Diabetes/Hyperlipidemia

Question 1

Glutamic Acid Decarboxylase Antibody is used to confirm diagnosis of ____

Answer 1

Type 1 Diabetes

Question 2

Diabetic Ketoacidosis (DKA) seen in ____

Answer 2

Type 1 Diabetes

Question 3

What laboratory findings must be present to diagnosis Diabetic Ketoacidosis?

Answer 3

Ketones

Anion gap

Question 4

Which of the following is NOT a symptom of Type 1 DM?
A. Weight gain
B. Dehydration
C. Fatigue
D. Nausea
E. Muscle cramps

Answer 4

A. Weight loss

Question 5

Which of the following is a sign of Type 1 DM?
A. Bradycardia 
B. Hypertension 
C. Hypothermia 
D. Edema

Answer 5

C

A. Tachycardia
B. Hypotension
D. Dehydration

Question 6

2 main sources of sugar

Answer 6

Hepatic gluconeogenesis: basal

Food: bolus

Question 7

Which of the following is NOT a long acting insulin?
A. Glargine
B. Glulisine
C. Determir
D. NPH

Answer 7

B. Glulisine is short acting

Question 8

How many times a day?

Glargine

Answer 8

1 x/ day

Question 9

How many times a day?

Determir

Answer 9

BID

Question 10

How many times a day?

NPH

Answer 10

BID

Question 11

Regular/NPH administration instruction

Answer 11

Take both BID w/ breakfast + supper

Question 12

Which of the following is NOT a short acting insulin?
A. Regular
B. Aspart
C. Glargine
D. Lispro
E. Glulisine

Answer 12

C. long acting

Question 13

Hyperosmolar Hyperglycemic States (HHS) seen in severe cases of _____

Answer 13

Type 2 Diabetes

Question 14

T/F: Only insulin will work at treating Type 1 Diabetes.

Answer 14

True

Question 15

T/F: Metformin should only be given to DM2 patients with HbA1c > 10%.

Answer 15

False. Metformin for EVERYONE!

Question 16

T/F: Every insulin agent drops HbA1c by ~1%.

Answer 16

False. Non-insulin agent

Question 17

If HbA1c >10%, treat w/ ____

Answer 17

insulin w/ metformin

Question 18

If HbA1c

Answer 18

non-insulin therapy. Start w/ metformin. ADD agents as needed.

Question 19

Name the drug:
Inhibits hepatic gluconeogenesis → decreased clearance of lactic acid
Reduces endogenous glucose production

Answer 19

Metformin

Question 20

Metformin is contraindicated for pts w/ (2)

Answer 20

heart failure

renal failure

Question 21

T/F: Metformin increases insulin sensitivity and leads to increase in insulin levels.

Answer 21

False. It does NOT do either of these features.

Question 22

Name the class of drug:
Acarbose

Answer 22

Alpha glucosidase inhibitors

Question 23

Name the class of drug:
Inhibit upper GI enzymes that convert complex polysaccharide carbohydrate in monosaccharides → slow absorption of glucose

Answer 23

Alpha glucosidase inhibitors (Acarbose)

Question 24

T/F: Alpha glucosidase inhibitors does NOT affect insulin secretion

Answer 24

True. Therefore, no hypoglycemia

Question 25

``` Name the class of drug: Pioglitazone ```

Answer 25

PPAR gamma agonists: thiazolidinediones

Question 26

PPAR gamma agonists is contraindicated for pts w/ ___

Answer 26

CHF

Question 27

Name the drug: • Lower blood glucose by enhancing effects of insulin • Enhance fat storage → Lower plasma free fatty acid

Answer 27

PPAR gamma agonist: Pioglitazone Expressed in adipose tissue → regulates genes involved in adipocyte differentiation, fatty acid uptake/storage, and glucose uptake

Question 28

``` Name the class of drug: Glipizide, glimepiride, glyburide ```

Answer 28

Sulfonylureas

Question 29

Sulfonylureas act by:

Answer 29

* Binds to sulfonylurea receptor on beta cell membrane → inhibit ATP sensitive K+ cannels → insulin release * Depolarize cell → calcium influx → insulin release WITHOUT the presence of glucose

Question 30

T/F: Sulfonylureas induces glucose independent insulin secretion.

Answer 30

True. Must take with food to avoid hypoglycemia

Question 31

``` Name the class of drug: Exenatide, liraglutide ```

Answer 31

GLP-1 agonists

Question 32

``` Which of the following does NOT enhance insulin secretion? A. Sulfonylureas B. GLP-1 agonists C. DDP-IV inhibitors D. PPAR gamma agonists ```

Answer 32

D. Enhances effects of insulin

Question 33

Which of the following is NOT glucose dependent in enhancing insulin secretion? A. GLP-1 agonist B. Sulfonylureas C. DDP-IV inhibitors

Answer 33

B. Glucose independent

Question 34

GLP-1 agonists are contraindicated for pts w/ ___

Answer 34

hx of pancreatitis

Question 35

T/F: Exenatide, liraglutide causes weight loss due to nausea from slow down gastric emptying.

Answer 35

True. GLP-1 agonists

Question 36

``` Name the class of drug: Sitagliptin, saxagliptin, linagliptin ``` Effect/Mechanism:

Answer 36

DDP-IV inhibitors • Makes endogenous GLP-1 last longer • Glucose dependent insulin secretion o NO hypoglycemia

Question 37

T/F: DDP-IV inhibitors cause weight loss.

Answer 37

False.

Question 38

``` Name the class of drug: Canagliflozin ```

Answer 38

SGLT-2 inhibitors

Question 39

Name the drug: | Promote renal excretion of glucose

Answer 39

Canagliflozin: SGLT-2 inhibitors

Question 40

T/F: Canaglifozin (SGLT-2 inhibitor) may cause hypoglycemia.

Answer 40

False.

Question 41

Screening for microvascular complications should be performed at the time of diagnosis in ____

Answer 41

Type 2 DM | Adult onset Type 1 DM

Question 42

T/F: Screening at the time of diagnosis of DM should be performed to prevent macrovascular complications

Answer 42

False. Screen test for macrovascular complications is NOT recommended: screening is asymptomatic pt does NOT improve outcome

Question 43

T/F: Tighter glycemic control decreases macrovascular disease in type 2 diabetes.

Answer 43

False. Type 1 diabetes Tighter glycemic control does NOT prevent macrovascular disease in type 2 diabetes

Question 44

PSCK9 mutation causes:

Answer 44

Excessive degradation of LDL receptor

Question 45

Triglycerides

Answer 45

Statin

Question 46

Triglycerides >500 mg/dL treated with ___

Answer 46

Fibrates niacin Fish oil

Question 47

T/F: There are no medications to increase HDL cholesterol

Answer 47

True

Question 48

Which of the following is NOT a patient that belongs to statin benefit group? A. Pts w/ atherosclerotic CVD B. Pts w/ LDL > 200 mg/dl C. Pts 40-75 y/o w/ LDL 70-189 and DM D. Pts 40-75 y/o w/ LDL 70-189, no DM, no CVD BUT 10 year of atherosclerotic CVD > 7.5%

Answer 48

B. Pts w/ LDL > 190 mg/dl