Endocrine System

Insulin & oral treatment of Diabetes Mellitus (X)

Incomplete notes. For more info, read up David Chong’s lecture. Insulin types Older types Soluble quick onset short duration NPH, ‘Lente’ & biphasic intermediate onset intermediate duration ‘Ultralente’ slow onset long duration Newer types (recombinant analogues) Lispro Aspart Glulisine slow onset long duration Mimics pulsed secretion (give with meals) Glargine Detemir long duration Mimics basal…

Diabetes Mellitus (X)

Incomplete notes. For more info, read up Prof Hla Yee Yee’s lecture & Dr. Nurjahan. Diabetes: Group of diseases characterised by persistently high levels  of blood glucose resulting from defects of insulin secretion, insulin action or both. It is associated with abnormality in carbohydrate, fat and protein metabolism and a variety of complications. Types of…

Hormones of the Endocrine pancreas

Insulin Biosynthesis & Structure 51 amino acids 2 poplypeptide chain linked by 2 disulphide linkages A B Human insulin gene on chromosome 11 2 preproinsulin –> proinsulin –> insulin + C peptide Regulation of insulin secretion Stimulation Increase in blood glucose Increase in amino acids Gastrointestinal hormones GIP CCK gastrin Pharmacological agents sulfonylurea Inhibition hormonal…

Structure of the pancrease

The pancrease is a mixed exocrine & endocrine gland. lies tranversely in the posterior abdominal wall L1-L2 level Retroperitoneal (outside peritoneal cavity) Divided into head neck body tail Important relations Head lies in the C-shaped concavity of the duodenum IVC & bile duct lie behind the head Neck portal vein behind the neck Body aorta,…

PBL: Graves’ Disease

Keywords: 35 y.o female secretary (brought in crying after a fight with her boyfriend, accuse him of hitting her) Fast & loud heartbeat Often anxious, nervous and unable to concentrate on her work (symptoms worsening) Could not tolerate hot temperature BP: 150/80 mmHg Pulse regular, pulse rate: 100 per minute Skin is warm & moist,…

Calcium Homeostasis

Brief info on calcium: Calcium is important for many physiologic processes Neurons are very sensitive with changes in Ca2+ ion concentration 0.1%: in ECF 1%: in cells 98.9%: stored in bones & teeth Most abundant cation in the body Calcium in plasma is present in 3 forms: protein bound form (can’t diffuse capillary membrane) ionized…

Disorders of thyroid

Hyperthyroidism Clinical features: Increased BMR Heat intolerance Weight loss Increased appetite Peripheral vasodilation increase heat loss increase blood flow skin soft, warm & flushed Increase cardiac output tachycardia palpitations, arrhythmias cardiomegaly congestive cardiac failure cardiomyopathy Overactivity of sympathetic nervous system tremor hyperactive anxiety inability to concentrate insomnia proximal muscle weakness due to muscle mass loss…

Hormones & Behaviour: Sex differences at puberty

This is an incomplete representation of the topic. I hope that some of you might be able to benefit from my short notes by grasping the key points. Behaviour: Reactions in relation to an environment. conscious/unconscious overt/covert voluntary/involuntary Puberty: Age at which a person if 1st capable of sexual reproduction The transition from childhood to…

PBL: Iatrogenic Cushing’s Syndrome

Keywords: 40 y.o woman Has diabetes & hypertension for 6 months On oral hypoglycemia & antihypertensive medication Height: 165cm Weight: 85kg BMI: overweight/obese Moon shaped facies Truncal obesity Abdominal striae Diminished motor strength of proximal limb muscles Also on prolonged oral corticosteroid treatment for rheumatoid arthritis for 5 years Wanted to stop the cortocosteroid immediately,…

Tumours of thyroid & Data Interpretation

Summary of thyroid tumour: Usually tumours seen are primary epithelial tumours. Adenomas are benign & carcinomas are malignant. Classification By it’s histogenic/differention properties: Exhibiting follicular cell differentiation (95%) Exhibiting C-cell differentition Exhibiting follocular & C-cell differentiation Types of thyroid tumours Epithelial tumours follicular adenoma (most common) papillary adenoma Hurthle cell (oncocytic) tumours hyperfunctioning follicular cell…