Diabetes + Insulins Flashcards
Which cells in the pancreas produce insulin?
a. Alpha cells
b. Beta cells
c. Delta cells
d. Gamma cells
The correct answer is: b. Beta cells.
Which hormone is produced by alpha cells in the pancreas?
a. Insulin
b. Glucagon
c. Somatostatin
d. Epinephrine
The correct answer is: b. Glucagon.
Somatostatin is produced by which type of pancreatic cells?
a. Alpha cells
b. Beta cells
c. Delta cells
d. Gamma cells
The correct answer is: c. Delta cells.
What severe condition is caused by a lack of insulin?
a. Hypoglycemia
b. Hyperglycemia
c. Hyperinsulinemia
d. Hypoinsulinemia
The correct answer is: b. Hyperglycemia.
Untreated severe hyperglycemia can lead to all of the following complications EXCEPT:
a. Retinopathy
b. Nephropathy
c. Neuropathy
d. Hypotension
The correct answer is: d. Hypotension.
Which of the following is a cardiovascular complication caused by untreated hyperglycemia?
a. Hypertension
b. Bradycardia
c. Retinopathy
d. Hypoglycemia
The correct answer is: a. Hypertension.
Lack of insulin and untreated hyperglycemia can cause which of the following ocular complications?
a. Cataracts
b. Retinopathy
c. Glaucoma
d. Myopia
The correct answer is: b. Retinopathy.
Which complication associated with hyperglycemia affects the kidneys?
a. Nephropathy
b. Hepatopathy
c. Neuropathy
d. Retinopathy
The correct answer is: a. Nephropathy.
Hyperglycemia can lead to nerve damage known as:
a. Retinopathy
b. Nephropathy
c. Neuropathy
d. Myopathy
The correct answer is: c. Neuropathy.
How many people worldwide are affected by diabetes?
a. 120 million
b. 150 million
c. 180 million
d. 200 million
The correct answer is: c. 180 million.
True or False: Diabetes is a single disease characterized by high blood glucose levels.
a. True
b. False
The correct answer is: b. False.
What characterizes diabetes as a group of syndromes?
a. High insulin production
b. High blood pressure
c. Elevation in glucose blood level and insufficient insulin secretion
d. High cholesterol levels
The correct answer is: c. Elevation in glucose blood level and insufficient insulin secretion.
Type 1 diabetes is classified as:
a. Non-insulin dependent
b. Insulin dependent
c. Medication-induced
d. Genetic-induced
The correct answer is: b. Insulin dependent.
Which type of diabetes is non-insulin dependent?
a. Type 1 diabetes
b. Type 2 diabetes
c. Gestational diabetes
d. Genetic-induced diabetes
The correct answer is: b. Type 2 diabetes.
Gestational diabetes occurs:
a. In children
b. In elderly patients
c. During pregnancy
d. Due to genetic factors
The correct answer is: c. During pregnancy.
What is a potential consequence of gestational diabetes?
a. Affects liver function
b. Affects fetal development
c. Causes high blood pressure
d. Causes kidney failure
The correct answer is: b. Affects fetal development.
Diabetes can be induced by factors other than type 1 or type 2 conditions. These factors include:
a. Genetic factors or medication
b. Lack of physical activity
c. Overeating
d. High cholesterol levels
The correct answer is: a. Genetic factors or medication.
Type 1 diabetes most commonly affects individuals in which stage of life?
a. Infancy
b. Puberty or early adulthood
c. Middle age
d. Elderly
The correct answer is: b. Puberty or early adulthood.
What is the cause of absolute insulin deficiency in Type 1 diabetes?
a. Insulin resistance
b. Massive β-cell necrosis
c. Overproduction of insulin
d. High glucose intake
The correct answer is: b. Massive β-cell necrosis.
Type 1 diabetes is associated with an autoimmune process directed against which cells?
a. Alpha cells
b. Delta cells
c. Beta cells
d. Gamma cells
The correct answer is: c. Beta cells.
The autoimmune process in Type 1 diabetes may be triggered by which factors?
a. Physical injury
b. Virus invasion or chemical toxins
c. High-fat diet
d. Excessive exercise
The correct answer is: b. Virus invasion or chemical toxins.
Which of the following is a common symptom of Type 1 diabetes?
a. Hyperactivity, Inattention, and depression.
b. Polydipsia, polyuria, and weight loss
c. Weight gain, hypoglycemia, and hyperuricemia.
d. Muscle cramps, muscle rigidity, and tremors.
