Endocrine System and Diabetes Quiz
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Questions and Answers

What is the primary hormone released by the pancreas that regulates blood glucose levels?

  • Insulin (correct)
  • Epinephrine
  • Cortisol
  • Glucagon

    • What characterizes Diabetes Mellitus?

  • Excessive insulin production
  • Always presenting with severe symptoms
  • Hyperglycemia due to insulin issues (correct)
  • Inflammation of the pancreas

    • Which of the following is NOT a common acute metabolic symptom of Diabetes Mellitus?

  • Weight loss
  • Lasting fatigue (correct)
  • Polydipsia
  • Polyuria

    • What type of complications are associated with Diabetes Mellitus?

    <p>Microvascular and macrovascular</p> Signup and view all the answers

    In what way does the endocrine system mainly differ from the nervous system?

    <p>Endocrine responses last longer than nervous responses</p> Signup and view all the answers

    What is primarily considered a microvascular complication of Diabetes Mellitus?

    <p>Neuropathy</p> Signup and view all the answers

    What is the role of incretins concerning insulin release?

    <p>They enhance insulin secretion in response to glucose</p> Signup and view all the answers

    Which statement about symptoms of Diabetes Mellitus is accurate?

    <p>Incidental discovery can occur during routine lab testing</p> Signup and view all the answers

    What is a benefit of using Insulin Lispro for diabetes management?

    <p>It allows flexible dosing and better postprandial control.</p> Signup and view all the answers

    Which class of hypoglycemic drugs includes thiazolidinediones?

    <p>Oral drugs</p> Signup and view all the answers

    What is unique about Insulin Degludec compared to other insulins?

    <p>It has no peak and lasts up to 42 hours.</p> Signup and view all the answers

    Why is insulin not suitable for oral administration?

    <p>It is destroyed by stomach acid during digestion.</p> Signup and view all the answers

    Insulin NPH is classified as which type of insulin?

    <p>Intermediate-acting</p> Signup and view all the answers

    Which of the following is NOT a route for insulin administration?

    <p>Inhalation</p> Signup and view all the answers

    What is the principal source of insulin currently used for production?

    <p>Bacteria or yeast through recombinant DNA technology</p> Signup and view all the answers

    Which insulin type is characterized by a cloudy appearance?

    <p>Insulin NPH</p> Signup and view all the answers

    What is the mechanism of Incretin Mimetics?

    <p>GLP-1 receptor agonist</p> Signup and view all the answers

    Which drug is the first oral glucagon-like peptide-1 (GLP-1) receptor agonist available in Canada?

    <p>Rybelsus®</p> Signup and view all the answers

    What is the initial dose for Ozempic® in terms of subcutaneous injection?

    <p>0.25 mg once weekly</p> Signup and view all the answers

    Which adverse effect is most commonly associated with Incretin Mimetics?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What is the purpose of tapering up the dose of Rybelsus®?

    <p>To reduce the risk of side effects</p> Signup and view all the answers

    Which condition is a contraindication for using Incretin Mimetics?

    <p>Pregnancy</p> Signup and view all the answers

    What is the dosing frequency for Trulicity®?

    <p>Once weekly</p> Signup and view all the answers

    How may Incretin Mimetics affect the absorption of oral medications?

    <p>They reduce the rate of absorption</p> Signup and view all the answers

    What is the primary mechanism of action of metformin?

    <p>Decreases hepatic glucose production</p> Signup and view all the answers

    Which of the following medications is classified as a sulfonylurea?

    <p>gliclazide</p> Signup and view all the answers

    Which of the following factors could effectively contraindicate the use of metformin?

    <p>Type I diabetes mellitus</p> Signup and view all the answers

    What is a common adverse reaction associated with sulfonylureas?

    <p>Hypoglycemia</p> Signup and view all the answers

    Which of the following statements about meglitinides is true?

    <p>They are taken only with meals.</p> Signup and view all the answers

    Which antihyperglycemic agent should be taken with food to minimize gastrointestinal side effects?

