MCQ Self-Test Drugs and Diabetes Flashcards
What is the cellular mechanism by which sulphonylureas increase insulin release from the pancreas?
a) open potassium (KATP) channels
b) close voltage-gated calcium channels
c) close potassium (KATP) channels
d) open voltage-gated calcium channels
c) close potassium (KATP) channels
Which of the following conditions is least likely to be a chronic effect of diabetes?
a) peripheral neuropathy
b) epilepsy
c) retinopathy
d) kidney failure
B) Epilepsy
Which antihypertensive drug gives added benefit to slow the progression of diabetic kidney disease?
a) ACE inhibitor
a) thiazide diuretics
b) beta blocker
c) calcium entry blocker
a) ACE Inhibitor
For which of the following drugs is lactic acidosis a potential adverse effect?
a) sitagliptin
b) glicazide
c) dulaglutide
d) metformin
d) metformin
Which of the following antihypertensive drugs is most likely to cause hypoglycaemia?
a) losartan
b) propranolol
c) ramipril
d) amlodipine
b) propranolol
Which is the drug of choice to treat type 2 diabetes in overweight patients where their diabetes remains uncontrolled by diet alone?
a) metformin
b) glicazide
c) pioglitazone
d) soluble insulin
a) metformin
Which of the following drugs stimulates insulin release by inhibiting the enzyme dipeptidyl peptidase 4 (DPP-4), elevating the incretins GIP/GLP1?
a) sitagliptin
a) exanetide
b) glicazide
c) rapaglinide
a) sitagliptin
Which of the following insulins has the shortest duration of action?
a) soluble insulin
b) isophane insulin
c) insulin aspart
d) insulin glargine
c) insulin aspart
A 40 year old woman reports polyuria and polydipsia for the last 2 months. She has a BMI of 18 and no other medical history. A fasting blood glucose was 8.8 mmol/L so the GP started dietary and exercise management for type 2 diabetes. Four months later she returns with a HbA1c of 58 mmol/mol (target <48mmol/mol) and is still reporting her old symptoms. Her random blood glucose is 14 mmol/L, her serum creatinine is 172 umol/L (60-120)
Write a prescription for a drug to improve her diabetic control?
a) glibenclamide
b) insulin
c) metformin
d) glicazide
d) glicazide
A 60 year old patient with benign prostatic hypertrophy is admitted with lethargy. He says he has not passed urine for 5 days and reports painful abdominal distension. Examination reveals a palpable bladder with over a litre of urine visible on the bladder scan.An ECG shows tail T-waves throughout and sinus tachycardia. Heart rate 115/min, BP 132/88 mmHg, SaO2 99% on air.
Glucose 7.2 mmol/L, sodium 136 mmol/L, potassium 7,1 mmol/L creatinine 346 umol/L, urea 18 mmol/L
Write a prescription for the first drug regimen to lower the patient’s potassium.
a) soluble insulin 10 units with IV glucose 20%, (100mL, 30 min)
b) soluble insulin 10 units
c) calcium resonium (polystyrene sulphate resin) 15G orally
d) calcium gluconate
a) soluble insulin 10 units with IV glucose 20%, (100mL, 30 min)
A 25 year old man is admitted to hospital with a first presentation of diabetic ketoacidosis and is diagnosed with type 1 diabetes mellitus. He is converted from an insulin sliding scale to a basal bolus regimen. You are asked to discuss insulin therapy with the patient.
Select the most appropriate statement to communicate with the patient.
a) poor glucose control is not linked to cardiovascular complications
b) HbA1c is useful to monitor plasma glucose day-to-day
c) hypoglycaemia is treated by giving a bottle of water
d) when unwell, the dose of insulin may have to be modified
d) when unwell, the dose of insulin may have to be modified
A 72 year old man on your ward is prescribed oral glicazide 120mg, 12 hourly for the treatment of type 2 diabetes. You are interrupted by one of the nurses during your morning ward round to be told that the patients blood glucose has been reported as 2.9 mmol/L and although conscious he is drowsy and seems agitated. You immediately review the patient.
Which statement is true concerning the treatment of drug induced hypoglycaemia?
a) conscious patients should first be given glucagon
b) a conscious patient should be given 10-20g glucose by mouth
c) unconscious patients should be given an IV infusion of glucose 50%
d) drug induced hypoglycaemia is less likely to occur with sulphonylureas than with metformin
b) a conscious patient should be given 10-20g glucose by mouth
Why does soluble insulin need to be given 15-30 minutes before a meal?
a) to prevent any possibility of developing hyperglycaemia
b) needs time to depolymerise
c) requires activation by the liver
d) to increase the uptake of potassium
b) needs time to depolymerise
Which of the following diuretics is most likely to inhibit insulin release?
a) bumetanide
b) spironolactone
c) bendroflumethazide
d) amiloride
c) bendroflumethazide
Which one of the following insulins would you prescribe to cover nocturnal hyperglycaemia?
a) isophane insulin
b) insulin glargine
c) insulin aspart
d) soluble insulin
b) insulin glargine
