Pharm: Endocrine

Question 1

At high doses bromocriptine will also inhibit _______ in addition to prolactin.

Answer 1

Growth hormone secreting tumors

Question 2

T/F Abarelix or Leuprolide may be used for ovulation induction.

Answer 2

TRUE. BOTH GnRH agonist and antagonist have the same pituitary halting effects.

Question 3

What are the 2 MOST SERIOUS complications of ovulation induction?

Answer 3

Multiple pregnancies AND ovulation hyper stimulation syndrome.

Question 4

What are the signs and sxs ovarian hyperstimulatin syndrome?

Answer 4

Ascites increase in ovary size and shock/ hypovolemia.

Question 5

What turns iodide ion to elemental iodine?

Answer 5

Thyroid peroxidase

Question 6

What drugs inhibits the coupling and organification steps in thyroid hormone formation?

Answer 6

Thioamides.

Iodides inhibit iodination AND hormone release

Question 7

What drugs inhibits the proteolysis step in thyroid hormone formation?

Answer 7

Iodides

Question 8

Why can’t one use iodides as treatment for hyperthyroidism?

Answer 8

Thyroid gland escapes from block after a few week.

Question 9

What is the dangerous adverse effect of giving perchlorate to inhibit iodide ion transport?

Answer 9

Aplastic anemia

Question 10

In cases of hyperthyroidism due to Amiodarone induced leakage of thyroid hormones into the circulation what is the treatment?

Answer 10

Corticosteroids

Question 11

At high doses what receptors are inhibited by mifepristone?

Answer 11

Glucocorticoids and progesterone

Question 12

Which does cortisol stimulate? Lipolysis or lipogenesis?

Answer 12

Both

Question 13

Which adrenal steroid synthesis inhibitor inhibits normal synthesis of cortisol BUT NOT of its precursors?

Answer 13

Metyrapone. Used for dxtic tests of renal fxn.

Question 14

How does aminoglutemide work in inhibiting adrenal steroid synthesis?

Answer 14

Block conversion of cholesterol to pregnenolone.

Question 15

Which has best topical activity? Dexa triamcinolone or prednisone or cortisol?

Answer 15

DExa. Cortisol has NONE.

Question 16

Then use of hormonal contraceptives result in an increase in thromboembolic events in which population?

Answer 16

Older women
Smokers
PMH of such events
Genetic clotting factor diseases

Question 17

What transporters for glucose are inserted in the liver as effect of insulin?

Answer 17

Glut 2

Question 18

What transporters for glucose are inserted in the muscle as effect of insulin?

Answer 18

Glut 4

Question 19

What 3 groups of people are most susceptible to hypoglycemia due to insulin?

Answer 19

Renal disease, elderly, children younger than 7 years

Question 20

Which group of anti diabetic agents result in weight gain and blunting of the myocardial ischemic conditioning?

Answer 20

Sulfonylureas and meglitinides

Question 21

Which group of anti diabetic agents result in lactic acidosis in alcoholics and vitamin b 12 deficiency?

Answer 21

Biguanides

Question 22

Which group of anti diabetic agents may result in increased risk of bone fractures and MI?

Answer 22

Thiazolidinediones: pioglitazone and rosiglitazone

Question 23

Alpha glucosidase inhibitors and pramlintide are only effective in controlling what kind of glucose levels?

Answer 23

Post prandial

Question 24

Which group of anti diabetic agents act by inhibiting the enzyme responsible for degrading glucagon like peptide 1?

Answer 24

Sitagliptin by inhibiting DPP4

Question 25

What pancreatic derived hormone may be useful in beta blocker overdose?

Answer 25

Glucagon

Question 26

Enumerate the mechanisms of action of metformin.

Answer 26

1 Inhibit hepatic and renal gluconeogenesis
2 stimulation of glucose uptake and glycolysis in peripheral tissues
3 slowing of glucose absorption in the GI tract
4 reduction of plasma glucagon

Question 27

Which bone cells are stimulate by PTH?

Answer 27

Osteoblasts and osteoclasts.

Osteoclasts stimulated by formation of the RANK ligand

Question 28

What is the plant form of vitamin D?

Answer 28

Ergocalciferol or vitamin d2

Vit d3 natural form from diet
Vitamin D Can also be synthesized from the skin from 7 dehydrocholesterol

Question 29

What 2 substances stimulate the renal synthesis of vitamin D?

Answer 29

Fibroblast growth factor 23 and PTH

Question 30

At low intermittent doses of PTH what will the effect one bone be?

Answer 30

Net increase in bone formation

Question 31

What is the net effect of PTH on urinary calcium?

Answer 31

Increased. Effects on bone and GI tract outweighs the effects on kidney (re absorption of calcium and potassium)

Question 32

What dermatological disease may be treated with calcipotriol?

Answer 32

Psoriasis

Question 33

What enzyme is inhibited by bisphosphonates?

Answer 33

Farnesyl pyro phosphate synthesis that is critical in osteoclasts survival

Question 34

What is the primary toxicity of low oral bisphosphonates?

How to prevent?

Answer 34

Gastric or esophageal irritation

Take meds with large amount of water in standing position.

Question 35

What is the toxicity of high dose bisphosphonates used to treat Hypercalcemia? Give 2.

Answer 35

Renal impairment AND Osteonecrosis of the jaw

Question 36

At high concentrations what is the effect of fluoride on bone?

Answer 36

Increase bone formation.

Question 37

How does strontium ranelate treat Osteoperosis?

Answer 37

Promotes osteoclast apoptosis

Question 38

What is sevelamer for?

Answer 38

Treat Hyperphosphatemia

Question 39

If there is a defect in GH receptor what drug do you give?

Answer 39

Mecasermin