    <p>Metformin</p> Signup and view all the answers

    What is a significant risk when using sulfonylureas in patients with kidney impairment?

    <p>Increased chance of hypoglycemia</p> Signup and view all the answers

    What is a common therapeutic use of DPP-4 inhibitors?

    <p>Increasing postprandial insulin secretion</p> Signup and view all the answers

    What should SGLT2 inhibitors not be used in conjunction with?

    <p>Diuretics</p> Signup and view all the answers

    Which of the following SGLT2 inhibitors is marketed under the name Jardiance?

    <p>Empagliflozin</p> Signup and view all the answers

    What is the effect of elevated levels of thyroid hormones on TSH levels?

    <p>Decrease TSH levels</p> Signup and view all the answers

    What is a common adverse reaction associated with SGLT2 inhibitors?

    <p>Postural dizziness</p> Signup and view all the answers

    What is the primary role of calcitonin in the body?

    <p>Control calcium homeostasis</p> Signup and view all the answers

    Which thyroid hormone is more potent?

    <p>T3</p> Signup and view all the answers

    What does a low TSH level indicate?

    <p>Hyperthyroidism</p> Signup and view all the answers

    What is the function of SGLT2 inhibitors in diabetes management?

    <p>Promote renal glucose excretion</p> Signup and view all the answers

    Study Notes

    Homeostasis

    • The endocrine system works with the nervous system to maintain homeostasis in the body.
    • The nervous system uses neurotransmitters to send signals over short distances (synapses), resulting in rapid effects.
    • The endocrine system uses hormones to send signals over long distances, resulting in slower but longer-lasting effects.

    Endocrine System

    • The endocrine system includes several glands: hypothalamus, pituitary gland, pineal gland, thyroid, parathyroid, thymus, pancreas, adrenal glands, testes, and ovaries.

    Diabetes

    • Diabetes is a chronic condition that results from abnormal insulin production or impaired insulin sensitivity.
    • Insulin and glucagon are released by the pancreas and are involved in blood glucose regulation.
    • Diabetes is characterized by hyperglycemia, which can lead to microvascular and macrovascular complications.
    • Microvascular complications include neuropathy, nephropathy, and retinopathy.
    • Macrovascular complications include hypertension, angina, and myocardial infarction.
    • Symptoms of diabetes include polyuria, polydipsia, weight loss, fatigue, blurred vision, and slow wound healing.

    Insulin

    • Insulin is a hormone that plays a crucial role in carbohydrate, fat, and protein metabolism by regulating blood glucose levels.
    • Insulin is produced by the pancreas and helps cells absorb glucose for energy.
    • Insulin can be administered by syringe, pen, or continuous subcutaneous insulin infusion (CSII) using an insulin pump.
    • Insulin is available in various forms with different durations of action: rapid-acting, short-acting, intermediate-acting, long-acting, and ultra long-acting.
    • The type and dose of insulin are adjusted based on individual needs, and insulin can be used to treat both type 1 and type 2 diabetes.
    • Insulin cannot be taken orally because it is broken down by stomach acid.
    • Insulin is now primarily produced using recombinant DNA technology in bacteria or yeast to match human insulin (insulin analogues).

    Incretin Mimetics

    • Incretin mimetics act as GLP-1 receptor agonists, promoting insulin secretion and reducing glucagon secretion, resulting in lower blood glucose levels.
    • They are used as add-on therapy to metformin, sulfonylureas, or basal insulin.
    • Incretin mimetics can be administered via injection or orally:
      • Injectable forms include Ozempic (semaglutide), Trulicity (dulaglutide), Victoza (liraglutide), Byetta (exenatide), and Adlyxine (lixisenatide).
      • Oral forms include Rybelsus (semaglutide).
    • Common side effects of incretin mimetics include nausea, vomiting, hypoglycemia, weight loss, arrhythmia, and pancreatitis.
    • They may reduce the absorption rate of some oral medications.
    • Incretin mimetics are contraindicated in pregnancy and those with personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2.

