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Review Endocrine Exam 2 (Friday)

Total questions: 65

Worksheet time: 1hrs 10mins

Name
Class
Date
1.

Function of somatostatin

a)

Inhibits gastrin, insulin & glucagon secretion

b)

Release gastrin, insulin & glucagon secretion

c)

Inhibits gastrin

2.

Which of the following will increase insulin secretion?

a)

A decrease in intracellular calcium levels

b)

A decrease in intracellular potassium levels

c)

Closing of the ATP-gated potassium channel

d)

Closing of the voltage-gated calcium channel

3.

A 39 YOM with untreated diabetes mellitus type I is brought to the ER. An injection of insulin will

a)

Increase urine glucose concentration

b)

Increase his blood glucose concentration

c)

Increases glucose transport into muscle and adipose

d)

Promote gluconeogenesis in the liver à glucagon

4.

Glucagon release will be stimulated when

a)

A person had a big dinner

b)

A person has been fasting for 24 hours

c)

A person receives a somatostatin injection

d)

A person has a blood glucose level

5.

Which of the above indicates insulin resistance?

a)

Insulin: Increase

Glucose: Increase

C-Peptide: Increase

b)

Insulin: Increase

Glucose: Increase

C-peptide: Decrease

c)

Insulin: Increase

Glucose: Decrease

C-peptide: Increase

d)

Insulin: Increase

Glucose: Decrease

C-peptide: Decrease

6.

Which of the above indicates insulin dependent DM?

a)

Insulin: Decrease

Glucose: Increase

C-Peptide: Decrease

b)

Insulin: Increase

Glucose: Increase

C-Peptide: Decrease

c)

Insulin: Increase

Glucose: Decrease

C-Peptide: Decrease

7.

Sulfonylureas, used to treat diabetes, block potassium channels in pancreatic beta cells. This allows 

a)

Depolarization of beta cells and glucagon secretion

b)

Depolarization of beta cells and calcium ion efflux

c)

Depolarization of beta cells and potassium ion efflux

d)

Depolarization of beta cells and insulin secretion

8.

Insulin activates glycogen synthase by

a)

Activating PKB which dephosphorylates GSK3

b)

Activating PKB which phosphorylates GSK3

c)

Activating PKA which phosphorylates GSK3

d)

Activating PKA which dephosphorylates GSK3

9.

Which of the following promotes glycolysis?

a)

Insulin

b)

Glucagon

c)

Epinephrine

d)

Cortiso;

10.

Which of the following promotes insulin?

a)

Promotes glycogen synthesis

b)

Promotes fatty acid synthesis

c)

Promotes Gluconeogenesis

d)

Promotes glycogenolysis

11.

Which of the following promotes glucagon?

a)

promotes gluconeogenesis

b)

promotes glycogenolysis

c)

promotes glycogen synthesis

d)

promotes fatty acid synthesis

12.

Which of the following promotes upregulation of GLUT receptors?

a)

Insulin

b)

Glucagon

c)

Epinephrine

d)

Cortisol

13.

Which of the following is used by the muscle to transport glucose into the cell?

a)

Glut 1

b)

Glut 3

c)

Glut 4

d)

Glut 5

14.

RBC

a)

Glut 1

b)

Glut 2

c)

Glut 3

d)

Glut 5

15.

intestines, beta cells, liver

a)

Glut 1

b)

Glut 2

c)

Glut 3

d)

Glut 5

16.

Brain

a)

Glut 3

b)

Glut 4

c)

Glut 1

d)

Glut 2

17.

lumen side of intestine

a)

Glut 5

b)

Glut 1

c)

Glut 3

d)

Glut 1

18.

Monosaccharides are absorbed into the blood from the epithelial cells by

a)

Glut 2

b)

A sodium glucose symporter

c)

A sodium glucose antiporter

d)

Glut 5

19.

The diagram above shows the fate of glucose once it enters most cells. The conversion of glucose to glucose-6-phosphate is important in all of these processes because the phosphate form prevents glucose from freely entering or leaving the cell 

a)

True

b)

False

20.

Which of the following is required for glycogen synthesis but not for glycogen breakdown?

a)

Glucose-6-phosphatase

b)

Glycogen phosphorylase

c)

Glycogennin

d)

Phosphoglucomutase à required for both processes

21.

