what regular activity is the most important and recommended in the patient with diabetes mellitus☆daily foot inspection
→clinicians are advised to complete comprehensive foot examinations annually on all diabetic patients, who should in turn be instructed on prophylactic foot care for trauma or infection (eg. wash and closely examined daily, change fitting socks daily, trim nails to the shape of the toe) endocrinologyUWorld SIM1 May 25, 2020, 7:00 AM HirotoShishido
patiromer
mechanism, clinical use, adverse effecta nonabsorbable cation exchange resin that binds colonic potassium in exchange for calcium, trapping potassium within the resin where it is then excreted in the feces.
often used for treatment of ★chronic hyperkalemia. (however, onset of action takes several hours, so it is not recommended as monotherapy in acute hyperkalemia)
GI disturbance, hypercalcemia, hypokalemia, hypomagnesemia
hypothyroidism and T3synthetic T3 (liothyronine) is not recommended for the routine treatment of hypothyroidism, as it has a short half-life and patients can experience wide fluctuations in plasma T3 levels
somatostatinoma
symptomstumor of pancreatic D cells
☆biliary gallstones(due to ↓cholecystokinin), steatorrhea
(may present with diabetes mellitus) endocrinology Dec 28, 2019, 9:11 PM HirotoShishido
synthetic analog of aldosteronefludrocortisone
(with a little glucocorticoid effects)
mineralocorticoid replacement in 1° adrenal deficiency endocrinology Dec 28, 2019, 7:23 PM HirotoShishido
neprilysin
mechanism, hypothermia☆metalloprotease that inactivates several peptide hormones including ☆ANP, BNP, glucagon, substance P etc.
hypothermia→
central blood volume increases→ baroreceptors (will register this relative increase as volume overload and) increase the rate of firing→
downregulate ADH ,neprilysin→
↓ADH, ↓neprilysin, ↑ANP, ↑BNP→
increase urinary frequency cardiovascularendocrinology Dec 31, 2019, 12:46 AM HirotoShishido
neurophysin Ⅰ, ⅡⅠ→ the carrier protein required for oxytocin
(knockout mouse→☆absent let-down reflex(催乳反射))
glucagon
signal pathwayG-protein-coupled receptor (GPCR) that activates adenylyl cyclase to produce an increase in intracellular ☆cAMP endocrinology Dec 9, 2019, 12:07 AM HirotoShishido
how to distinguish between endogenous and exogenous causes of hyperinsulinemiaa low C-peptide level in the setting up hyperinsulinemia indicates exogenous insulin administration
