Diabetes

Question 1

risk factors for DM

Answer 1

physical inactivity
BMI >/= 25
race/ethnicity
PMH gestational
a1c >/=5.7
first degree relative
HDL <35, TG >250
BP >140/90
CVD or smoking hx

Question 2

s/sx diabetes

Answer 2

3 P’s
polyuria
polydipsia
polyphagia

Question 3

what a1c, FBG and PPG are considered pre-DM

Answer 3

a1c 5.7-6.5
FBG 100-125
PPG 140-199

Question 4

what a1c, FBG and PPG are considered DM

Answer 4

a1c >/= 6.5
FBG >/= 126
PPG >/= 200

Question 5

an a1c of 6% = average BG of ______
and an increase of 1% = an increase in average BG of_______________-

Answer 5

126mg/dL

1% : 28mg/dL

Question 6

lifestyle modifications for DM

Answer 6

weight loss 5% +
carb counting
exercise 150+ min a week
smoking cessation
comprehensive care

Question 7

microvascular complications

Answer 7

nephropathy
retinopathy
neuropathy

Question 8

macrovascular complications

Answer 8

ASCVD, MI, CVD
CVA
PAD

Question 9

ASA recommendation for DM

Answer 9

secondary prevention only, 81mg po qd

Question 10

how often should patients get an eye exam in DM

Answer 10

q1-2 years

1 year is if they have retinopathy

Question 11

what vaccines are recommended in DM

Answer 11

HBV
influenza
pneumococcal

Question 12

how often should DM patients get foot exams

Answer 12

annually

Question 13

HLD management in DM

which statin? what is the LDL goal?

Answer 13

> 40 yo w ASCVD – > high intensity

no ASCVD or <40 w ASCVD –> mod intensity

goal <55 w ASCVD
goal <70 without ASCVD

Question 14

how often should eGFR and UAlb be monitored in DM

Answer 14

yearly

Question 15

what medications are recommended for hyperalbuminuria in DM

Answer 15

ACEi, ARB, SGLT2i, finerenone

Question 16

BP goal in DM

Answer 16

<130/80

Question 17

BP management in DM

Answer 17

no albuminuria or CAD: thiazide, ACE, ARB, CCB

albuminuria or CAD: ACEi or ARB

Question 18

first line for ASCVD or high risk patient (>55 w 2 RFs)

Answer 18

GLP1RA
SGLT2i

Question 19

first line for HF concern

Answer 19

SGLT2i

Question 20

first line for CKD concern
= eGFR ____
= Ualb____

Answer 20

eGFR </= 60
UAlb >30

SGLT2i if eGFR >20 then GLP1RA

Question 21

rybelsus dosing

Answer 21

3mg po qd 30 min before breakfast x30d then increase to 7mg po qd, MDD 14mg

Question 22

GLP1RAs with cardiorenal benefits

Answer 22

semaglutide SC, liraglutide, dulaglutide

Question 23

SGLT2i with cardiorenal benefits

Answer 23

dapa empa canag

Question 24

TZD example

Answer 24

pioglitazone

Question 25

DPP4-i
drugs in class

Answer 25

-gliptins

Question 26

GLP1RA are not to be used with ______ due to overlapping MOA

Answer 26

DPP4-i

Question 27

metformin is titrated every ________

Answer 27

week

Question 28

metformin should not be started when __________, but is safe to continue until ______

Answer 28

should not be started with eGFR 40-45 but is ok to continue until eGFR of 30

Question 29

BBW for metformin

Answer 29

lactic acidosis

Question 30

lactic acidosis due to metformin is at an increased risk with

Answer 30

alcohol consumption

Question 31

glyburide
brand
dosing
MDD

Answer 31

Glynase
2.5-5mg QD, MDD 30mg

Question 32

glipizide
brand
dosing
MDD

Answer 32

Glucotrol
5mg QD (MDD 40 for IR, 20 for ER)

Question 33

doses >_____ must be divided BID with glipizide

Answer 33

15mg

Question 34

glimepiride
brand
dosing
MDD

Answer 34

Amaryl
1-2mg QD
MDD 8mg

Question 35

glipizide should be administered

A. with breakfast
B. 30 min before a meal
C. after lunch
D. anytime of day with a glass of water

Answer 35

B. 30 min before a meal

preferably breakfast

Question 36

sitagliptin
brand
MOA
dosing

Answer 36

Januvia
DPP4-i
100mg PO QD
eGFR <30 –> 25mg PO QD
eGFR 30-45 –> 50mg PO QD

Question 37

linagliptin
brand
MOA
dosing

Answer 37

Tradjenta
DPP4-i
5mg PO QD

Question 38

which DPP4-is have a warning for HF

Answer 38

saxogliptin and alogliptin

Question 39

pioglitazone
dosing

Answer 39

15-30mg PO QD, MDD 45mg

Question 40

rapid acting insulins

Answer 40

Novolog (aspart)
Admelog (lispro)

Question 41

short-acting insulins

Answer 41

regular!!
Humulin-R
Novolin-R

Question 42

intermediate acting insulins

Answer 42

NPH
(Humulin-N)
(Novolin-N)

Question 43

glargine brand names

Answer 43

Semglee
Lantus
Toujeo
Basaglar

Question 44

detemir

Answer 44

Levemir

Question 45

degludec brand

Answer 45

Tresiba

Question 46

basal insulin dose for patients with T2DM

Answer 46

0.1-0.2 units/kg/day

Question 47

how do we add on a bolus insulin dose in a T2DM

Answer 47

10% of TDD

Question 48

how do we initiate insulin in a T1DM

Answer 48

0.5U/kg/day
take 50% as bolus and 50% as basal

Question 49

how do we calculate ICR for type 1 diabetics

Answer 49

for regular insulin 450/TDD
for rapid insulin 500/TDD

Question 50

what does an ICR represent

Answer 50

1 unit of insulin will cover X carbs

Question 51

correction factor calculations

Answer 51

regular insulin 1500/TDD
rapid acting insulin 1800/TDD

Question 52

humalog expiration date

Answer 52

10 days

Question 53

novolog exp date

Answer 53

14 days

Question 54

glargine exp date

Answer 54

28d

Question 55

regular insulin exp date

Answer 55

28d

Question 56

levemir exp date

Answer 56

42d

Question 57

tresiba exp date

Answer 57

56d

Question 58

toujeo exp date

Answer 58

56d

Question 59

what drugs dec BG

Answer 59

FQ
BB
tramadol
linezolid

Question 60

what meds inc BG

Answer 60

steroids
FQ
APs
BB
thiazides
loops
tacro
CYA
protease-i

Question 61

inpatient BG goals

Answer 61

140-180mg/dL

Question 62

DKA vs HHS

Answer 62

DKA: BG >250, ketones, HAGMA, pH <7.35
HHS: BG >600, pH>7.3, osmolality >320

Question 63

DKA/HHS treatment

Answer 63

fluids (NS then D5W1/2NS once BG <200)

regular insulin 0.1U/kg bolus then 0.1U/kg/hr OR 0.14 U/kg/hr

bicarb if acidotic

K if needed