meds + physiology

Question 1

where is insulin produced

Answer 1

beta cells of pancreas

Question 2

function of insulin

Answer 2

causes liver, skeletal, and fat tissues to absorb glucose from the blood

Question 3

how + where is sugar stored

Answer 3

liver and skeletal = glycogen // adipocytes = triglucerides

Question 4

how is insulin formed

Answer 4

rough ER makes pro-insulin –> cleaved to insulin + C peptite

Question 5

what electrolyte causes insulin to be released

Answer 5

Ca

Question 6

function insulin (5)

Answer 6

manage hyperglycaemia // glycogen synthesis // inhibit lipolysis // reduce muscle loss // increase uptake of K+

Question 7

what do alpha pancreas cells secrete

Answer 7

glucagon (encourage glucose stores to be released)

Question 8

what do delta pancreas cells release

Answer 8

somatostatin

Question 9

function somatostatin

Answer 9

inhibits release of GH, glucagon, and insulin

Question 10

what is octreotide

Answer 10

somatostatin analogue

Question 11

uses ocrteotide (6)

Answer 11

variceal bleed // acromegaly // carcinoid // VIPoma // prevent complication in pancreatic surgery // diarrhoea

Question 12

SE octreotide

Answer 12

gallstones

Question 13

when is GH therapy indicated (4)

Answer 13

GH deficiency // turner’s // prader willi // renal insufficiency pre-puberty

Question 14

SE GH therapy

Answer 14

headache, intracranial hypertension, fluid retention

Question 15

what hormones are increased in the body’s stress response (8)

Answer 15

GH, cortisol, renin, ACTH, aldosteroine, prolactin, ADH, glucagon

Question 16

what hormones are decreased in the body’s stress response (3)

Answer 16

insulin, testosterone, oestrogen

Question 17

what hormones are unchanged in stress (3)

Answer 17

FSH, LH, TSH

Question 18

what does the sympathetic NS stimulate release of –> what response

Answer 18

catecholamines (norephiphrine) –> tachycardia + hypertension

Question 19

what stimuates cortisol release

Answer 19

ACTH

Question 20

functions cortisol

Answer 20

break down protein via skeletal muscle // stimulate lipolysis (anti-insulin) // anti -inflamattory // mineralcorticoid effects

Question 21

metabolic effects of stress response (5)

Answer 21

hyperglycaemia // protein anabolism, (catabolism if severe) // lipolysis –> ketones // Na + water retention // interluekins

Question 22

what mx can suppress stress response

Answer 22

opioids // spinal anaesthesia // nutrition // (GH + steroids maybe)

Question 23

what steroid has minimal glucocorticoid activity, and v high mineralocorticoid

Answer 23

fludrocortisone

Question 24

what steroid has low glucocorticoid activity, and high mineralocorticoid

Answer 24

hydrocortisone

Question 25

what steroid has mostly glucocorticoid activity, and low mineralocorticoid

Answer 25

prednisolone

Question 26

what steroid has high glucocorticoid activity, and minimal mineralocorticoid

Answer 26

dexamethasone, betmethasone

Question 27

endocrine SE steroids (5)

Answer 27

impaired glucose regulation // increased appetite // hirsutism // raised lipids // cushings - moon face, hump, striae

Question 28

psychiatric SE steroids (4)

Answer 28

insomnia // mania // depression // psychosis

Question 29

MSK SE steroids (3)

Answer 29

osteoporosis // proximal myopathy // AVN femoral head

Question 30

GI steroid SE (2)

Answer 30

peptic ulcer, pancreatitis

Question 31

eye SE steroids (2)

Answer 31

glaucoma // cataracts

Question 32

general health SE (5)

Answer 32

reactivated TB // infection // supressed growth // neutrophilia (raised WCC) // intracranial hypertension

Question 33

SE mineralocorticoids (2)

Answer 33

fluid retention // raised BP

Question 34

what should happen to those on long term steroid in acute illness

Answer 34

double dose

Question 35

whatc can sudden withdrawal of corticosteroids cause

Answer 35

addisons croisis

Question 36

when should systemic steroids be considered for gradual withdrawal > abrupt stopping (3)

Answer 36

40mg+ of pred daily for more than 1 week + received more than 3 weeks + recently repeated dose

Question 37

where is prolactin released from

Answer 37

ant pit (with ADH)

Question 38

function prolactin

Answer 38

stimulated breast develpoment + milk production // decreased GnRH (and blocks LH)

Question 39

what inhibits prolactin secretion

Answer 39

dopamine

Question 40

what increases secretion of prolactin

Answer 40

thyrotropin releasing hormone // pregnancy + breastfeeding // oestrogen // sleep // stress // metoclopramide