11 Thera VI Midterm Study Questions

Question 1

What drugs should you avoid/use caution when you don’t want weight gain?

Answer 1

SFUs, Meglitinides, TZDs

Question 2

What drugs should you avoid/use caution when you don’t want GI symptoms?

Answer 2

Metformin, a-glucosidase inhibitor

Question 3

What drugs should you avoid/use caution when you don’t want Hypoglycemia?

Answer 3

SFUs, Meglitinides

Question 4

What drugs should you avoid/use caution when you have impaired renal function?

Answer 4

Metformin (look at SCr levels). SFUs (depends what the CrCl is). DPP-4 inhibitor (Linagliptin ok)

Question 5

What drugs should you avoid/use caution when you have impaired hepatic function?

Answer 5

Metformin, TZDs, a-glucosidase inhibitor

Question 6

What drugs should you avoid/use caution when you have impaired CV/pulmonary function?

Answer 6

Metformin, TZDs

Question 7

What is the normal C-peptide level?

Answer 7

2

Question 8

What is the most identifiable risk factor for microvascular complications?

Answer 8

Hyperglycemia

Question 9

What is more important to control in T2DM as A1c improves?

Answer 9

PPG

Question 10

When giving long-acting and rapid-acting insulin to a patient, which one usually makes up the majority of the insulin taken in that day?

Answer 10

Long-acting (50-60%). Rapid-acting (40-50%)

Question 11

What is the Empiric Dosing of insulin in T1DM?

Answer 11

0.5-0.8 units/kg/day

Question 12

At what dose should insulin be started for T2DM?

Answer 12

0.1-0.2 units/kg/day

Question 13

What is more common in T1DM: DKA or HSS?

Answer 13

DKA (presents with ketoacidosis, hyperglycemia, and hyperosmolarity)

Question 14

What is more common in T2DM: DKA or HSS?

Answer 14

HSS (presents with hyperglycemia and hyperosmolarity)

Question 15

What are the steps in muscle/FA storage breakdown?

Answer 15

Breakdown goes through 1) plasma glucose, 2) plasma FFA, 3) muscle TG, and finally 4) muscle glycogen

Question 16

For women with Diabetes while pregnant (NOT GDM), what are their pre-meal/bedtime/overnight glucose goals?

Answer 16

60-99

Question 17

For women with Diabetes while pregnant (NOT GDM), what are their peak PPG goals?

Answer 17

100-129

Question 18

For women with Diabetes while pregnant (NOT GDM), what is their A1c goal?

Answer 18

< 6.1%

Question 19

For women with GDM, what is their pre-prandial goal?

Answer 19

< 95

Question 20

For woman with GDM, what is their 1h- and 2-hour post-meal goal?

Answer 20

1h: < 140. 2h: < 120

Question 21

Which disorder do you usually find Thyroid Receptor Antibodies (TRAb)?

Answer 21

Graves ONLY (not in Hashimoto’s)

Question 22

Which SFU requires hepatic metabolism to active metabolite?

Answer 22

Glyburide

Question 23

Which diabetic medication is contraindicated with the use of Gemfibrozil?

Answer 23

Repaglinide (Meglitinide)

Question 24

A patient has HF (NYHA Functional Class III/IV), which diabetes medications are contraindicated?

Answer 24

Thiazolidinediones (Pioglitazone, Rosiglitazone)

Question 25

Which diabetes medications have a rare side-effect of causing hepatic failure?

Answer 25

Thiazolidinediones. a-Glucosidase Inhibitors (acarbose, miglitol)

Question 26

Which DPP-4 Inhibitor does not require any renal or hepatic adjustment?

Answer 26

Linagliptin (Tradjenta)

Question 27

Which Incretin Mimetic does not require any renal adjustment?

Answer 27

Liraglutide (Victoza)

Question 28

What is the DOC for thyroid storm?

Answer 28

Propylthiouracil

Question 29

What is the BBW associated with Propylthiouracil?

Answer 29

Hepatotoxicity

Question 30

Which thioamide is ok to use in breastfeeding?

Answer 30

Propylthiouracil is safe in pregnancy and lactation. Methimazole is secreted in breast milk

Question 31

When using BBs for hyperthyroidism, which agents should be avoided?

Answer 31

Intrinsic Sympathomimetic Activity (Acebutolol, Pinolol)

Question 32

What are the BBs used as adjunctive therapy for Hyperthyroidism?

Answer 32

Propranolol, Esmolol, Nadolol. PEN

Question 33

Which BB has the longest experience and the preferred BB for nursing mothers?

Answer 33

Propranolol

Question 34

How do BBs work in hyperthyroidism?

Answer 34

Blocks T4 --> T3 conversion

Question 35

When do you use SSKI (Iodine) for Thyroid Storm?

Answer 35

Do not start until 1 hour after antithyroid drugs

Question 36

What agents are indicated for controlling PPG?

Answer 36

SFUs. Meglitinides. a-Glucosidase Inhibitors. DPP-4 Inhibitors (by MOA of promoting early satiety, increasing insulin secretion, and slowing gastric emptying). Short and Rapid-Acting Insulin

Question 37

What agents are indicated for controlling FPG?

Answer 37

Biguanides. TZDs. DPP-4 Inhibitors (by MOA of suppressing secretion of glucagon)

Question 38

What is the criteria for diagnosing DM?

Answer 38

1) A1c > 6.5%. 2) FPG > 126. 3) A 2h plasma glucose > 200 during 75g OGTT. 4) Symptoms of DM + random blood glucose > 200

Question 39

What are the goal levels for the 75g OGTT?

Answer 39

Fasting: 92. 1h: 180. 2h: 153. 3h: 140

Question 40

Whats an easy way to determine A1c with someones average blood glucose level?

Answer 40

140 = 6.5%. Every 1% increase or decrease is about 30 extra glucose

Question 41

Which diabetes medication is preferred in advanced liver disease?

Answer 41

Insulin

Question 42

Which diabetes medications are not eliminated by kidneys, no restriction on use?

Answer 42

Pioglitazone. Linagliptin

Question 43

What are the GDM glucose goals?

Answer 43

Fasting < 95. 1h < 140. 2h < 120

Question 44

What is the typical starting dose (after 28 weeks) of insulin for GDM?

Answer 44

NPH insulin 20 units every morning and 10 units of regular insulin