bio 19 Flashcards
Your diabetic patient has recently been placed on pramlintide (Symlin) to help control his diabetes. Which of the following best describes the mechanism of action of this medication? (A) It decreases glucose-6-phospate (B) It increases hexokinase (C) It stimulates glycogen phosphorylase (D) It inhibits glucagon secretion (E) It inhibits insulin secretion
(D) It inhibits glucagon secretion
Your 20-year-old male patient has had multiple episodes of lightheadedness, sweating, fatigue, tremor, and
intense hunger. He had one seizure. During two of these
episodes, his blood glucose was 40 mg/dL. This patient
was desperately trying to get a discharge from the military, and you suspected he was inducing his symptoms
by doing which of the following?
(A) Self injection of glucagon
(B) Self injection of insulin
(C) “Carb loading” before exercise
(D) Taking metformin before exercise
(E) Taking an amylin blocker
(B) Self injection of insulin
A patient had new glasses prescribed by his optometrist.
Less than a week later, his prescription was inadequate
and he could not see well with his new glasses. His
optometrist checked his vision twice more over the next
week and the patient’s prescription was different both
times. His optometrist refers the patient to an ophthalmologist. What is the reason the patient is having such
rapid changes in his glasses prescription?
(A) Elevated levels of galactose in the lens
(B) Elevated levels of glucose in the lens
(C) Elevated levels of sorbitol in the lens
(D) Cataract formation
(E) Increased intraocular pressure from hyperglycemia
(C) Elevated levels of sorbitol in the lens
A type 2 diabetic has been taking metformin to help regulate blood glucose levels. What effect will metformin
also exert within the muscle?
(A) Reduce glucose uptake from the circulation
(B) Enhance fatty acid oxidation
(C) Reduce fatty acid oxidation
(D) Stimulate glucose release
(E) Enhance gluconeogenesis
(B) Enhance fatty acid oxidation
5 Your patient with type 2 diabetes mellitus is usually in
good control with an HbA1C of 7.1 and fasting blood
glucose values between 90 and 100 mg/dL. His problem is with his 1-h postprandial glucose levels at lunch
and dinner. A recall of his usual diet reveals some type
of meat, potato, broccoli, milk, and diet drink at these
meals. Which of these foods is most likely responsible
for his postprandial high blood glucose?
(A) Meat
(B) Potato
(C) Broccoli
(D) Milk
(E) Diet drink
(B) Potato
You see a 56-year-old female patient in follow-up after
discharge from the hospital. She was treated for ketoacidosis and hyperglycemia and now is on basal and rapid
acting insulins. You wonder if she really has type 1 diabetes mellitus and was in ketoacidosis or has type 2 diabetes mellitus and had a hyperosmolar state with lactic
acidosis. Which of the following lab tests would help
you determine whether this patient has type 1 or type 2
diabetes mellitus?
(A) Insulin levels
(B) C-peptide levels
(C) Fasting blood glucose levels
(D) Random blood glucose levels
(E) Hemoglobin A1C levels
(B) C-peptide levels
Your patient, with a BMI of 36 and a waist circumference
of 44 in., has a fasting blood glucose level of 145 mg/dL.
One reason for the elevated blood glucose is which of
the following?
(A) Enhanced release of glucose from the intestinal epithelial cells
(B) Stimulation of GLUT4 transporters in muscle
(C) Activation of pyruvate carboxylase
(D) Inhibition of liver GLUT4 transporters
(E) Activation of protein kinase B
(C) Activation of pyruvate carboxylase
Considering the patient in the previous question, the
primary energy source being used by the muscle is
which of the following (in the untreated state)?
(A) Glucose
(B) Amino acids
(C) Lactate
(D) Glycerol
(E) Fatty acids
(E) Fatty acids
Considering the patient described in the last two questions, it is likely that your patient is now leptin resistant.
This has occurred due to which of the following?
(A) Activation of SMAD4
(B) Downregulation of the leptin receptor
(C) Activation of the insulin receptor
(D) Activation of SOCS3
(E) Downregulation of anorexigenic factors
(D) Activation of SOCS3
Sequelae of insulin resistance in type 2 diabetes mellitus and metabolic syndrome is reduced secretion
of insulin in response to increases in blood glucose.
Insulin release from the pancreas appears to be dependent upon increase in concentration of which pair of
metabolites?
(A) ATP and CO2
(B) ATP and NADH
(C) ATP and NADPH
(D) Glucose-6-phosphate and CO2
(E) Glucose-6-phosphate and NADH
(C) ATP and NADPH
An increase in serum free fatty acid levels, as evident in
individuals exhibiting metabolic syndrome, occurs due
to which of the following?
(A) Increased activity of lipoprotein lipase
(B) Increased activity of pancreatic lipase
(C) Substrate-induced activation of hormone-sensitive
lipase
(D) Increased transcription of colipase
(E) Activation of microsomal triglyceride transfer protein
(C) Substrate-induced activation of hormone-sensitive
lipase
Your patient with metabolic syndrome is in for a
checkup. His HbA1C is 9.0 and his fasting triglycerides
are 325 mg/dL. You prescribe pioglitazone (Actos) to
better treat his diabetes, but nothing else specifi c for the
high lipids. A month later, the fasting triglyceride levels
have dropped to 155 mg/dL due to a direct activation of
which of the following?
(A) AMP-activated protein kinase
(B) PPAR-γ
(C) Leptin
(D) Adiponectin
(E) LKB1
(B) PPAR-γ
Your type 2 diabetic patient has been taking metformin
for the past 6 months and has reduced fasting blood
glucose levels from 185 to 112 mg/dL. This occurs due
to which of the following effects of metformin?
(A) Activation of adenylate cyclase
(B) Inhibition of the electron transfer chain
(C) Activation of LKB1
(D) Stimulation of amidophosphoribosyl transferase
(E) Stimulation of adenylate kinase
(B) Inhibition of the electron transfer chain
The major, defi ning difference between a type 1 diabetic
and a type 2 diabetic is which of the following?
(A) Weight
(B) Ability to produce insulin
(C) LDL levels
(D) Blood glucose levels
(E) Serum triglyceride levels
(B) Ability to produce insulin
Your type 1 diabetic patient was managing their disease
using a combination of Humulin R and Humalog. The
Humalog is more rapid acting than the Humulin R due
to which of the following?
(A) Humalog is taken orally, rather than subcutaneously
(B) Humulin R is complexed with zinc, which slows its
absorption
(C) Humalog is complexed with manganese, which
accelerates its absorption
(D) Humulin R is taken orally, which slows its absorption
(E) Humalog is taken through an insulin pump
mechanism
(B) Humulin R is complexed with zinc, which slows its
absorption