The correct answer is: b. Polydipsia, polyuria, and weight loss.
A life-threatening complication of Type 1 diabetes is:
a. Hypertension
b. Ketoacidosis
c. Hypoglycemia
d. Hyperthyroidism
The correct answer is: b. Ketoacidosis.
To control hyperglycemia and ketoacidosis, Type 1 diabetes requires:
a. Oral hypoglycemic agents
b. Diet and exercise only
c. Exogenous insulin
d. Herbal supplements
The correct answer is: c. Exogenous insulin.
Maintaining the accepted level of glycosylated hemoglobin (HbA1c) is important to avoid:
a. Short-term fatigue
b. Long-term complications
c. Immediate hypoglycemia
d. Sudden weight gain
The correct answer is: b. Long-term complications.
Type 1 diabetes patients can neither maintain normal insulin secretion levels nor respond to variations in:
a. Blood pressure
b. Circulating glucose and amino acid
c. Body temperature
d. Heart rate
The correct answer is: b. Circulating glucose and amino acid.
What type of diabetes is most common?
a. Type 1
b. Type 2
c. Gestational diabetes
d. Secondary diabetes
The correct answer is: b. Type 2.
Type 2 diabetes is influenced by which of the following factors?
a. Genetic factors
b. Aging
c. Obesity and peripheral insulin resistance
d. All of the above
The correct answer is: d. All of the above.
Metabolic alterations in Type 2 diabetes are generally:
a. Severe
b. Milder than Type 1 diabetes
c. Non-existent
d. Worse than Type 1 diabetes
The correct answer is: b. Milder than Type 1 diabetes.
Which of the following is NOT a characteristic of Type 2 diabetes?
a. Ketoacidosis
b. Milder metabolic alterations than Type 1 diabetes
c. Retention of some β-cell function
d. Variable insulin secretion insufficient to maintain glucose homeostasis
The correct answer is: a. Ketoacidosis.
In Type 2 diabetes, the pancreas retains:
a. No β-cell function
b. Some β-cell function
c. Excessive β-cell function
d. Irregular α-cell function
The correct answer is: b. Some β-cell function.
What happens to the β-cell mass in Type 2 diabetes over time?
a. It increases
b. It remains the same
c. It becomes gradually reduced
d. It fluctuates without a clear pattern
The correct answer is: c. It becomes gradually reduced.
The major cause of Type 2 diabetes is:
a. Overproduction of insulin
b. Lack of sensitivity of target organs to insulin
c. Excessive glucose intake
d. High physical activity
The correct answer is: b. Lack of sensitivity of target organs to insulin.
The treatment goal for Type 2 diabetes is to:
a. Cure the disease
b. Prevent long-term complications
c. Eliminate the need for insulin
d. Increase insulin resistance
The correct answer is: b. Prevent long-term complications.
As Type 2 diabetes progresses, what typically happens to β-cell function?
a. It improves
b. It remains stable
c. It declines
d. It fluctuates
The correct answer is: c. It declines.
In the later stages of Type 2 diabetes, achieving satisfactory serum glucose levels often requires:
a. Increased physical activity
b. Insulin therapy
c. Reduced carbohydrate intake
d. No treatment
The correct answer is: b. Insulin therapy.
True regarding insulin administration:
a. It can be taken orally.
b. It is degraded in the kidney if taken orally.
c. It is degraded in the GIT if taken orally.
d. It is degraded in the liver if taken orally.
The correct answer is: c. It is degraded in the GIT if taken orally.
True regarding the synthesis of insulin:
a. It is synthesized as insulin directly.
b. It is synthesized as a precursor called pro-insulin.
c. It does not require any cleavage to become active.
d. It is synthesized by the α cells of the pancreas.
The correct answer is: b. It is synthesized as a precursor called pro-insulin.
The process by which insulin becomes active involves:
a. No change in its structure.
b. Addition of a phosphate group.
c. Proteolytic cleavage of pro-insulin.
d. Cleavage of the A chain.
The correct answer is: c. Proteolytic cleavage of pro-insulin.
Insulin and C peptide are secreted by:
a. The α cells of the pancreas.
b. The δ cells of the pancreas.
c. The β cells of the pancreas.
d. The γ cells of the pancreas.
The correct answer is: c. The β cells of the pancreas.
