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WorksheetsDiabetes exam
Total questions: 25
Worksheet time: 51mins
Which of the following drugs cause weight gain?
insulin
metformin
glyburide
pioglitazone
canagliflozin
Which of the following is NOT a sign or symptom of diabetes?
polyuria
hyperglycemia
polyphagia
hypernatremia
lethargy
Which of the following is true?
Type II diabetics produce no insulin due to autoimmune processes
A1c >7% is diagnostic of diabetes
Insulin is responsible for increasing glucose production
In the liver, amylin increases insulin’s activity to cause fasting hyperglycemia
Adipose tissue can contribute to decreased insulin sensitivity in peripheral tissues
Who is at lowest risk for developing diabetes?
35 yo pregnant female who developed gestational hyperglycemia during her first pregnancy
9 yo male whose parents both have type I diabetes
70 yo underweight African American female
43 yo morbidly obese white female with family history of cardiovascular disease
52 yo male with hypertension, hyperlipidemia, and COPD whose brother was recently diagnosed with diabetes
Which trial observed Type 1 DM patients?
UKPDS
EMPA-REG
DCCT
ACCORD
VADT
Which medication is first line therapy to prevent progression of renal disease in diabetics?
Metoprolol
hydralazine
lisinopril
isosorbide mononitrate
Which is not a counseling point for metformin?
this may cause upset stomach and diarrhea, it may help to take with food
you may see "ghost tablets" in the XR version
avoid drinking due to increased risk of lactic acidosis
it can cause vitamin C deficiency
-LT is a 56 yo type II diabetic who has been controlled on metformin 1000 mg BID for five years. At his most recent appointment, though, his A1c was 10.4%.
-Other medical conditions: hypertension, hyperlipidemia, CHF
-Current medications: metformin 1000 mg BID, losartan 50 mg daily, furosemide 40 mg BID, atorvastatin 80 mg daily
What medication would NOT be a good choice to start?
Glimepiride
Pioglitazone
Insulin glargine
Dulaglutide
The team decides to start LT on exenatide 5 mcg BID. He complains of bad nausea with this new medication. What do you tell him?
Nausea usually improves over time with exenatide
Try switching to liraglutide 1 mg daily
His nausea might improve is he injects exenatide at least an hour before eating
The nausea is an intentional effect; it’s why many patients lose weight when using exenatide
Move the injection time closer to meal time
DG uses NPH (Humulin N) 15 units at breakfast and dinnertime. The last three nights, he has woken up feeling shaky, dizzy, and sweaty. What do you recommend?
Increase his dinnertime NPH dose to 18 units
Increase both NPH doses to 16 units BID
Add insulin glulisine for better prandial control
Move dinnertime NPH dose to late afternoon
Decrease dinnertime NPH dose to 12 units
Which is not a counseling point for hypoglycemia?
have 4 oz of diet coke then test your blood sugar
have 6 lifesavers and wait 15 minutes to retest your blood sugar
take your medications the same way every day
have a regular eating schedule
you'll feel dizzy, shaky, have a rapid heartbeat and/or anxious during a hypoglycemic episode
Which of the following patients is the best candidate for an SGLT2 inhibitor?
elderly woman with a history of repeat UTIs and yeast infections
65 yo male who is on furosemide 80mg
45 yo female with hypertension and a family history of CKD
75 yo male with a history of repeated hospitalizations due to dehydration
38 yo female with stage 4 CKD
What did the FDA’s 2008 Guidance for Industry recommend prior to new drug approval?
must assess CVD safety prior to approval
must lower A1c at least 1%
must be safe for patients with Class 3/4 heart failure
must be used in type 1 and type 2 patients
What is the important disease state to counsel patients on when starting a GLP-1?
thyroid cancer
bladder cancer
liver toxicity
pancreatitis
Which medications should not be used in elderly patients?
glyburide
empagliflozin
metformin
exenatide
Which of the following are sensitizers?
glipizide
metformin
repaglinide
pioglitazone
glyburide
How often should a T2DM patient get an eye exam?
monthly
yearly
every visit
every 3-5 months
What is the correction factor for a patient using 90 total units of insulin?
1 unit of insulin will lower the plasma glucose 200 units
1 unit of insulin will lower the plasma glucose 20 units
1 unit of insulin will cover 20G of carbs
1 unit of insulin will cover 5.6G of carbs
Which medication is correctly associated with its risk?
Dapogliflozin- bone cancer
Canagliflozin- bladder cancer
Liraglutide- pancreatitis
Metformin- bone fractures
Which DPP-4 inhibitor does not need to be renally dose adjusted?
sitagliptin
linagliptin
saxagliptin
alogliptin
Which correctly lists all THREE of the lab values cut offs observed for diabetes?
A1c >6.5%, 2 HR postload >200mg/dl, fasting plasma glucose >126
A1c >7%, 2 HR postload >220mg/dl, fasting plasma glucose >126
A1c >6.5%, 2 HR postload >200mg/dl, fasting plasma glucose >100
A1c >6.5%, 2 HR postload >160mg/dl, fasting plasma glucose >145
Which insulin has the longest duration of action?
Aspart
Lispro
Degludec
Detemir
Glargine
Which GLP-1 has the greatest A1c lowering effect?
Liraglutide
Exenatide XL
Semaglutide
Exenatide
Dulaglutide
Which of the following drugs is correctly matched to it's A1c lowering potential and it's effect on weight?
Metformin, 1.5-2%, weight gain
Pioglitazone, 0.7-1%, weight gain
Sitagliptin 0.7-1%, weight neutral
Canagliflozin 0.8%, weight loss
Glipizide 1.5-2%, weight loss
A patient is on 225 units of u-500 TID (in divided 3 doses), your pharmacy only has TB syringes, how do you tell your patient to measure one dose?
measure 15mL in the TB syringe for each dose
measure 75mL in the TB syringe for each dose
measure 45mL in the TB syringe for each dose
measure 22.5mL in the TB syringe for each dose