    Oral Anti-diabetic Agents

    • Oral antidiabetic agents are used to manage type 2 diabetes by lowering blood glucose levels.
    • They are available in various classes: Biguanides, Sulfonylureas, Meglitinides, Glitazones, α-glucosidase inhibitors, DPP-4 inhibitors, SGLT2 inhibitors, and combinations.

    Metformin

    • Metformin is a biguanide medication that enhances insulin sensitivity in liver, muscle, and fat cells, reducing hepatic glucose production.
    • It is often the first-line treatment for type 2 diabetes and can be used in combination with insulin.
    • Metformin does not cause hypoglycemia.
    • It is available in immediate-release and extended-release formulations, with a recommended daily dose of 500mg to 2g.
    • Metformin has potential non-diabetic benefits.
    • Metformin is contraindicated in patients with type 1 diabetes, kidney or liver dysfunction, and history of lactic acidosis.
    • Common side effects include gastrointestinal issues like nausea, vomiting, diarrhea, metallic taste, and flatulence.
    • It is important to start with a low dose and gradually increase as tolerated to minimize gastrointestinal side effects.

    Sulfonylureas

    • Sulfonylureas are insulin secretagogues that stimulate insulin release from the pancreas, increasing both prandial (meal-related) and basal (between meals) insulin release.
    • Sulfonylureas are contraindicated in patients allergic to sulfa drugs, type 1 diabetes, liver or kidney impairment, and thyroid impairment.
    • Sulfonylureas are typically taken with meals.
    • They are generally not the first-line treatment and can worsen glycemic control if used as the sole agent.
    • Sulfonylureas can be associated with weight gain, hypoglycemia, photosensitivity, and various gastrointestinal and skin adverse effects.
    • Interactions can occur with alcohol, enzyme inducers, and inhibitors.

    Meglitinides

    • Meglitinides are rapid-acting insulin secretagogues that primarily increase postprandial insulin release.
    • They are taken with meals within 15 minutes to improve postprandial glucose control.
    • They are not recommended for patients with type 1 diabetes or those requiring basal insulin.
    • Meglitinides can be associated with hypoglycemia, especially if meals are missed.

    SGLT2 Inhibitors

    • SGLT2 inhibitors lower blood glucose by inhibiting the reabsorption of glucose in the kidneys, leading to increased urinary glucose excretion.
    • They are used as monotherapy or in combination with other antidiabetic agents but require good kidney function.
    • They should not be used with diuretics and are typically given once daily with the first meal.
    • They are associated with adverse effects like hypotension, orthostatic hypotension, syncope, dehydration, electrolyte disturbances, increased LDL, weight loss, urinary tract infections, vaginal infections, and increased urination frequency and volume.

    Thyroid Gland

    • The thyroid gland produces hormones T4 (thyroxine) and T3 (triiodothyronine) that regulate metabolism and calcium homeostasis.
    • These hormones affect almost all body cells and rely on iodine for their synthesis.
    • The thyroid gland is regulated by a negative feedback loop involving TRH, TSH, and thyroid hormones.
    • Calcitonin is a hormone produced by the thyroid gland that regulates calcium homeostasis by increasing bone formation and inhibiting bone breakdown.
    • Thyroid disorders can involve overactivity (hyperthyroidism) or underactivity (hypothyroidism).
    • Thyroid disorders are more common in women than men.
    • Diagnosis of thyroid disorders involves laboratory tests of TSH and free T4 (FT4), as well as thyroid antibody tests, which can indicate autoimmune thyroid disease.
      • Low TSH with high FT4 indicates hyperthyroidism.
      • High TSH with low FT4 indicates hypothyroidism.

    Thyroid Hormone Synthesis

    • The thyroid gland selectively takes up iodine to synthesize T4 and T3.
    • T3 is about 4 times more potent than T4.
    • T4 is converted to T3 by deiodination.

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    Description

    Test your knowledge on the endocrine system and its role in maintaining homeostasis, particularly concerning diabetes management. This quiz covers the various glands involved, insulin function, and the implications of diabetes on health. Challenge yourself on these critical concepts in human physiology.

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