A better index of insulin levels is provided by measuring:
a. Blood glucose levels.
b. Circulating insulin directly.
c. Circulating C peptide.
d. Glycogen levels.
The correct answer is: c. Circulating C peptide.
Insulin secretion is primarily regulated by:
a. Certain amino acids.
b. Blood glucose.
c. Gastrointestinal hormones.
d. Autonomic mediators.
The correct answer is: b. Blood glucose.
Which of the following is NOT a regulator of insulin secretion?
a. Blood glucose.
b. Certain amino acids.
c. Gastrointestinal hormones.
d. Lipid levels.
The correct answer is: d. Lipid levels.
Which of the following statements about insulin secretion is true?
a. Autonomic mediators have no effect on insulin secretion.
b. Insulin secretion is not influenced by gastrointestinal hormones.
c. Certain amino acids regulate insulin secretion.
d. Blood glucose is the least important regulator of insulin secretion.
The correct answer is: c. Certain amino acids regulate insulin secretion.
The first step in the regulation of insulin secretion involves:
a. Phosphorylation of glucose by glucokinase.
b. Inhibition of Ca++ influx.
c. Depolarization of the cell membrane.
d. ATP degradation.
a. Phosphorylation of glucose by glucokinase.
Following glucose phosphorylation in the pancreas, the next step is:
a. Increased K+ influx.
b. Inhibition of K+ efflux.
c. Increased ATP degradation.
d. Decreased intracellular Ca++ secretion.
b. Inhibition of K+ efflux.
The inhibition of K+ efflux in the β cells leads to:
a. Hyperpolarization of the cell membrane.
b. Depolarization of the cell membrane.
c. Increased K+ influx.
d. Decreased ATP production.
The correct answer is: b. Depolarization of the cell membrane.
Depolarization of the β cell membrane results in:
a. Decreased ATP production.
b. Increased ATP degradation.
c. Increased intracellular Ca++ secretion.
d. Decreased intracellular Ca++ secretion.
The correct answer is: c. Increased intracellular Ca++ secretion.
The final result of increased intracellular Ca++ secretion in the β cells is:
a. Decreased insulin secretion.
b. Increased insulin secretion.
c. Inhibition of ATP production.
d. Hyperpolarization of the cell membrane.
The correct answer is: b. Increased insulin secretion.
Insulin increases:
a. Glucose uptake.
b. Glycogenolysis.
c. Gluconeogenesis.
d. Lipolysis.
The correct answer is: a. Glucose uptake.
Insulin’s effect on glycogen synthesis is:
a. Decreased.
b. Increased.
c. Unaffected.
d. Only in the liver.
The correct answer is: b. Increased.
Insulin decreases:
a. Glycolysis in muscles.
b. Lipogenesis.
c. Gluconeogenesis in the liver.
d. Glycogen synthesis.
The correct answer is: c. Gluconeogenesis in the liver.
The effect of insulin on glycolysis in muscles is:
a. Decreased.
b. Increased.
c. Unaffected.
d. Only in the liver.
The correct answer is: b. Increased.
Insulin promotes:
a. Glycogen breakdown.
b. Conversion of carbohydrates to fat (lipogenesis).
c. Increased lipolysis.
d. Decreased glucose uptake.
b. Conversion of carbohydrates to fat (lipogenesis).
Insulin’s effect on lipolysis is:
a. Increased.
b. Decreased.
c. Unaffected.
d. Only in muscles.
The correct answer is: b. Decreased.
Insulin increases:
a. Amino acid uptake and protein synthesis.
b. Protein degradation.
c. Lipolysis.
d. Gluconeogenesis.
The correct answer is: a. Amino acid uptake and protein synthesis.
Insulin preparations vary primarily in:
a. Their routes of administration.
b. Their times of onset and durations of activity.
c. Their side effects.
d. Their color and appearance.
The correct answer is: b. Their times of onset and durations of activity.
The variation in insulin preparations is due to:
a. Differences in the dosage.
b. Differences in the administration frequency.
c. Differences in the amino acid sequences of the polypeptides and the type of formulation.
d. Differences in the storage conditions.
The correct answer is: c. Differences in the amino acid sequences of the polypeptides and the type of formulation.
Insulins like lispro, aspart, and glulisine have:
a. Slower onset and longer duration of action.
b. Faster onset and shorter duration of action.
c. No difference in action compared to regular insulin.
d. Faster onset and longer duration of action.
