June 7th

Question 1

Standard DKA tx

Answer 1

IV fluids, IV insulin and K+ replacement

Question 2

DKA DDx

Answer 2

Infection 
Serious medical illness (MI/Stroke)
Nonadherence to insulin 
Drugs/Alcohol
Dehydration

Question 3

Standard tx for DM1

Answer 3

Insulin

Question 4

Standard Tx for DM2

Answer 4

Low carb diet
Weight loss
Oral hyperglycemic drugs (Metformin)
Insulin

Question 5

DM 2 Drug with lactic acidosis risk

Answer 5

Metformin

Question 6

DM 2 Drug with most common side effect hypoglycemia

Answer 6

Sulfonylureas

Question 7

DM 2 Drug recommend first line

Answer 7

Metformin

Question 8

DM 2 Drug not safe in symptomatic CHF

Answer 8

TZDs (Pioglitazone & Rosiglitazone)

Question 9

DM 2 Drug not to use in abnormal kidney function

Answer 9

Metformin
SGLT-2 inhibitors
TZD (Pioglitazone & Rosiglitazone)

Question 10

DM 2 Drug weight neutral/weight loss

Answer 10

Metformin
GLP-1 analog (Exenatide, Lirafgutide)
SGLT-2 inhibitor (Canaglifozin)
DPP-4 inhibitors (Linagliptin, Saxagliptin, Sitagliptin)

Question 11

DM 2 Drug metabolized by liver can be used in renal dysfunction

Answer 11

TZDs

Question 12

DM 2 Drug MOA of closing K channel on B cells > cell deploy > Ca influx > Insulin release

Answer 12

Sulfonylureas

Meglitinides

Question 13

DM 2 Drug MOA inhibiting alpha glucosidase at intestinal brush border

Answer 13

Acarbose

Miglitol

Question 14

DM 2 Drug agonist at PPAR-y&raquo_space; improved target cell response to insulin

Answer 14

TZD

Question 15

DM 2 Drug decreased hepatic gluconeogneeis

Answer 15

Metformin TZDs

Question 16

DM 2 Drug decreased glucose resorb in renal tubules

Answer 16

SGLT-2 inhibitors

Question 17

DM 2 Drug used in organ failure

Answer 17

DDP-4 inhibitors

Question 18

Metformin Class

Answer 18

Biguanide

Question 19

Glimepiride, Glipizide, Glyburide Class

Answer 19

Sulfonylureas

Question 20

Pioglitazone and Rosiglitazone Class

Answer 20

TZDs

Question 21

Exenatide Lirglutide Class

Answer 21

GLP-1 analogs

Question 22

Linagliptin, Saxagliptin, Sitagliptin Class

Answer 22

DPP-4 inhibitors

Question 23

Pramlintide Class

Answer 23

Amylin analogs

Question 24

Canagliflozin

Answer 24

SGLT-2 inhibitors

Question 25

Acarbose, Miglitol Class

Answer 25

alpha glucosidase inhibitors

Question 26

Number needed to harm

Answer 26

1/Atrributable Risk

Question 27

Antibiotics inhibiting prokaryotic DNA topoisomerase

Answer 27

Fluroquinolones

Question 28

Where is leptin produced?

Answer 28

Adipocytes

Question 29

What two hypothalamic nuclei does leptin affect?

Answer 29

Lateral hypothalamus | Venteromedial nuclei

Question 30

What is leptin's effect on the lateral hypothalamus?

Answer 30

With stimulation >> hunger | With leptin/lesion/inhibiton >> anorexia

Question 31

What is leptin's effect on the ventromedial nucleus?

Answer 31

With stimulation/leptin >> satiety | With inhibition/lesion >> hyperphagia

Question 32

What is leptin effect on each nuclei?

Answer 32

Leptin stimulates venteromedial | Leptin inhibits lateral

Question 33

5 criteria for Metabolic Syndrome

Answer 33

``` Need 3/5 Abdominal circumference Triglycerides HDL Blood pressure Fasting serum glucose ```

Question 34

Liver disease associated with obesity?

Answer 34

Non-Alcoholic Steatohepatitis (NASH)

Question 35

BMI of underweight, normal, overweight and obese

Answer 35

Underweight 30

Question 36

What inhibits RNA polymerase II in eukaryotes causing liver damage?

Answer 36

Alpha-amantin found in death cap mushrooms

Question 37

Three functions of Vit D

Answer 37

Increased gut resorption of Ca & P04 | Increased bone turnover

Question 38

How is bone affected by PTH?

Answer 38

Increased bone turnover | PTH receptors located on osteoblasts which then secreted RANK ligand which activates osteoclasts

Question 39

PTH functions

Answer 39

Increased bone turnover Increased Ca resorption at kidney at DCT Increased PO4 excretion at kidney

Question 40

What cell types produce PTH and calcitonin

Answer 40

``` PTH = chief cells of parathryoid Calcitonin = Parafollciular C cells of thyroid (neural crest derivative) ```

Question 41

Most common causes of hyperparathyroidism?

Answer 41

1) Paraythyroid adenoma | 2) Parathyroid hyperplasia

Question 42

Causes of hypocalcemia

Answer 42

Acute pancreatitis Vit D deficiency Chronic renal fialure Hypoparathyroidism DiGeorge and accidental removal

Question 43

Most common cause of hypercalcemia

Answer 43

Hyperparathyroidism