Hyper-prolactinemia+Exceess GH +DI

Question 1

sleep……………. increase prolactin

Answer 1

Deprivation

Question 2

Hyperprolactinemia cause 🫡

Answer 2

👇GnRH

Question 3

How does excess prolactin cause weight gain + hirsutism

Answer 3

Stimulating adrenal androgens

Question 4

> 200

Answer 4

Prolactinoma

Question 5

Dopamine agonists for medical treatment of prolactinoma

Answer 5

Bromocrptin
Cabergolin
Methyldopa

Question 6

……………from stomach , stimulate pituitary gland for synthesis of GH

Answer 6

Ghrelin

Question 7

خيال كة
GH فرة
باقي گشتي كةمةمةو بوود

Answer 7

ربما ورم يگة كة هرمون النمو دةردةد ، وضغط كةدة بان اجزاء تر الغدة النخامية

Question 8

Symptoms of excess GH

Answer 8

Sleep apnea
Carpal tunnel syndrome
Osteoarthritis
Colonic polyp
Peripheral neuropathy due to enlargement of joints
Hypertrophy of sweat and sebaceous glands
Sexual dysfunction

Question 9

Measuring of GH Levels

Answer 9

2 hours after an oral glucose load

Question 10

Somatostatin agonists for medical treatment of Gigantism + Acromegaly

Answer 10

Octreotide

Question 11

علاج اشعاعي ارا كةمكردني هرمون النمو

Answer 11

٢٠ سال تواد تا أثري دةربكةفد😒😒😒😒😒😒😒
ولةي اثنائة حتما احتمال قصور عام غدة النخامية هةس

Question 12

initially…………tumor bulk is reduced with surgery , but are often resistant to removal

مما يلزم عدة عمليات جراحية او عدة جرعات من العلاج الأشعاعي

Answer 12

TSH. Secreting tumors

Question 13

DI

Primary polydipsia

هردگي هرمون ضد ادرار كةمةو بوود

Answer 13

كةمبووني هرمون ضد ادرار او كةمبووني استجابة له

شرب الكثير من الماء مما يؤدي الى كةمبووني هرمون ضد ادرار

Question 14

SIADH

Answer 14

Excess amount of ADH

بديهي س ٣٤

Treatment of underlying condition /fluid restriction

خشتةي سلايد ٣٨

Question 15

………….test for distinguishing between DI +Primary polydipsia

Distinguishing between central and nephrogenic DI.

Answer 15

Water deprivation
If urine osmolality 👆,—primary polydipsia.
خوةي كابرا مشكلة نيسي لة دةرداني هرمون ضد ادرار،ولكن دةرنيدةد وةسبب ئاو زياي خواردن، وقتي ئاو لةلي گريمنةو ،ترشح هرمونةگة كةد و بالتالي ميزي مركزوة بوود

After reaching plateu of urine osmo , will administrate ADH
Neurogenic —لأن قبلا نةتوانستياد هرمونةگة دةربيةد ولكن ايسة دايمنةي پي ايتر ميز مركزةوة بوود
Nephrogenic —خود زاني المشكلة هي ان الكلى لا تستجيب ، ميز مركزةو بوود ولكن اقل من خمسين بالمية

Question 16

لة خيالد دانة ، وجود هرمون ضد ادراد

Answer 16

ميز مركز

Question 17

Treatment of DI

Answer 17

Central
Desmopressin acetate (DDAVP) —Synthetic ADH.

Nephrogenic
نيليمنةي خوا بخوةد
Thiazide diuretics or amiloride
Prostaglandin inhibitor/indomethacin

Question 18

Normal Plasma osmolality

طريقة القياس

Answer 18

س٣٣

Question 19

Monogenic forms of diabetes mellitus

Answer 19

MODY 3 /(an HNF-1α mutation) /respond to sulfonylureas.

MODY 2 /mutations in the glucokinase gene/stable hyperglycemia /does not require treatment.

Transient or permanent neonatal diabetes (onset <6 months of age)

Homozygous MODY2 mutations cause a severe form of neonatal
diabetes,
while mutations in mitochondrial DNA are associated with
diabetes and deafness.

Question 20

Symptoms of hyperglycaemia

Answer 20

Frequent superficial infections (vaginitis, fungal skin infections) .

Question 21

HbA1c

Answer 21

Glycosylated Hb

Pregnancy plans (HbA1c <6.5% prior to conception).
DM more or equal with 6.5

Question 22

Hyperglycaemia causes osmotic diuresis

Answer 22

👆Glomerular filteration of glucose—>👆Osmotic pressure of renal tubular fluid—>👇water reabsorption

Question 23

قياسكردن نبضات محيطي اوانةي سكر ديرن

Answer 23

كل الأماكن

Temporal: It is felt in the head.
Carotid: It is felt in the neck.
Branchial: It is felt in the elbow.
Femoral: It is felt at the groin.
Radial: It is felt on the wrist.
Popliteal: It is felt on the knee.
Dorsalis pedis: It is felt on the foot.

Question 24

APPROACH TO THE PATIENT

Answer 24

5 years after diagnosis of type 1 DM and
• At the time of diagnosis of type 2 DM

Question 25

Symptoms of diabetes usually resolve when the plasma glucose is

Answer 25

< (200 mg/dL)

Question 26

خشتةي سلايد ٤٨

Answer 26

خالي 3
5a-d
6a-d

Question 27

سبب دروستبووني الأجسام الكيتونية

Answer 27

نةچينة ناوةوةي گلوكوز الى الخلايا / چ وة سبب نةبوون انسولين او مقامة تجاهه

لة سكري نوع ١ خطر ترة

Question 28

Continuous Glucose Monitoring
• The glucose sensors are placed subcutaneously and are replaced every

Answer 28

3-14 days

Question 29

………………is the standard method for assessing long-term glycemic

Answer 29

HbA1c
**reflects the glycemic history over the previous 2–3mo

**The fructosamine assay (measuring glycated albumin) reflects the
glycemic status over the prior 2 weeks.

Question 30

Target 🎯 levels of glycemic control

Answer 30

In most individuals, the target HbA1c should be <7% with a more
stringent (≤6.5%) target for some patients.ex/pregnancy

• Higher HbA1c target <7.5 or 8% for patients with impaired awareness of
hypoglycemia.