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Flashcards in June 7th Deck (43):
1

Standard DKA tx

IV fluids, IV insulin and K+ replacement

2

DKA DDx

Infection
Serious medical illness (MI/Stroke)
Nonadherence to insulin
Drugs/Alcohol
Dehydration

3

Standard tx for DM1

Insulin

4

Standard Tx for DM2

Low carb diet
Weight loss
Oral hyperglycemic drugs (Metformin)
Insulin

5

DM 2 Drug with lactic acidosis risk

Metformin

6

DM 2 Drug with most common side effect hypoglycemia

Sulfonylureas

7

DM 2 Drug recommend first line

Metformin

8

DM 2 Drug not safe in symptomatic CHF

TZDs (Pioglitazone & Rosiglitazone)

9

DM 2 Drug not to use in abnormal kidney function

Metformin
SGLT-2 inhibitors
TZD (Pioglitazone & Rosiglitazone)

10

DM 2 Drug weight neutral/weight loss

Metformin
GLP-1 analog (Exenatide, Lirafgutide)
SGLT-2 inhibitor (Canaglifozin)
DPP-4 inhibitors (Linagliptin, Saxagliptin, Sitagliptin)

11

DM 2 Drug metabolized by liver can be used in renal dysfunction

TZDs

12

DM 2 Drug MOA of closing K channel on B cells > cell deploy > Ca influx > Insulin release

Sulfonylureas
Meglitinides

13

DM 2 Drug MOA inhibiting alpha glucosidase at intestinal brush border

Acarbose
Miglitol

14

DM 2 Drug agonist at PPAR-y >> improved target cell response to insulin

TZD

15

DM 2 Drug decreased hepatic gluconeogneeis

Metformin TZDs

16

DM 2 Drug decreased glucose resorb in renal tubules

SGLT-2 inhibitors

17

DM 2 Drug used in organ failure

DDP-4 inhibitors

18

Metformin Class

Biguanide

19

Glimepiride, Glipizide, Glyburide Class

Sulfonylureas

20

Pioglitazone and Rosiglitazone Class

TZDs

21

Exenatide Lirglutide Class

GLP-1 analogs

22

Linagliptin, Saxagliptin, Sitagliptin Class

DPP-4 inhibitors

23

Pramlintide Class

Amylin analogs

24

Canagliflozin

SGLT-2 inhibitors

25

Acarbose, Miglitol Class

alpha glucosidase inhibitors

26

Number needed to harm

1/Atrributable Risk

27

Antibiotics inhibiting prokaryotic DNA topoisomerase

Fluroquinolones

28

Where is leptin produced?

Adipocytes

29

What two hypothalamic nuclei does leptin affect?

Lateral hypothalamus
Venteromedial nuclei

30

What is leptin's effect on the lateral hypothalamus?

With stimulation >> hunger
With leptin/lesion/inhibiton >> anorexia

31

What is leptin's effect on the ventromedial nucleus?

With stimulation/leptin >> satiety
With inhibition/lesion >> hyperphagia

32

What is leptin effect on each nuclei?

Leptin stimulates venteromedial
Leptin inhibits lateral

33

5 criteria for Metabolic Syndrome

Need 3/5
Abdominal circumference
Triglycerides
HDL
Blood pressure
Fasting serum glucose

34

Liver disease associated with obesity?

Non-Alcoholic Steatohepatitis (NASH)

35

BMI of underweight, normal, overweight and obese

Underweight 30

36

What inhibits RNA polymerase II in eukaryotes causing liver damage?

Alpha-amantin found in death cap mushrooms

37

Three functions of Vit D

Increased gut resorption of Ca & P04
Increased bone turnover

38

How is bone affected by PTH?

Increased bone turnover
PTH receptors located on osteoblasts which then secreted RANK ligand which activates osteoclasts

39

PTH functions

Increased bone turnover
Increased Ca resorption at kidney at DCT
Increased PO4 excretion at kidney

40

What cell types produce PTH and calcitonin

PTH = chief cells of parathryoid
Calcitonin = Parafollciular C cells of thyroid (neural crest derivative)

41

Most common causes of hyperparathyroidism?

1) Paraythyroid adenoma
2) Parathyroid hyperplasia

42

Causes of hypocalcemia

Acute pancreatitis
Vit D deficiency
Chronic renal fialure
Hypoparathyroidism DiGeorge and accidental removal

43

Most common cause of hypercalcemia

Hyperparathyroidism