L1.ii · Blood Glucose Regulation

This viva will examine endocrine pharmacology and physiology Explain the metabolic effects of insulin on the body.

This viva will examine metabolism and nutrition. Describe the metabolic and hormonal changes that occur during the following: (a) prolonged starvation (b) reintroduction of nutrition in a malnourished patient

This viva will explore your understanding of the control of blood sugar and metabolic responses to insulin. Explain how fluctuations of blood sugar level are minimized between meals.

This viva will explore your knowledge of glucose physiology and related pharmacology. Can you describe the storage of glucose in the body?

This viva is about insulin and glomerular filtration. What are the effects of insulin?

This viva tested knowledge of physiology around glucose utilization and the pharmacology of insulin.

This viva tested knowledge of blood glucose homeostasis and the pharmacology of insulin.

This viva tested knowledge of physiology around metabolic rate and went on to discuss metabolism particularly of carbohydrates and the influence of insulin.

This Viva tested knowledge of blood gas interpretation and insulin physiology.

This Viva tested knowledge on liver physiology and blood flow and then explored understanding of nutrition, including the changes seen with fasting and stress.

This Viva tested knowledge on glucose and lipid metabolism and went on to explore daily nutritional requirements and aspects of insulin physiology.

This Viva will examine your knowledge of the physiology of glucose regulation and hypoglycaemic drugs as well as the physiology of the Thyroid gland Q 1. Describe the physiology of Insulin This viva began with a discussion on the physiology of insulin, physiological consequences of insulin deficiency, oral hypoglycaemic drugs and the thyroid gland. Generally candidates performed well in this viva. The role of insulin beyond metabolism of glucose, fat and protein was not well understood. The differences in the pharmacology between T4 and T3 was another area of weakness.

The initial information given to the candidates was - This viva will mostly cover pharmacology and physiology of insulin. Describe the primary function of insulin. This viva explored the candidates’ knowledge in relation to the following points Structure, mechanism of action and physiology of natural insulin Insulin preparations Pathophysiology of re-feeding syndrome Examination feedback: Candidates knowledge in relation to the physiology of insulin was good and much stronger than their knowledge in relation to the pharmacology of the different insulin preparations. It is important that candidates have a good understanding of the pharmacology of insulin preparations as well as remain up to date with changes in those preparations. Candidates also struggled with describing the basic elements, in particular the changes to electrolytes, associated with the re-feeding syndrome.