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[h] Endocrinology Flashcards

[i] Master this session in just 5 minutes.

[q] ………….. starts working 30 minutes after subcutaneous injection, with peak effects occurring between 2-4 hours. Preferred for DKA (because it can be used intravenously), hyperkalemia (with glucose to prevent hypoglycemia), stress hyperglycemia.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNob3J0IGFjdGluZyBpbnN1bGluIChSZWd1bGFyKS4=

Cg==

Cg==[Qq]

[q] ……………. onset of action is under 15 minutes and peaks between 45-75 minutes, a pattern that closely mimics the endogenous postprandial insulin response of normal individuals.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFJhcGlkIGFjdGluZyBpbnN1bGluIChMaXNwcm8sIEFzcGFydCwgR2x1bGlzaW5lKS4=

Cg==

Cg==[Qq]

[q] ………….. is a type of insulin that is good for about 18 hours (shots given twice a day).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEMuIEludGVybWVkaWF0ZSBhY3RpbmcgaW5zdWxpbiAoTlBIKS4=

Cg==

Cg==[Qq]

[q] ………… is insulin analog with no peak “peakless”, used to supply a constant background level and administered as once-a-day shots.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IExvbmctYWN0aW5nIGluc3VsaW4gKERldGVtaXIsIEdhbGFyZ2luZSku

Cg==

Cg==[Qq]

[q] The most common side effects of insulin are …….. and …….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGh5cG9nbHljZW1pYSBhbmQgd2VpZ2h0IGdhaW4u[Qq]

[q] In patients with advanced chronic kidney disease and diabetes mellitus, decreased renal clearance of insulin can lead to ………….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHN5bXB0b21hdGljIGh5cG9nbHljZW1pYS4=[Qq]

[q] ………….. decreases blood sugar by inhibition of hepatic gluconeogenesis and the action of glucagon, ↑ glycolysis, peripheral glucose uptake (↑ insulin sensitivity). There is no risk of hypoglycemia with metformin use “Euglycemic” and causes modest weight loss (often desired).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEJpZ3VhbmlkZXMgKE1ldGZvcm1pbiku[Qq]

[q] The major side effects of metformin are …….. and ………?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGdhc3Ryb2ludGVzdGluYWwgdXBzZXQgYW5kIGxhY3RpYyBhY2lkb3Npcy4=[Qq]

[q] Renal failure Patients are contraindicated to take metformin as oral hypoglycemic drugs due to increased risk of ……….?

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGxhY3RpYyBhY2lkb3Npcy4=[Qq]

[q] ………. is monitored periodically in patients taking metformin.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNlcnVtIGNyZWF0aW5pbmUu[Qq]

[q] ………… close K channel in β-cell membrane —> cell depolarizes —> insulin release via ↑ Ca influx —> Stimulate release of endogenous insulin in type 2 DM and useless in type 1 DM. It causes disulfiram-like effects in alcoholics.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEZpcnN0IGdlbmVyYXRpb27CoFN1bGZvbnlsdXJlYXM6IENobG9ycHJvcGFtaWRlLCBUb2xidXRhbWlkZS4=

Cg==

Cg==[Qq]

[q] ………… close K channel in β-cell membrane —> cell depolarizes —> insulin release via ↑ Ca influx —> Stimulate release of endogenous insulin in type 2 DM and useless in type 1 DM. It causes hypoglycemia as a side effect and risk of hypoglycemia ↑ in renal failure.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IMKgU2Vjb25kIMKgZ2VuZXJhdGlvbiBTdWxmb255bHVyZWFzOiBHbGltZXBpcmlkZSwgR2xpcGl6aWRlLCBHbHlidXJpZGUu

Cg==

Cg==[Qq]

[q]  ……….. are short-acting glucose-lowering medications. They are functionally similar to sulfonylureas and act by binding to and closing the ATP-dependent K channel (membrane ion channels) in the pancreatic beta cell membrane but have a weaker binding affinity and faster dissociation from the binding site. Their short half-life requires frequent dosing, typically with each meal, but may reduce the risk of hypoglycemia.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IE1lZ2xpdGluaWRlcyAocmVwYWdsaW5pZGUsIG5hdGVnbGluaWRlKS4=

Cg==

Cg==[Qq]

[q] ………. exert their glucose-lowering effect by decreasing insulin resistance through transcription modulation.

 

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoaWF6b2xpZGluZWRpb25lcyAoUGlvZ2xpdGF6b25lLFJvc2lnbGl0YXpvbmUpLg==[Qq]

[q] ……… bind to peroxisome proliferator activated receptor gamma (PPAR-gamma, nuclear receptors), which is a transcriptional regulator of the genes involved in glucose and lipid metabolism. One of the most crucial genes regulated by PPAR-gamma is adiponectin, which is a cytokine secreted by fat tissue (adipocytokine).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoaWF6b2xpZGluZWRpb25lcyAoUGlvZ2xpdGF6b25lLFJvc2lnbGl0YXpvbmUpLg==

Cg==

Cg==[Qq]

[q] As the glucose lowering effect of …………. requires alteration in gene transcription and protein synthesis, it takes days to weeks after initiation of therapy to observe a significant reduction in glucose levels.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoaWF6b2xpZGluZWRpb25lcyAoUGlvZ2xpdGF6b25lLFJvc2lnbGl0YXpvbmUpLg==

Cg==

Jm5ic3A7

Cg==

[Qq]

