Endocrine System 2

Question 1

What causes Osteoporosis?

Answer 1

decreased osteoblast function

Question 2

T/F: osteoporosis is more common in post-menopausal women?

Answer 2

TRUE

Question 3

Types of Osteoporosis

Answer 3

1). primary 2). seconday

Question 4

What causes primary osteoporosis?

Answer 4

1). idiopathic (unknown 2). increased age

Question 5

what causes secondary osteoporosis?

Answer 5

1). underlying diseases 2). medications

Question 6

Clinical manifestations for osteoporosis

Answer 6

1). sudden back pain (compression fx of vertebral body) 2). increased kyphosis of T spine 3). decreased height

Question 7

Risk factors for developing osteoporosis (9)

Answer 7

1). decreased bone mass after 35 years old 2). female hormone changes 3). genetics 4). Caucasian 5). low physical activity 6). tobacco/alcohol use 7). medications 8). depression 9). diet/nutrition deficits

Question 8

TX for osteoporosis?

Answer 8

1). calcium and Vitamin D 2). Bisphosphonates (most common tx) 3). Denosumab 4). Sclerostin Inhibitor 5). Teriparatide

Question 9

AEs of calcium?

Answer 9

Consitipation

Question 10

suffix for Bisphosphonates

Answer 10

-dronate

Question 11

MOA of Bisphosphonates

Answer 11

binds key enzyme to inhibit natural bone turnover pathway >> increases osteoclast apoptosis which decreases bone turnover

Question 12

Bisphosphoantes considerations

Answer 12

1). stay upright 2). take w/water 30-60 minutes before food

Question 13

Bisphosphonates common AE

Answer 13

GI issues (increased if not upright)

Question 14

Rare Bisphosphoantes AE

Answer 14

1). atypical femur fx 2). osteonecrosis of jaw (ONJ) - from IV use or long-term trx

Question 15

Bisphosphonates contraindications

Answer 15

1). hypocalcemia 2). esophageal abnormalities 3). inability to remain upright

Question 16

what type of drug is denosumab (Prolia)

Answer 16

Anti-RANKL

Question 17

denosumab (Prolia) AEs

Answer 17

same as bisphospnates

Question 18

denosumab (Prolia) considerations

Answer 18

administered in provider’s office

Question 19

Sclerostin inhibitors MOA

Answer 19

increase bone formation

Question 20

Sclerostin inhibitors common AE

Answer 20

arthraligia

Question 21

Sclerostin inhibitors rare AEs

Answer 21

1). hypocalcemia (atypical) 2). femur fx 3). ONJ 4). increased risk of MI, stroke, or CV death

Question 22

Synthetic PTH MOA

Answer 22

1). stimulate osteoblast function 2). increases GI calcium absorption 3). increase renal calcium absorption all this increases BMD

Question 23

Synthetic PTH AEs

Answer 23

transient OH within 4 hours of dose

Question 24

Drug name for Synthetic PTH

Answer 24

Teriparatide (Forteo)

Question 25

Osteoporosis medication considerations

Answer 25

also given to pts with longterm steroid use and men receiving androgen deprivation therapy

Question 26

Osteoporosis meds Therapeutic Concerns

Answer 26

1). excessive doses of Ca supplements can cause arrhythmias 2). utilize weight bearing activities to promote bone growth 3). avoid high impact activities for pts with osteroporosis

Question 27

Types of Diabetes

Answer 27

Type 1 Type 2

Question 28

Pathophysiology T1DM

Answer 28

selective beta cell destruction in the pancreas >> can’t produce insulin

Question 29

what causes T1DM?

Answer 29

Autoimmune dysfunction, genetic, viral infections

Question 30

What is T2DM?

Answer 30

1). moderate beta cell destruction that can become more severe 2). Insulin resistance

Question 31

Which type of diabetes is more prevalent in youth?

Answer 31

T1DM

Question 32

what is LADA?

Answer 32

latent autoimmune diabetes in adults (Type 1.5 >> requires insulin)

Question 33

What type of diabetes can only be treated with insulin?

Answer 33

T1DM

Question 34

Pathophysiology of T2DM?

Answer 34

Egregious Eleven

Question 35

What are the egregious elevn

Answer 35

Question 36

what is the overall result of the egregious eleven?

Answer 36

Hyperglycemia

Question 37

TX options for T2DM?

Answer 37

1). diet 2). exercise 3). non-insulin meds 4). insulin

Question 38

what are non-insulin meds that treat T2DM also called?

Answer 38

Antihyperglycemic Drug

Question 39

List the classes of Antihyperglycemic Drugs (6)

Answer 39

1). Biguanide 2). Sulfonylureas 3). Thiazolidinedione (TZDs) 4). DPP-4 inhibitor 5). SGLT2 Inhibitor 6). GLP1 Receptor agonist

Question 40

MOA for Biguanide

Answer 40

unclear, but it stops: 1). production of glucose 2). intestinal absorption of glucose also 3). increases insulin sensitivity in muscle and fat

Question 41

AE of Biguanide

Answer 41

1). GI (N/V/cramps) 2). Vitamin B12 deficiency

Question 42

how is vitamin B12 deficiency from Biguanide important?

