Lectures II

Question 1

What is the value of HbA1c which will point towards diabetes?

Answer 1

> /- 48mmol/mol (6.5%)

Question 2

When is the HbA1c test avoided?

Answer 2

In pregnancy, children and T1DM

Question 3

What is thyroid acropachy and which condition is it frequently associated with?

Answer 3

Thyroid acropachy refers to a dermopathy associated with Grave’s disease. It is characterised by soft-tissue swelling of the hands and clubbing of fingers.

Question 4

What is the medication indicated for hyperthyroidism?

Answer 4

Carbimazole 15-40MG OD

Question 5

What is the complication of Carbimazole?

Which other drug can also cause this complication?

Answer 5

Agranulocytosis which is the decrease in WBC.
Patients are advised to report any sore throat.
Clozapine (antipsychotic used mainly for schizophrenia) can also cause agranulocytosis.

Question 6

What are the problems that pregnant women with hypothyroidism may face?

Answer 6

Pre-eclampsia, prematurity, anaemia and stillbirth

Question 7

What is the treatment for hypothyroidism?

Answer 7

Levothyroxine

Question 8

What are the symptoms of phaeochromocytoma?

Answer 8

Phaeochromocytoma classic triad: Sweating, Headache and Tachycardia

Question 9

What is Phaeochromocytoma?

Answer 9

Phaeochromocytomas is a relatively rare tumour of the adrenal gland which secretes catecholamine hormones such as adrenaline. It involves the chromaffin cells

Question 10

What is the normal fasting blood glucose level?

What is the normal random blood glucose level 2 hours later in an oral glucose tolerance test?

Answer 10

Normal fasting glucose level: <6mmol/L

Normal blood glucose level 2 hours later: <7.8mmol/L

Question 11

What is the fasting blood glucose level in impaired fasting glycaemia (IFG) ?
What is the blood glucose level 2 hours later in an oral glucose tolerance test?

Answer 11

Equal to or more than 6.1mmol/L but less than 7mmol/L

2 hours later: blood glucose level is normal at <7.8mmol/L

Question 12

What is the fasting blood glucose level in impaired glucose tolerance?
What is the blood glucose level 2 hours later?

Answer 12

In impaired glucose tolerance, the fasting blood glucose level is <7mmol/L, and the blood glucose level 2 hours later is above 7.8mmol/L but less than 11.1mmol/L

Question 13

What is the fasting blood glucose level in T2DM and the glucose level 2 hours later after the 75g of glucose drink?

Answer 13

In T2DM, the fasting blood glucose level is above 7mmol/L.

The random blood glucose level 2 hours later is above 11.1mmol/L

Question 14

What are the main side effects of sulphonylureas?

Answer 14

Weight gain and hypoglycaemia

Question 15

What is the action of Acarbose?

Answer 15

Acarbose is an inhibitor of intestinal alpha glucosidases, delays the digestion and absorption of starch and sucrose

Question 16

What is the physical symptom of iodine deficiency?

Answer 16

Goitre and cretinism

Question 17

Can radioactive iodine therapy given to patients with hyperthyroidism lead to increased risk of cancer?

Answer 17

NO

Question 18

What factors affect the rate at which radioactive iodine is removed from the body?

Answer 18

Age group: Younger people get rid of radioactive iodine more readily than older adults.
Drinking fluids can help to flush out radioactive iodine

Question 19

What steps/precautions are taken by patients who have undergone radioactive iodine therapy?

Answer 19

1. Keeping a distance from pregnant women and children for more than 1 hour.
2. Sleep alone in a separate room and avoid close contact
3. Use separate towels, washcloths, and sheets. Wash personal clothings separately for 1 week
4. Flush the toilet twice after each use. Rinse the bathroom sink and tub thoroughly after each use.

Question 20

What are the side effects of radioactive iodine treatment?

Answer 20

Dry mouth, metallic taste, sore throat, Neck pain (radioactive iodine can make the neck swell), Constipation or diarrhoea, Nausea or vomiting.

Question 21

What are the main sources of iodine?

Who are commonly affected by iodine deficiency?

Answer 21

Seafood, fruits and vegetables, fortified cereals.

Iodine deficiency is commonly seen for inland areas at high altitude

Question 22

What is Cretinism?

Answer 22

It is a condition of severely stunted physical and mental growth owing to untreated congenital deficiency of thyroid hormone (congenital hypothyroidism) usually owing to maternal hypothyroidism.

Question 23

What test is done together with the screening test for congenital hypothyroidism?

Answer 23

Guthrie heel prick test for phenylketonuria PKU.

Question 24

Which gender is more commonly affected by hypo- and hyperthyroidism?

Answer 24

Females

Question 25

``` Growth factors and histamine are chemical agents released in small amounts that act locally on neighboring cells. Which of the following best describes the function of growth factors and histamine? A) Endocrine function B) Paracrine function C) Autocrine function D) None of the above ```

Answer 25

Answer is B) Paracrine function. Hormones act on neighbouring cells. In autocrine function, hormones act on the cell it was released from. In endocrine, hormones act on distant organs. https://www.khanacademy.org/test-prep/mcat/organ-systems/endocrine-system/e/endocrine-system-questions-1

Question 26

``` Which hormone increases basal metabolic rate in the body? A) Thyroid Hormone B) Secretin C) Parathyroid hormone D) Glucagon ```

Answer 26

Answer is A) Thyroid hormone. Thyroid hormone increases the basal metabolic rate, affects protein synthesis, and helps regulate long bone growth. Just remember that thyroid hormones help regulate metabolism throughout the body.

Question 27

Which of the following accurately describes thyroid hormone? A) Binds to receptors on the inside of the cell B) Released from the anterior pituitary C) Derived from cholesterol D) Binds to receptors outside the cell

Answer 27

Answer is A. In general, steroid hormones readily diffuse across the cell membrane and peptide/amine hormones are hydrophilic and bind to cell receptors on the surface. Thyroid hormone is an exception. Even though it is derived from the amino acid tyrosine, it is lipid soluble and diffuses across the cell membrane and will bind to receptors inside the cell. Thyroid hormone acts like a steroid.

Question 28

All of the following are true of posterior pituitary hormones EXCEPT: A) They include direct and tropic hormones B) They are released from the posterior pituitary C) A nerve signal from the hypothalamus stimulates their release

Answer 28

Answer: A. These hormones do NOT include the direct and tropic FLAT PEG hormones, which are synthesized by the anterior pituitary. Non-tropic hormones are hormones that directly stimulate target cells to induce effects. This differs from the tropic hormones, which act on another endocrine gland.