questions ! Flashcards
insulin receptor type
tyrosine kinase receptor
growth hormone receptor
cytokine receptor
calcium sensing receptor
G-protein coupled receptor
nerves of the cavernous sinus
III - oculomotor IV - trochlear V1 - ophthalmic nerve V2 - maxillary nerve VI - abducens
which structure is most at risk during total thyroidectomy?
recurrent laryngeal nerve
insulin effect on DNA synthesis
increases DNA synthesis
insulin effect on hepatic gluconeogenesis?
decreases
effect of insulin of hepatic glycogen synthesis
increases
effect of insulin of adiposes lipolysis
decreases
what % of dextrose should be used in hypoglycaemia treatment
10 or 20 %
when must patients on insulin always check their blood glucose
before they drive
what is the target action of dapagliflozin?
inhibits SGLT2
reduces glucose reabsorption + increase urine glucose exretion
diabetic foot ulcer with fever, nausea + night sweats
start IV antibiotics
- dont wait for swab results - may take days
scintigraphy uptake in thyroiditis
no uptake
Graves patient taking carbimazole presents with severe sore throat + fever - what do you do?
stop cabimazole immediately + request urgent FBC
agranulocytosis !
non-functioning pituitary tumour initial treatment
hydrocortisone
give steroid n worry about rest later
patient with marked BP + hypokalaemia, what should be done to investigate Conn’s?
paired renin + aldosterone measurement
saline suppression test later
test for acromegaly
suppress growth hormone - do this via oral glucose tolerance test (OGTT)
patient with Addisons has food poisoning with D+V, now hypotensive + tachycardia, treatment?
Give IV saline + hydrocortison
hydro more important than fludrocortisone, fludro not as urgent
sodium levels in diabetes insipidus
HYPERnatraemia
most important side effect of carbimazole
sore throat - agranulocytosis (bone marrow suppression)
Graves disease
what type of drug is dapagliflozin?
gliflozins = SGLT-2 inhibitor
reversibly inhibit sodium-glucose co-transporter 2 (SGLT-2) in the renal proximal convoluted tubule to reduce glucose reabsorption and increase urinary glucose excretion.
what type of drug is linagliptin?
DPP-4 inhibitor
increase levels of incretins (GLP-1 and GIP) by decreasing their peripheral breakdown
which part of the adrenal gland is most likely at fault in a dysfunctional renin-angiotensinogen system dysfunction?
zona glomerulosa –> produces aldosterone
zona fasciculata = glucocorticoids
zona reticularis = androgens
potassium levels in conns, cushings, addisons and phaeochromocytoma?
conns = hypOkaleamia cushings = hypOkaleamia phaeochromocytoma = hypOkaleamia
addisions = hyPERkalaemia
What type of cells secrete parathyroid hormone?
chief cells
- produced in response to hypocalcaemia
What electrolyte disturbance would make you consider a diagnosis of SIADH?
hyponatraemia
excessive ADH. Therefore, excessive water is reabsorbed into the blood. This excess of water in the blood dilutes sodium, causing a hyponatraemia.
what type of drug is eplernone?
Eplerenone and spironolactone are aldosterone antagonists.
They are commonly used in severe heart failure, particularly following an MI. They are also used hyperaldosteronism.
In what disease could you find pretibial myxoedema?
Graves
Pretibial Myxoedema is a dermatological condition where there are deposits of mucin under the skin on the anterior aspect of the leg (pre-tibial area). This gives a discoloured, waxy, oedematous appearance to the skin over this area
What type of cells produce adrenalin in the adrenal glands?
chromaffin cells
A pheochromocytoma is a tumour of the chromaffin cells, that secretes unregulated, excessive adrenalin
Adrenalin is a “catecholamine” hormone
potassium levels in Conns?
hypOkalaemia
Aldosterone causes sodium reabsorption and potassium and hydrogen excretion at the kidneys. Therefore, you expect to find hypokalaemia, hypertension (due to excessive sodium – serum sodium is usually the higher end of normal) and alkalosis.
effects of cortisol on the body
Inhibits the immune system Inhibits bone formation Raises blood glucose Increases metabolism Increases alertness