The correct answer is: b. Faster onset and shorter duration of action.
The reason for the faster onset and shorter duration of action of insulins like lispro, aspart, and glulisine is:
a. They aggregate and form complexes.
b. They do not aggregate or form complexes.
c. They are administered in higher doses.
d. They are taken orally.
The correct answer is: b. They do not aggregate or form complexes.
Long-acting insulins such as glargine and detemir:
a. Have shorter duration of action compared to regular insulin.
b. Show prolonged, flat levels of the hormone following injection.
c. Are used only in emergency situations.
d. Are taken orally.
The correct answer is: b. Show prolonged, flat levels of the hormone following injection.
Which of the following insulin preparations can be given intravenously in emergencies?
a. Insulin aspart
b. Insulin glulisine
c. Insulin lispro
d. Regular insulin
The correct answer is: d. Regular insulin
Which of the following insulin preparations is a rapid-acting insulin?
a. Insulin glargine
b. Insulin lispro
c. Insulin detemir
d. Insulin degludec
The correct answer is: b. Insulin lispro
Which of the following is NOT a rapid-acting insulin?
a. Insulin glargine
b. Insulin aspart
c. Insulin lispro
d. Insulin glulisine
The correct answer is: a. Insulin glargine
True regarding rapid-acting insulin preparations:
a. They slowly lower blood glucose.
b. They rapidly lower blood glucose.
c. They do not affect blood glucose levels.
d. They have no effect on blood glucose levels.
The correct answer is: b. They rapidly lower blood glucose.
Insulin lispro has a more rapid absorption after SC injection than:
a. Insulin isophane
b. Insulin detemir
c. Regular insulin
d. Insulin glargine
The correct answer is: c. Regular insulin
Which of the following statements about rapid-acting insulin preparations is correct?
a. They are usually administered long before meals.
b. They are usually administered long after meals.
c. They are usually administered immediately before or following the meal.
d. They are usually administered only at bedtime.
The correct answer is: c. They are usually administered immediately before or following the meal.
Insulin lispro belongs to which pregnancy category?
a. Category C
b. Category B
c. Category D
d. None of the above.
The correct answer is: b. Category B
The primary purpose of rapid-acting insulin preparations is to mimic the:
a. Basal release of insulin
b. Nocturnal release of insulin
c. Prandial (mealtime) release of insulin
d. Stress-induced release of insulin
The correct answer is: c. Prandial (mealtime) release of insulin
True regarding the use of rapid-acting insulin preparations:
a. They are used alone to assure proper glucose control.
b. They are used along with a longer-acting insulin to assure proper glucose control.
c. They are never used with other insulin types.
d. They are only used in emergency situations.
The correct answer is: b. They are used along with a longer-acting insulin to assure proper glucose control.
Neutral protamine Hagedorn (NPH) insulin is also known as:
a. Insulin glargine
b. Insulin detemir
c. Insulin lispro
d. Insulin isophane
The correct answer is: d. Insulin isophane
NPH insulin should only be administered:
a. Intravenously
b. Intramuscularly
c. Subcutaneously
d. Orally
The correct answer is: c. Subcutaneously
True regarding NPH insulin:
a. It is a solution
b. It is a suspension
c. It is a powder
d. It is a gel
The correct answer is: b. It is a suspension
NPH insulin should never be given:
a. Subcutaneously
b. Orally
c. Intramuscularly
d. Intravenously
The correct answer is: d. Intravenously
The pH of NPH insulin is:
a. Acidic
b. Neutral
c. Basic
d. Variable
The correct answer is: b. Neutral
The delayed absorption of NPH insulin is due to the formation of:
a. Highly soluble complex
b. Less-soluble complex
c. Neutral complex
d. Acidic complex
The correct answer is: b. Less-soluble complex
The formation of the less-soluble complex in NPH insulin is due to:
a. Addition of zinc
b. Addition of chloride ions
c. Addition of protamine
d. Addition of glucose
The correct answer is: c. Addition of protamine
The duration of action of NPH insulin is:
a. Short
b. Long
c. Intermediate
d. Ultra-long
The correct answer is: c. Intermediate
Intermediate-acting insulin is useful in treating all forms of diabetes except:
a. Type 1 diabetes
b. Type 2 diabetes
c. Diabetic ketoacidosis or emergency hyperglycemia
d. Gestational diabetes
The correct answer is: c. Diabetic ketoacidosis or emergency hyperglycemia
Intermediate-acting insulin is usually given along with:
a. Long-acting insulin for basal control
b. Rapid- or short-acting insulin for mealtime control
c. Oral hypoglycemic agents
d. No additional medication
The correct answer is: b. Rapid- or short-acting insulin for mealtime control
A similar compound to NPH insulin is:
a. Insulin aspart
b. Insulin detemir
c. Neutral protamine lispro (NPL) insulin
d. Insulin glargine
The correct answer is: c. Neutral protamine lispro (NPL) insulin
Neutral protamine lispro (NPL) insulin is used only in combination with:
a. Regular insulin
b. Insulin glargine
c. Insulin lispro
d. Insulin aspart
The correct answer is: c. Insulin lispro
Which of the following is a premixed combination of human insulins?