Answer 42

it can be misdiagnosed as peripheral neuropathy

Question 43

Biguanide boxed warnings

Answer 43

lactic acidosis

Question 44

Sulfonylureas MOA

Answer 44

increase insulin release

Question 45

Sulfonylureas AE

Answer 45

1). hypoglycemia 2). weight gain

Question 46

AE from Sulfonylureas are increased in which populations?

Answer 46

1). elderly 2). individuals with renal dysfunction

Question 47

T/F: some Sulfonylureas are on the Beer’s List?

Answer 47

TRUE

Question 48

Thiazolidinedione (TZDs) MOA

Answer 48

increase insulin sensitivity in muscle and fat

Question 49

Thiazolidinedione (TZDs) AE

Answer 49

1). edema 2). long-term increased risk of bone fractures

Question 50

Thiazolidinedione (TZDs) boxed warnings

Answer 50

HF

Question 51

What does DPP-4 inhibitor stand for?

Answer 51

Dipeptidyl peptidase 4 inhibitor

Question 52

DPP-4 inhibitor MOA

Answer 52

inhibit breakdown of incretin => 1). increases insulin sensitivity and release 2). decreases glucagon secretion 3). decreases liver glucose production

Question 53

DPP-4 inhibitor AE

Answer 53

very well tolerated

Question 54

rare AE of DPP-4 inhibitor

Answer 54

1). arthraliga 2). increased risk of HF

Question 55

SGLT-2 Inhibitor MOA

Answer 55

blocks glucose reabsorption in kidneys => increases urinary glucose excretion

Question 56

SGLT2 inhibitor AE

Answer 56

1). volume depletion related 2). genitourinary infections 3). renal insufficiency

Question 57

Rare SGLT2 inhibitors AE

Answer 57

euglycemic diabetic ketoacidosis

Question 58

SGLT2 inhibitor boxed warnings

Answer 58

increased risk of bone fractures and lower limb amputations

Question 59

GLP1 receptor agonist MOA

Answer 59

1). increase insulin secretion 2). decrease glucagon secretion 3). decrease gastric emptying (incretin hormones)

Question 60

GLP1 receptor agonist AE

Answer 60

GI (nausea, bloating, diarrhea)

Question 61

Sulfonylureas suffix

Answer 61

-ide

Question 62

DPP-4 inhibitor suffix

Answer 62

-gliptin

Question 63

SGLT2 inhibitor suffix

Answer 63

-flozin

Question 64

GLP1 receptor agonist suffix

Answer 64

-tide

Question 65

What are the symptoms of Diabetes? (10)

Answer 65

1). tired 2). always hungry 3). frequent urination 4). always thirsty 5). blurry vision 6). numb/tingling hands or feet 7). sexual problems 8). sudden weight loss 9). wounds that won’t heal 10). vaginal infections

Question 66

MOA of Insulin

Answer 66

1). increase glucose uptake 2). inhibit glucose production

Question 67

Types of Insulin

Answer 67

1). basal 2). bolus 3). Other

Question 68

What are the “Other” types of insulin?

Answer 68

1). intermediate (NPH) 2). mixed 3). concentrated 4). U-500 5). inhaled regular insulin (afrezza)

Question 69

how often is basal insulin injected?

Answer 69

normally only once daily, sometimes twice

Question 70

types of bolus insulin

Answer 70

1). rapid 2). regular

Question 71

onset for rapid bolus insulin

Answer 71

10-30 min lasts for 3-5 hours

Question 72

onset for regular bolus insulin

Answer 72

~30 min lasts 4-12 hours

Question 73

what type of insulin can be given as correction insulin?

Answer 73

rapid bolus insulin

Question 74

Therapeutic considerations for DM?

Answer 74

1). exercise = good 2). monitor blood glucose 3). avoid heat/massage @ injection site 4). need good footwear 5). exercise after meals

Question 75

if blood glucose is <100 mg/dL then _______

Answer 75

eat a snak

Question 76

if blood glucose is >300 mg/dL then _______-

Answer 76

No PT

Question 77

what are the signs of hypoglycemia?

Answer 77

1). shaky 2). sweaty 3). dizzy 4). confusion 5). difficulty speaking 6). weak/tired 7). HA 8). nervous/upset

Question 78

_______ masks all the symptoms of hypoglycemia except ______

Answer 78

1). Beta blockers 2). sweating

Question 79

Which Antihyperglycemic Drugs reduce the risk for hypoglycemia?

Answer 79

1). Biguanide 2). Thiazolidinedione (TZDs) 3). DPP-4 inhibitors