Between NPH and [long acting insulin] which is more likely to cause hypOglycemia?
NPH
Sulfonylurea MOD ; List examples-3
Stimulates pancreas to release endogenous insulin
- Glimepiride
- Glyburide
- Glipizide
Meglitinide MOD ; List examples-2
Stimulates pancreas to release endogenous insulin
- Nateglinide
- Repaglinide
[DPP-4 inhibitors] MOD ; List examples-2
Inactivates [DPP-4 GLP1 peptidase] –> ⬆︎GLP1–> ⬆︎Glucose-induced insulin release
- SitaGliptin
- SaxaGliptin
Microalbuminuria is an indicator of __(3)___.
What lab value is used and what are the values for normal, micro and macro?
- DM
- HTN
- PSGN
Urine [Albumin Creatinine Ratio];
30-300
normal = < 30
micro = 30-300
MACRO = 300+
What are all the functions of Cortisol - 6
BIG FIB
- ⬆︎Blood pressure (⬆︎a1 receptors)
- ⬆︎Insulin resistance –> DM
- ⬆︎Gluconeogenesis
- ⬇︎Fibroblast –> striae
- ⬇︎Immune system (WHITE)
- ⬇︎Bone formation by ⬇︎osteoBlast
Tx for PCOS - 3
DM/Obesity–>Hyperinsulinemia which –> ⬆︎⬆︎⬆︎LH secretion –> ⬆︎ovarian theca Androgen secretion –>
Tx = Wt loss–> OCP –> Clomiphene for infertility and [Combined OCPs for irregular menses]
SOCK:Spironolactone,OCP (1st line after wt loss),Clomiphene for infertility,Ketoconazole
What level of prolactin indicates a Prolactinoma
>200
Prolactin inhibits LH release
etx of PCOS ; What are the primary effects of this etx?-5
DM/Obesity–>Hyperinsulinemia which –> ⬆︎⬆︎⬆︎LH secretion –> ⬆︎ovarian theca Androgen secretion –>
- Androgen characteristics (acne, balding, hirsutism)
- menstrual irregularities from Anovulation
- PCOS on US from Follicular atresia
- Infertility from Anovulation
- ⬆︎Estrogen (from Androgen conversion) –> Endometrial ADC
Tx = Wt loss–> OCP –> [Clomiphene for infertility] and [Combined OCP for irregular menses]
[High Output Heart Failure] clinical presentation -3
- Edema (pulmonary & peripheral)
- warm extremities
- [systolic flow murmur with laterally displaced PMI]
Causes of [High Output Heart Failure] -7
________________
What’s the most common?
MOD for [High Output Heart Failure]
what is [sub-clinical hypOthyroidism] ?
(INC TSH)
but
(normal [T4 Thyroxine])
most common cause of [sub-clinical hypOthyroidism]
[Hashimoto Chronic lymphocytic thyroiditis]
how do you know when [subclinical hypOthyroidism] is advancing to hypOthyroidism
[INC anti-TPO (antiThyroid PerOxidase)]
What does [subClinical hypOthyroidism] but females at risk for?
Pregnancy complication
(spontaneous abortion/preeclampsia, abruptio placenta)
In Hashimoto chronic lymphocytic Thyroiditis, which antibodies are responsible for the attack on the thyroid gland?
AntiThyroidPerOxidase
AntiTPO is also a/w miscarriage!!
cp of hypopituitarism - 5
FLAT PiG
- FSH/LH ⬇︎ –> Amenorrhea, testicular atrophy
- ACTH ⬇︎ –> ⬇︎Cortisol BUT NOT ALDOSTERONE –> hypotension from ⬇︎arterial resistance
- TSH⬇︎ –> Fatigue/hypOthyroidism
- Prolactin⬇︎ –> LACTATION FAILURE (1ST SIGN OF SHEEHAN!)
- GH⬇︎ –> Anorexia
