passmed qs

Question 1

what can stimulate the release of insulin

Answer 1

Glucose
Amino acid
Vagal cholinergic
Secretin/Gastrin/CCK
Fatty acids
Beta adrenergic drugs

Question 2

describe the relationship between somatostatin and glucagon

Answer 2

somatostatin decreases the secretion of glucagon

Question 3

Catecholamine hormones are derived from….

Answer 3

tyrosine

Question 4

how does pth affect phosphates

Answer 4

PTH causes a decrease in renal phosphate reabsorption

Question 5

what does secretin do

Answer 5

causes secretion of water and electrolytes

Question 6

what is the main function of aldosterone

Answer 6

Aldosterone causes reabsorption of sodium and water as well as causing excretion of potassium. This results in an increase in blood volume.

Question 7

which is a more sensitive measure of thyroid function

TSH, T3,T4

Answer 7

TSH- if it is high or low it will give you an indicator that t3 or t4 are not appropiate

Question 8

In males which hormone stimulates Sertoli cells to produce androgen binding globulin (ABG)?

Answer 8

FSH

Question 9

best description of a toxic thyroid adenoma?

Answer 9

A benign tumour of the thyroid gland which produces excessive amounts of thyroid hormones. These arise from the follicular cells of the thyroid.

Question 10

if a gym goer was to inject growth hormone what would this most likely cause and why

Answer 10

increased risk of DM
mobilises glucose from fat stores (to build muscle), thus increasing its concentration in the blood

Question 11

Apart from prolactin releasing hormone which other hypothalamic hormone can increase the secretion of prolactin?

Answer 11

thyrotropin releasing hormone

Question 12

what cells make up 50% of the cells in the anterior pituitary gland

Answer 12

somatotrophs

Question 13

what is ocreotide

Answer 13

a somatostatin analogue

Question 14

fluid retention is caused commonly by what what 4 things

Answer 14

corticosteroids
pioglitazone
hydralazine
ciclosporin

Question 15

common presentation of thryotoxicsos

Answer 15

restlessness

Question 16

what three things increase lipolysis

Answer 16

cortisol
glucagon
growth hormone

Question 17

Most common cause of thyrotoxicosis in the developed world:

Answer 17

graves

Question 18

hypercalcaemia is present in what issues and disorders

Answer 18

Addison’s disease
thiazides
dehydration
primary hyperparathyroidism
thyrotoxicosis
bone metastases
acromegaly
vitamin D intoxication
myeloma
squamous cell lung cancer
sarcoidosis
milk-alkali syndrome

Question 18

hypercalcaemia is present in what issues and disorders

Answer 18

Addison’s disease
thiazides
dehydration
primary hyperparathyroidism
thyrotoxicosis
bone metastases
acromegaly
vitamin D intoxication
myeloma
squamous cell lung cancer
sarcoidosis
milk-alkali syndrome

Question 19

Side effects of SLGT2

Answer 19

urinary tract infection as they cause more glucose to be excreted rather than reabsorbed

Question 20

DO SLGT2 cause weight loss or weight gain

Answer 20

weight loss

Question 21

DPP-4 inhibitors work by ?

Answer 21

Works by blocking inactivation of incretin, increasing levels which inhibit glucagon secretion

Question 22

side effects of thiazolidinediones

Answer 22

fluid retention and weight gai

Question 23

What diabetes medications cause weight gain

Answer 23

Thiazolidiones
Insulin
Sulfonylurea

Question 24

What best describes the mechanism of action of exenatide?

Answer 24

glucagon - like peptide 1 mimetic

Question 25

Thiazolidinediones work by

Answer 25

Activating PPAR gamma receptor in adipocytes to promote adipogenesis and fatty acid uptake

Question 26

What organism is responsible for diabetic foot ulcers

Answer 26

pseudomonas aeruginosa

Question 27

clinical features that will suggest a diagnosis of diabetic neuropathy

Answer 27

sensory loss in a stocking distribution

Question 28

'He also reports feeling full after eating only a small amount of food and has offensive burps that smell like eggs' What is this complication and its background

Answer 28

gastroparesis - autonomic dysfunction of the vagus nerve leading to delayed gastric emptying

Question 29

mechanism of sitagliptin

Answer 29

decrease glp-1 breakdown

Question 30

a known disadvantage of of breast milk

Answer 30

inadequate levels of vit K

Question 31

Where does glucagon like peptide 1 released from

Answer 31

ileum

Question 32

Which is the primary ketone body involved in diabetic ketoacidosis?

Answer 32

Acetoacetate

Question 33

What is waterhouse freidrechsen syndrome

Answer 33

describes adrenal gland failure secondary to a previous adrenal haemorrhage that was caused by a severe bacterial infection

Question 34

Diabetic ketosis

Answer 34

Hyperglycaemia and raised ketones in the abscence of acidosis Ie if ph was normal

Question 35

What bacteria caused diabetic foot ulcers

Answer 35

Pseudomonas aeruginosa

Question 36

Patient with t2dm and cardio problems should have what as next line after metformin

Answer 36

Sglt2 inhibitor Empaglaflozin

Question 37

Non Proliferative diabetic retinopathy features

Answer 37

Cotton wool spots Dot blot Venous beading

Question 38

Proloferative diabetic retinopathy features

Answer 38

Neovascularsarion

Question 39

what meds can cause hyperkalaemia

Answer 39

- trimethoprin - ramipril - ibuprofen

Question 40

what electrolyte changes occur in refeeding syndrome

Answer 40

hypokaelaemia, hypophosphataemia, hypomagnesemia

Question 41

bullimia nervosa is associated with what electrolyte imbalances

Answer 41

- metabolic alkalosis - hypokalemia - hypochloroaemia

Question 42

What can soft tissue swelling in the nasal area of a patient with acromegaly cause ?

Answer 42

obstructive sleep apnea

Question 43

octeoride is an example of ..?

Answer 43

somatostatin analogu

Question 44

first line investigation for addisons

Answer 44

morning serum cortisol 9am cortisol test

Question 45

what is waterhouse friderichsen syndrome

Answer 45

adrenal gland failure due to bleeding into the adrenal gland - caused by severe meningococcal infection

Question 46

what drugs can cause SIADH

Answer 46

- sulfonylureas - SSRI's - carbamaepine - vincristine - cyclophosphoamide

Question 47

what can reduce responsiveness of the collecting tubules to adh

Answer 47

democlocycline

Question 48

orphan annie eyes and psammoma bodies are indicative of ?

Answer 48

papillary thyroid cancer

Question 49

side effect of carbimazole?

Answer 49

agranulocytosis which can lead to neutropenia and severe sepsis a sore throat is an early sign of this

Question 50

side effect of levothyroxine

Answer 50

osteoporosis cardiac arrythmias

Question 51

mild side effects of carbimazole

Answer 51

rash pruritus

Question 52

mechanism of action of thyroid peroxidase

Answer 52

inhibits thyroid peroxidase enzyme

Question 53

first line treatment for patients with MODY

Answer 53

Sulfonylureas- gliclazide to help increase insulin secretion it shuts potassium channels

Question 54

first sign of male puberty is ..?

Answer 54

testicular growth

Question 55

tumor marker used for thyroid cancer to check reoccurence

Answer 55

calcitonin

Question 56

causes of gynaecomastia

Answer 56

- physiological : normal in puberty - kallmans, kleinfelters - testicular failure - liver disease -hyperthyroidism - haemodialysis

Question 57

what drugs can cause gynaecomastia

Answer 57

- spironolactone - digoxin - finasteride - oestrogens - goserelins