passmed qs Flashcards
what can stimulate the release of insulin
Glucose
Amino acid
Vagal cholinergic
Secretin/Gastrin/CCK
Fatty acids
Beta adrenergic drugs
describe the relationship between somatostatin and glucagon
somatostatin decreases the secretion of glucagon
Catecholamine hormones are derived from….
tyrosine
how does pth affect phosphates
PTH causes a decrease in renal phosphate reabsorption
what does secretin do
causes secretion of water and electrolytes
what is the main function of aldosterone
Aldosterone causes reabsorption of sodium and water as well as causing excretion of potassium. This results in an increase in blood volume.
which is a more sensitive measure of thyroid function
TSH, T3,T4
TSH- if it is high or low it will give you an indicator that t3 or t4 are not appropiate
In males which hormone stimulates Sertoli cells to produce androgen binding globulin (ABG)?
FSH
best description of a toxic thyroid adenoma?
A benign tumour of the thyroid gland which produces excessive amounts of thyroid hormones. These arise from the follicular cells of the thyroid.
if a gym goer was to inject growth hormone what would this most likely cause and why
increased risk of DM
mobilises glucose from fat stores (to build muscle), thus increasing its concentration in the blood
Apart from prolactin releasing hormone which other hypothalamic hormone can increase the secretion of prolactin?
thyrotropin releasing hormone
what cells make up 50% of the cells in the anterior pituitary gland
somatotrophs
what is ocreotide
a somatostatin analogue
fluid retention is caused commonly by what what 4 things
corticosteroids
pioglitazone
hydralazine
ciclosporin
common presentation of thryotoxicsos
restlessness
what three things increase lipolysis
cortisol
glucagon
growth hormone
Most common cause of thyrotoxicosis in the developed world:
graves
hypercalcaemia is present in what issues and disorders
Addison’s disease
thiazides
dehydration
primary hyperparathyroidism
thyrotoxicosis
bone metastases
acromegaly
vitamin D intoxication
myeloma
squamous cell lung cancer
sarcoidosis
milk-alkali syndrome
hypercalcaemia is present in what issues and disorders
Addison’s disease
thiazides
dehydration
primary hyperparathyroidism
thyrotoxicosis
bone metastases
acromegaly
vitamin D intoxication
myeloma
squamous cell lung cancer
sarcoidosis
milk-alkali syndrome
Side effects of SLGT2
urinary tract infection as they cause more glucose to be excreted rather than reabsorbed
DO SLGT2 cause weight loss or weight gain
weight loss
DPP-4 inhibitors work by ?
Works by blocking inactivation of incretin, increasing levels which inhibit glucagon secretion
side effects of thiazolidinediones
fluid retention and weight gai
What diabetes medications cause weight gain
Thiazolidiones
Insulin
Sulfonylurea
What best describes the mechanism of action of exenatide?
glucagon - like peptide 1 mimetic
Thiazolidinediones work by
Activating PPAR gamma receptor in adipocytes to promote adipogenesis and fatty acid uptake
What organism is responsible for diabetic foot ulcers
pseudomonas aeruginosa
clinical features that will suggest a diagnosis of diabetic neuropathy
sensory loss in a stocking distribution
‘He also reports feeling full after eating only a small amount of food and has offensive burps that smell like eggs’
What is this complication and its background
gastroparesis
- autonomic dysfunction of the vagus nerve leading to delayed gastric emptying
mechanism of sitagliptin
decrease glp-1 breakdown
a known disadvantage of of breast milk
inadequate levels of vit K
Where does glucagon like peptide 1 released from
ileum
Which is the primary ketone body involved in diabetic ketoacidosis?
Acetoacetate
What is waterhouse freidrechsen syndrome
describes adrenal gland failure secondary to a previous adrenal haemorrhage that was caused by a severe bacterial infection
Diabetic ketosis
Hyperglycaemia and raised ketones in the abscence of acidosis
Ie if ph was normal
What bacteria caused diabetic foot ulcers
Pseudomonas aeruginosa
Patient with t2dm and cardio problems should have what as next line after metformin
Sglt2 inhibitor
Empaglaflozin
Non Proliferative diabetic retinopathy features
Cotton wool spots
Dot blot
Venous beading
Proloferative diabetic retinopathy features
Neovascularsarion
what meds can cause hyperkalaemia
- trimethoprin
- ramipril
- ibuprofen
what electrolyte changes occur in refeeding syndrome
hypokaelaemia, hypophosphataemia, hypomagnesemia
bullimia nervosa is associated with what electrolyte imbalances
- metabolic alkalosis
- hypokalemia
- hypochloroaemia
What can soft tissue swelling in the nasal area of a patient with acromegaly cause ?
obstructive sleep apnea
octeoride is an example of ..?
somatostatin analogu
first line investigation for addisons
morning serum cortisol
9am cortisol test
what is waterhouse friderichsen syndrome
adrenal gland failure due to bleeding into the adrenal gland
- caused by severe meningococcal infection
what drugs can cause SIADH
- sulfonylureas
- SSRI’s
- carbamaepine
- vincristine
- cyclophosphoamide
what can reduce responsiveness of the collecting tubules to adh
democlocycline
orphan annie eyes and psammoma bodies are indicative of ?
papillary thyroid cancer
side effect of carbimazole?
agranulocytosis which can lead to neutropenia and severe sepsis
a sore throat is an early sign of this
side effect of levothyroxine
osteoporosis
cardiac arrythmias
mild side effects of carbimazole
rash
pruritus
mechanism of action of thyroid peroxidase
inhibits thyroid peroxidase enzyme
first line treatment for patients with MODY
Sulfonylureas- gliclazide to help increase insulin secretion
it shuts potassium channels
first sign of male puberty is ..?
testicular growth
tumor marker used for thyroid cancer to check reoccurence
calcitonin
causes of gynaecomastia
- physiological : normal in puberty
- kallmans, kleinfelters
- testicular failure
- liver disease
-hyperthyroidism - haemodialysis
what drugs can cause gynaecomastia
- spironolactone
- digoxin
- finasteride
- oestrogens
- goserelins
