are the side effects of metformin?
GI
Lactic acidosis secondary to AKI
What is the suffix of SGLT-2 medications?
-flozin
What is the MOA of SGLT-2 medications?
Increases urinary excretion of glucose
What are the side effects associated with SGLT-2 medications?
Hypoglycaemia & DKA
Weight loss
UTI/thrush/fournier’s
Lower limb amputation
What is the suffix associated with thiazolidinedones?
Increases insulin sensitivity
Decreases glucose production by the liver
What are the side effects associated with thiazolidinedones?
Weight gain
Heart failure
Bone fractures
Bladder cancer
What is the suffix of Sulfonylureas?
-zide
What is the MOA of Sulfonylureas?
Stimulates insulin release from the pancreas
What are the side effects associated with Sulfonylureas?
Weight gain
Hypoglycaemia
What is the suffix associated with DPP-4 inhibitors?
-gliptin
What is the MOA of DPP-4 inhibitors?
Incretin- Increase insulin secretion, inhibit glucagon production, slow absorption from GI tract
What are the side effects associated with DPP-4 inhibitors?
Headache
Pancreatitis
What is the suffix associated with GLP-1
-tide
What is the MOA of GLP-1?
Incretin- Increase insulin secretion, inhibit glucagon production, slow absorption from GI tract
What are the side effects associated with GLP-1?
Reduced appetite
Weight loss
GI