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Keystone: Exam 1 > Diabetes/Hyperlipidemia > Flashcards

Diabetes/Hyperlipidemia Flashcards

1
Q

Glutamic Acid Decarboxylase Antibody is used to confirm diagnosis of ____

A

Type 1 Diabetes

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2
Q

Diabetic Ketoacidosis (DKA) seen in ____

A

Type 1 Diabetes

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3
Q

What laboratory findings must be present to diagnosis Diabetic Ketoacidosis?

A

Ketones

Anion gap

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4
Q 
Which of the following is NOT a symptom of Type 1 DM?
A. Weight gain
B. Dehydration
C. Fatigue
D. Nausea
E. Muscle cramps
A

A. Weight loss

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5
Q 
Which of the following is a sign of Type 1 DM?
A. Bradycardia 
B. Hypertension 
C. Hypothermia 
D. Edema
A

C

A. Tachycardia
B. Hypotension
D. Dehydration

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6
Q

2 main sources of sugar

A

Hepatic gluconeogenesis: basal

Food: bolus

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7
Q 
Which of the following is NOT a long acting insulin?
A. Glargine
B. Glulisine
C. Determir
D. NPH
A

B. Glulisine is short acting

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8
Q

How many times a day?

Glargine

A

1 x/ day

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9
Q

How many times a day?

Determir

A

BID

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10
Q

How many times a day?

NPH

A

BID

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11
Q

Regular/NPH administration instruction

A

Take both BID w/ breakfast + supper

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12
Q 
Which of the following is NOT a short acting insulin?
A. Regular
B. Aspart
C. Glargine
D. Lispro
E. Glulisine
A

C. long acting

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13
Q

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

A

Type 2 Diabetes

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14
Q

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

A

True

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15
Q

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

A

False. Metformin for EVERYONE!

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16
Q

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

A

False. Non-insulin agent

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17
Q

If HbA1c >10%, treat w/ ____

A

insulin w/ metformin

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18
Q

If HbA1c

A

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

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19
Q

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

A

Metformin

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20
Q

Metformin is contraindicated for pts w/ (2)

A

heart failure

renal failure

21
Q

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

A

False. It does NOT do either of these features.

22
Q 
Name the class of drug:
Acarbose
A

Alpha glucosidase inhibitors

23
Q 
Name the class of drug:
Inhibit upper GI enzymes that convert complex polysaccharide carbohydrate in monosaccharides → slow absorption of glucose
A

Alpha glucosidase inhibitors (Acarbose)

24
Q

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

A

True. Therefore, no hypoglycemia

25
Q 
Name the class of drug:
Pioglitazone
A

PPAR gamma agonists: thiazolidinediones

26
Q

PPAR gamma agonists is contraindicated for pts w/ ___

A

CHF

27
Q

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

A

PPAR gamma agonist: Pioglitazone

Expressed in adipose tissue → regulates genes involved in adipocyte differentiation, fatty acid uptake/storage, and glucose uptake

28
Q 
Name the class of drug:
Glipizide, glimepiride, glyburide
A

Sulfonylureas

29
Q

Sulfonylureas act by:

A
  • 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
30
Q

T/F: Sulfonylureas induces glucose independent insulin secretion.

A

True. Must take with food to avoid hypoglycemia

31
Q 
Name the class of drug:
Exenatide, liraglutide
A

GLP-1 agonists

32
Q 
Which of the following does NOT enhance insulin secretion?
A. Sulfonylureas
B. GLP-1 agonists
C. DDP-IV inhibitors 
D. PPAR gamma agonists
A

D. Enhances effects of insulin

33
Q

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

A

B. Glucose independent

34
Q

GLP-1 agonists are contraindicated for pts w/ ___

A

hx of pancreatitis

35
Q

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

A

True. GLP-1 agonists

36
Q 
Name the class of drug:
Sitagliptin, saxagliptin, linagliptin

Effect/Mechanism:

A

DDP-IV inhibitors

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

37
Q

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

A

False.

38
Q 
Name the class of drug:
Canagliflozin
A

SGLT-2 inhibitors

39
Q

Name the drug:

Promote renal excretion of glucose

A

Canagliflozin: SGLT-2 inhibitors

40
Q

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

A

False.

41
Q

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

A

Type 2 DM

Adult onset Type 1 DM

42
Q

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

A

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

43
Q

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

A

False. Type 1 diabetes

Tighter glycemic control does NOT prevent macrovascular disease in type 2 diabetes

44
Q

PSCK9 mutation causes:

A

Excessive degradation of LDL receptor

45
Q

Triglycerides

A

Statin

46
Q

Triglycerides >500 mg/dL treated with ___

A

Fibrates
niacin
Fish oil

47
Q

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

A

True

48
Q

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%

A

B. Pts w/ LDL > 190 mg/dl

Keystone: Exam 1 (12 decks)

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