a. 30% NPH insulin and 70% insulin glargine
b. 70% NPH insulin plus 30% regular insulin
c. 50% NPH insulin and 50% insulin detemir
d. 25% NPH insulin and 75% insulin lispro
The correct answer is: b. 70% NPH insulin plus 30% regular insulin
Premixed combination of human insulins includes:
a. 60% NPH insulin and 40% insulin aspart
b. 40% NPH insulin and 60% insulin glargine
c. 75% NPL insulin plus 25% insulin lispro
d. 80% NPL insulin and 20% insulin detemir
The correct answer is: c. 75% NPL insulin plus 25% insulin lispro
Which of the following describes a premixed combination of human insulins with equal parts?
a. 60% NPH insulin plus 40% regular insulin
b. 50% NPH insulin plus 50% regular insulin
c. 40% NPH insulin plus 60% insulin lispro
d. 30% NPH insulin plus 70% insulin glargine
The correct answer is: b. 50% NPH insulin plus 50% regular insulin
True regarding intermediate-acting insulin preparations:
a. They are used for immediate glucose control.
b. They provide intermediate duration of action.
c. They have the longest duration of action.
d. They are never used in combination with other insulins.
The correct answer is: b. They provide intermediate duration of action.
The isoelectric point of insulin glargine is:
a. Higher than that of human insulin
b. Equal to that of human insulin
c. Lower than that of human insulin
d. Variable compared to human insulin
The correct answer is: c. Lower than that of human insulin
The lower isoelectric point of insulin glargine leads to:
a. Faster absorption
b. Precipitation at the injection site, thereby extending its action
c. Reduced efficacy
d. Increased solubility
The correct answer is: b. Precipitation at the injection site, thereby extending its action
True regarding the onset of insulin glargine:
a. It is slower in onset than NPH insulin
b. It is faster in onset than NPH insulin
c. It has the same onset as NPH insulin
d. It has a rapid onset
The correct answer is: a. It is slower in onset than NPH insulin
Insulin glargine is associated with:
a. Short duration of action
b. No hypoglycemic effect
c. Prolonged hypoglycemic effect
d. Rapid hypoglycemic effect
The correct answer is: c. Prolonged hypoglycemic effect
The action profile of insulin glargine can be described as:
a. Biphasic
b. Flat with no peak
c. Spiking
d. Irregular
The correct answer is: b. Flat with no peak
Insulin glargine must be administered:
a. Intravenously
b. Intramuscularly
c. Orally
d. Subcutaneously
The correct answer is: d. Subcutaneously
Insulin detemir has a fatty-acid side chain that:
a. Reduces its effectiveness
b. Enhances association to albumin
c. Increases its solubility in water
d. Speeds up its absorption
The correct answer is: b. Enhances association to albumin
The association of insulin detemir with albumin results in:
a. Short-acting properties
b. Medium-acting properties
c. Rapid-acting properties
d. Long-acting properties
The correct answer is: d. Long-acting properties
True regarding insulin detemir’s dissociation from albumin:
a. It has slow dissociation from albumin
b. It has rapid dissociation from albumin
c. It does not dissociate from albumin
d. It dissociates at the same rate as regular insulin
The correct answer is: a. It has slow dissociation from albumin
The long-acting properties of insulin detemir are similar to:
a. Insulin aspart
b. Insulin lispro
c. Insulin glargine
d. NPH insulin
The correct answer is: c. Insulin glargine
Insulin detemir is characterized by which of the following?
a. Short duration of action
b. Rapid peak of action
c. Slow and prolonged duration of action
d. Immediate onset of action
The correct answer is: c. Slow and prolonged duration of action
