Endocrine

Question 1

Causes of elevated CK

Answer 1

Dermatomyositis, polymyositis
Muscular Dystrophy (Duchenne, becker)
Hypothyroidism (Myxedema, delayed relaxation ankle/knee reflex)
Statins/Fibrates

Question 2

Maternal hypothyroidism leads to…

Answer 2

Cretinism

- large tongue, puffy face, mental retardation

Question 3

Pseudohypoparathyroidism

Answer 3

End organ resistance to PTH - hypocalcemia, hyperphosphatemia, elevated PTH

Question 4

Glitazone mechanism and side effects

Answer 4

PPAR-gamma agonists that increase insulin sensitivity –> adiponectin = adipocyte differentiation and increased GLUT-4

Side effect: Weight gain and CHF

Question 5

Metformin mechanism and side effects

Answer 5

Decreased gluconeogenesis

Side effect: Lactic acidosis and GI upset

Question 6

Sulfonylurea mechanism

Answer 6

Close K+ channel –> influx Ca2+ –> insulin release

Question 7

1st and 2nd gen sulfonylurea

Answer 7

1st gen: Tolbutamide, chlorpropamide (disulfuram rxn)

2nd gen: Glyburide (long), glimipride, glipizide (short)

Question 8

Acarbose mechanism

Answer 8

alpha glucosidase inhibitor (decreased brush border glucosidase - GI discomfort