Diabetes

Question 1

The endocrine effects of insulin on muscle and adipose tissue include

Answer 1

increased glycogen synthesis


Question 2

Metabolic actions of GLP-1 receptor agonists (incretin mimetics) include

Answer 2

glucose dependent insulin secretion


Question 3

Inhibition of intestinal enzymes that break down carbohydrates, delaying carbohydrate absorption is from the intestine into the vasculature is the mechanism of action of which drug class?



Answer 3

alpha-glucosidase inhibitors (acarbose)


Question 4

Consideration related to prescribing a biguanide (metformin) of which the APN provider should be aware include:



Answer 4

potential for lactic acidosis.

possible modest weight loss


Question 5

You are the provider for a patient with Type 2 diabetes and inflammatory bowel disease. Select the drug least appropriate to prescribe in this patient

Answer 5

alpha glycosidase inhibitor

Question 6

The study of how individual genetic differences affect drug response is termed

Answer 6

pharmacogenomics


Question 7

Which antibiotic class has bacteriocidal activity, post antibiotic effect, concentration dependent killing and excellent gram negative organism coverage?



Answer 7

fluoroquinolones


Question 8

Adverse effects of peripheral neuropathy and seizures, caution for use in patients with preexisting CNS disorders and reaction to alcohol ingestion are all associated with which of the following agents

Answer 8

metronidazole


Question 9

The serious hypersensitivity reaction of Steven Johnson Syndrome is most associated with which antimicrobial agent?



Answer 9

Trimethoprim-Sulfamethoxazole


Question 10

Genetic alterations; modifications of target sites; and enzymatic inactivation; are all examples of:



Answer 10

mechanisms of resistance


Question 11

Where does non-insulin dependent glucose uptake take place at?

Answer 11

Brain and splenic bed

Question 12

Where does insulin dependent glucose take place at?

Answer 12

muscle

Question 13

β-cell destruction and absolute insulin deficiency represents which type of diabetes?

Answer 13

DM1

Question 14

Insulin resistance and progressive relative insulin deficiency represents which type of diabetes?

Answer 14

DM2

Question 15

Diabetes is a metabolic disorder characterized by?

Answer 15

1. Resistance to insulin
2. Insufficient insulin release
3. Both insulin resistance and insulin insufficiency

Question 16

Type 1 DM is described as?

Answer 16

–Absolute insulin deficiency

– Autoimmune destruction of the β cells

Question 17

Type 2 DM is described as?

Answer 17

Deficit in insulin secretion
• β-cells lose function
Insulin resistance

Question 18

What is the primary site for insulin resistance

Answer 18

muscle

Question 19

What are the acute complications of DM2?

Answer 19

Hypoglycemia
DKA
HHS

Question 20

What are the chronic complications of DM2?

Answer 20

Cardiovascular disease

retinopathy

Question 21

The 3 clinical P’s of DM2?

Answer 21

Polydipsia
Polyphagia
Polyuria

Question 22

DKA at diagnosis and the honeymoon phase are related to what form of DM?

Answer 22

DM1

Question 23

what are the pre diabetes criteria

Answer 23

impaired fasting glucose 100-125
impaired glucose tolerance 140-199
HgbA1C 5.7-6.4

Question 24

A1c levels for glycemic control should be?

Answer 24

under 7

Question 25

Binds to receptors on the pancreatic β-cells leading to membrane depolarization with subsequent stimulation of insulin secretion is the mechanism of action of what drug class?

Answer 25

sulfonylureas

Question 26

The first generation of sulfonyureas are?

Answer 26

chlorpropmide | tolbutmide

Question 27

the second generation of sulfonyureas are?

Answer 27

glyburide glipizide glimepiride

Question 28

Reducing hepatic gluconeogenesis and increase in insulin sensitivity of peripheral tissue is the mechanism of action for what drug class?

Answer 28

Biguanides

Question 29

the main biguanide is what?

Answer 29

metformen

Question 30

The two meglitinides are?

Answer 30

Starlix | Prandin

Question 31

Meglitinides depend on what for their mechanism of actions?

Answer 31

glucose for activity

Question 32

The increase in the expression of genes responsible for glucose metabolism and increase in insulin sensitivity represents the mechanism of action for what drug?

Answer 32

Thiazolidinediones

Question 33

The two thiazolidinediones are?

Answer 33

Actos | Avandia

Question 34

The major side effects of thiazolidinediones are?

Answer 34

***HF*** | Bone fracture

Question 35

Slowing the absorption of glucose from the intestines into the vasculature is the mechanism of action for what drug?

Answer 35

Alpha glucosidase inhibitors

Question 36

The two alpha glucosidase inhibitors are?

Answer 36

acarbose | miglitol

Question 37

Patients with inflammatory bowel disease should not be given what drug class?

Answer 37

alpha glucosidase inhibitors

Question 38

If an alpha glucosidase inhibitor is combined with secretagogue hyperglycemia occurs. How do you treat it?

Answer 38

with glucose

Question 39

what mechanism of action is used primary for cholesterol?

Answer 39

bile acid sequestrates

Question 40

Bile acid sequestrates should not be used with patients suffering from?

Answer 40

URI or UTIs | bowel obstruction

Question 41

The one bile acid drug is?

Answer 41

colesevelam

Question 42

Incretin Analogs include?

Answer 42

GLP-1 analogs | Amylin analogs

Question 43

Glucose dependent insulin, reduction in glucagon, reduced gastric emptying, promotion of satiety occur when this mechanism of action occurs

Answer 43

GLP-1 analogs

Question 44

The two GLP-1 analogs are?

Answer 44

Exenatide (Byetta) | Liraglutide (Victoza)

Question 45

GLP-1 analogs are contraindicated in patients suffering with?

Answer 45

impaired renal function | medullary thyroid carcinoma

Question 46

The amylin analog is?

Answer 46

Pramalintide

Question 47

The black box warning for pramalintide is

Answer 47

hypoglycemia in patients with DM1

Question 48

Rapid acting insulin includes

Answer 48

Humalog (lispro) Novalog (aspart) Apidra (glulisine)

Question 49

Long acting insulin includes

Answer 49

Lantus (gargine) | Levemir