[q] The main side effects of ………… are fluid retention, weight gain, and the precipitation of congestive heart failure from fluid retention. This excess fluid can exacerbate underlying congestive heart failure. It also increases the risk of bone fracture.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRoaWF6b2xpZGluZWRpb25lcyAoUGlvZ2xpdGF6b25lLFJvc2lnbGl0YXpvbmUpLg==

Cg==

Jm5ic3A7

Cg==

[Qq]

[q] ……. was the first TZD released for clinical use but was withdrawn from the market due to a high incidence of severe hepatotoxicity.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFRyb2dsaXRhem9uZS4=[Qq]

[q] Incretins, especially GLP-1 and GIP are secreted by K and L cells in the gut and stimulate a decrease in blood glucose level by causing an increase in the amount of insulin released from pancreatic beta cells after eating, before blood glucose level become elevated. They also inhibit the release of glucagon from alpha cells. They have an outstanding effect on slowing gastric motility and promoting weight loss (often desired).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEdMUC0xIGFuYWxvZ3MgKEV4ZW5hdGlkZSwgTGlyYWdsdXRpZGUpLg==

Cg==

Cg==[Qq]

[q] ……… inhibit DPP-4 leaving GLP-1 and GIP without inactivation to ↑ insulin release and ↓ glucagon secretion from alpha cells. It causes mild urinary or respiratory infections

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IERQUC00IGluaGliaXRvcnMgKFNheGFnbGlwdGluIGFuZCBzaXRhZ2xpYnRpbiku[Qq]

[q] ……………. decrease the activity of disaccharides on the intestinal brush border (disaccharides are membrane-bound enzymes).

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFscGhhLWdsdWNvc2lkYXNlIGluaGliaXRvcnMgKEFjYXJib3NlLCBNaWdsaXRvbCku[Qq]

[q] The major side effects of ……………. are flatulence, gastrointestinal bloating, abdominal pain, and rash.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFscGhhLWdsdWNvc2lkYXNlIGluaGliaXRvcnMgKEFjYXJib3NlLCBNaWdsaXRvbCku[Qq]

[q] The major side effects of …………. are flatulence, gastrointestinal bloating, abdominal pain, and rash.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFscGhhLWdsdWNvc2lkYXNlIGluaGliaXRvcnMgKEFjYXJib3NlLCBNaWdsaXRvbCku[Qq]

[q] ………. block reabsorption of glucose in PCT. It cause Glycosuria, UTIs, vaginal yeast infections.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNHTFQtMiBpbmhpYml0b3JzIChDYW5hZ2xpZmxvemluLCBkYXBhZ2xpZmxvemluLCBlbXBhZ2xpZmxvemluKS4=[Qq]

[q] The effectiveness of ………… inhibitors is dependent on glomerular filtration of glucose, which is decreased in patients with chronic kidney disease. Serum creatinine should be measured prior to therapy.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IFNHTFQtMiBpbmhpYml0b3JzIChDYW5hZ2xpZmxvemluLCBkYXBhZ2xpZmxvemluLCBlbXBhZ2xpZmxvemluKS4=[Qq]

[q] …………. work by ↓ gastric emptying, ↓ glucagon release and cause Hypoglycemia, nausea, diarrhea.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFteWxpbiBhbmFsb2dzIChQcmFtbGludGlkZSku

Cg==

Cg==[Qq]

[q] Thionamides (methimazole and propylthiouracil) act as antithyroid medications by decreasing the formation of thyroid hormones via inhibition of the enzyme ………..?. …………… also decreases the peripheral conversion of T 4 to T3.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IHRoeXJvaWQgcGVyb3hpZGFzZSwgUHJvcHlsdGhpb3VyYWNpbC4=

Cg==

Cg==[Qq]

[q] ……… is a rare but very serious complication of antithyroid drugs. A WBC count with a differential is necessary in any patient receiving either methimazole or PTU who presents with a fever and sore throat.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEFncmFudWxvY3l0b3Npcy4=[Qq]

[q]Administration of potassium iodide may also prevent thyroid absorption of radioactive iodine isotopes by ………… and is often administered following nuclear accidents to protect the thyroid and prevent development of radiation- induced thyroid carcinoma.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGNvbXBldGl0aXZlIGluaGliaXRpb24u

Cg==

Cg==[Qq]

[q] ………. such as prednisone are used to control severe Graves’ ophthalmopathy. They are helpful in decreasing the severity of inflammation and decreasing extraocular volume. Conventional antithyroid drugs do not improve ophthalmopathy.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEhpZ2gtZG9zZSBnbHVjb2NvcnRpY29pZHM=[Qq]

[q] The acute effects of corticosteroids on the CBC include increased neutrophil count, and decreased lymphocyte, monocyte, basophil, and eosinophil counts. The increase in neutrophil count results from …………. of neutrophils previously attached to the vessel wall.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IGRlbWFyZ2luYXRpb24u[Qq]

[q] ………… is synthetic analog of aldosterone with little glucocorticoid effects. It can be used as a mineralocorticoid replacement in 1° adrenal insufficiency.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IEZsdWRyb2NvcnRpc29uZS4=[Qq]

[q] ………… sensitizes Ca-sensing receptor (CaSR) in parathyroid gland to circulating Ca2+ à ↓ PTH. It can be used for treatment of Hypercalcemia due to 1° or 2° hyperparathyroidism.

[c]IFNob3cgbWUgdG hlIGFuc3dlcg==[Qq]

[f]IENpbmFjYWxjZXQu[Qq]

[q] ……………. is nonabsorbable phosphate binder that prevents phosphate absorption from the GI tract. It can be used for treatment of Hyperphosphatemia in CKD.

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