Which of the following statements are TRUE (select all that apply)

a)

Glycogen phosphorylase will be more active when it is phosphorylated

b)

Glycogen phosphorylase will be more active when it is dephosphorylated -> glycogen synthase will be active

c)

Glycogen synthase will more active when PKB is active -> insulin activates PKB à MAKE glycogen  

d)

Glycogen synthase will be more active when PKA is active -> Glucagon activates PKA à BREAK down glycogen

22.

A 20YOF, otherwise healthy, experiences muscle cramps when she performs strenuous exercise. She is diagnosed with McArdle’s disease. This disease is a

a)

Deficiency in debranching enzyme => enlarged liver

b)

Deficiency in branching enzyme => enlarged liver

c)

Deficiency in liver phosphorylase à HER’s disease => will have enlarged liver  

d)

Deficiency in muscle phosphorylase 

23.

Which of following enzymes are involved in gluconeogenesis? (select all that apply)

a)

Glucokinase

b)

Pyruvate carboxylase 

c)

Glucose 6-phosphatase

d)

Fructose bisphosphatase

e)

Phosphoenolpyruvate carboxkinase

24.

What FALSE regarding 2,6-bisphosphate in the liver? (select all that apply)

a)

It will activate phosphofructokinase 1

b)

It will activate fructose 1,6 bisphosphatase

c)

Levels of fructose 2,6-bisphosphate will be high in presence of insulin

d)

Levels of fructose 2,6-bisphosphate will be high in presence of glucagon 

25.

The non-oxidative phase of the pentose phosphate pathway produces 2 NADPH

a)

TRUE

b)

FALSE

26.

A patient with glucose-6-phosphate dehydrogenase

a)

Should consume fava beans -> contain divicine which produce oxygen radicals

b)

Should reduce vitamin E intake

c)

Is at increased risk of hemolysis

d)

Is at risk of thiamine deficiency

27.

A patient with aldose B deficiency would have problems with

a)

Cataracts -> galactosemia

b)

Gout

c)

Hypoglycemia

d)

Hyperbilirubinemia

e)

High lactate and low ATP

28.

Entry of glucose into the brain is regulated by insulin

a)

True

b)

False

29.

Entry of glucose into muscles and adipose tissues is regulated by

a)

Insulin

b)

Glucagon

30.

Incretins will ____________ blood sugar while Dipeptidyl Peptidase (DPP-4) will _____________ blood sugar

a)

decrease, decrease

b)

decrease, increase

c)

increase, increase

d)

increase, decrease

31.

In the absence of insulin, which of the following are used for energy and as a result, places a diabetic patient at risk of ketoacidosis?

a)

Acetoacetic acid

b)

Beta-hydroxybutyric acid

c)

None of the above

32.

Which structural part of insulin may be modified without significant loss of activity? (select all that apply)

a)

A21

b)

B28

c)

A29

d)

B30

33.

GlyB23-PheB24-PheB25-TyrB26 is important for

a)

activity

b)

non-activity

34.

Which of the following is a rapid acting insulin?

a)

Glulisine

b)

Glargine

c)

Regular

d)

NPH

e)

Detemir

35.

Which of the following is a rapid acting insulin?

a)

Lispro

b)

Aspart

c)

Afreeza

d)

Glargine

36.

Which of the following is a intermediate insulin?

a)

NPH

b)

Glargine

c)

Detemir

d)

Lispro

37.

Which of the following is a Long acting insulin?

a)

Detemir

b)

Glargine

c)

NPH

d)

Afreeza

38.

Which of the following is a ultra long acting insulin?

a)

Degludec

b)

Regular

c)

Afreeza

d)

Aspart

39.

Which of the following is a ultra rapid acting insulin?

a)

Afreeza

b)

Lispro

c)

NPH

d)

Detemir

40.

Which of the following is a short acting insulin?

a)

Regular

b)

NPH

c)

Lispro

d)

Glulisine

41.

Addition of which of the following improves solubility of insulin products?

a)

Protamine

b)

Zinc

c)

Vitamin B3

d)

Fatty acid chain

42.

The drug above is from which class of diabetic medications and what is the role of the group circled in red?

a)

GLP1 agonist, increases potency

b)

Biguanide, enhances binding

c)

Sulfonylurea, increases potency

d)

Sulfonylurea, pharmacophore  

43.

Which of the following drugs stimulates insulin release similarly to that of a sulfonylurea drug but does not bind to the same region that sulfonylureas bind?

a)

Glimepiride

b)

Metformin

c)

Acarbose

d)

Repaglinide

44.

What is FALSE regarding metformin

a)

It is a biguanide

b)

It is 100% renally eliminated

c)

It stimulates insulin release from pancreatic beta cells

d)

It should be avoided with IV contrast media

45.

Which of the following is an alpha-glucosidase inhibitor?

a)

Migitol

b)

Sitagliptin

c)

Rosiglitazone

d)

Enexatide

46.

Which of the following is an DPP4I ?

a)

Sitagliptin

b)

Migitol

c)

Rosiglitazone

d)

Enezatide

47.

Which of the following is an TZD ?

a)

Roziglitazone

b)

Enexatide

c)

Sitagliptin

d)

Migitol

48.

Which of the following is an GLP-1 analog?

a)

Enexatide

b)

Migitol

c)

Sitagliptin

d)

Rosiglitazone

49.

Which of the following works by binding to peroxisomes proliferator-activated receptor gamma (PPAR-γ)

a)

Sulfonylurea

b)

DPP4 inhibitor

c)

Incretin mimetic

d)

Thiazolidinediones

50.

Adverse effects of insulin therapy include

a)

Pancreatitis

b)

Lipodystrophy

c)

Hepatotoxicity

d)

Nephrotoxicity

51.

Pramlintide, a(n) ________ analogue, is _______ ant-diabetic

a)

Amylin, peptide

b)

Amylin, non- peptide

c)

Incretin, peptide

d)

Incretin, non-peptide

52.

Which of the following GLP-1 agonists has the longest half life?

a)

Exenatide

b)

Dulaglutide

c)

Liraglutide

d)

Semaglutide

53.

Which DPP-4 inhibitor is extensively metabolized by CYP 3A4

a)

Sitagliptin

b)

Saxagliptin

c)

Linagliptin

d)

Alogliptin

54.

Which DPP-4 inhibitor is NOT renally eliminated, enterohepatic recycling?

a)

Linagliptin

b)

Sitagliptin

c)

Alogliptin

d)

Saxagliptin

55.

Based on the structures above, which would have a longer duration of action?

a)

Linagliptin

b)

Alogliptin

56.

Based on the structures above, which one has a higher affinity for the SUR1 receptor?

a)

Tolbutamide

b)

Chlorpropamide

c)

Acetohexamide

d)

Glipizide

57.

Which of the following drugs is 1st gen but longest duration of action and highest incidence of hypoglycemia?

a)

Chlorpropamide

b)

Tolbutamide

c)

Acetohexamide

d)

Glipizide

58.

The structures above belong to which class of anti-diabetics?

a)

Peptide, SGLT2

b)

Non-peptide, DPP4-1

c)

Non-peptide, SGLT2

d)

Peptide, DPP4-1

59.

Which of the following is a biguanide?

a)

Blue

b)

Purple

c)

Green

60.

Which of the following is associated with increased risk of hypoglycemia?

a)

Dapafliflozin

b)

Metformin

c)

Pramlinitide

d)

Exenatide

61.

Which of the following is associated with less risk of hypoglycemia?

a)

GLP-1 AGONIST

b)

DPP4 INHIBITORS

c)

METFORMIN

d)

INSULIN

62.

Which of the following is associated with weight loss? (select all that apply)

a)

Glipizide

b)

Metformin

c)

Pramlinitide

d)

Exenatide

63.

Which of the following is associated with weight neutral?

a)

Metformin

b)

Glipizide

c)

Glimepiride

d)

Exenatide

64.

Which of the following is associated with weight gain? select all that apply

a)

glyburide

b)

nateglinide

c)

glipizide

d)

Pramlinitide

65.

Which of the following is TRUE regarding pancreatic cells? (select all that apply)

a)

Alpha cells secrete glucagon

b)

Beta cells secrete insulin

c)

Delta cells secrete insulin -> secretes somatostatin

d)

Acinar cells secrete glucagon  -> secrete electrolytes, fluid and zymogens

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