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Dr. Gupta endocrine exam 2 pptx part 2

Total questions: 62

Worksheet time: 2hrs 4mins

Name
Class
Date
1.

Which of the following is adverse reaction for insulin products?

a)

Hypoglycemia

b)

allergic reaction (IgE mediated)

c)

Lipodystrophy

d)

Hyperglycemia

2.

Which of the following is true when insulin products cause hypoglycemia?

a)

-Release of epinephrine, glucagon, cortisol

-These hormones try to compensate

b)

Sweating, hunger, palpitations, tremor, anxiety

c)

-May lead to convulsions & coma

3.

Lipodystrophy: Common when same injection site utilized. Loss of fat may impact insulin absorption from that site

a)

True

b)

False

4.

Analog of human ______ with additional amino acids and substitutions for aqueous stability.

Ready to use aqueous product for treatment of severe _______ via SC injection in both pediatric and adult diabetic patients

a)

Glucagon, Hypoglycemia

b)

Insulin, Hypoglycemia

c)

Insulin, Hyperglycemia

d)

Glucagon, Hyperglycemia

5.

______, insulin and glucagon work together in inter-related fashion to maintain normal world glucose

a)

Amylin

b)

GLP-1 agonist

c)

DPP4Is

d)

SGLT2

6.

Group of gastric hormones stimulating insulin release are commonly called as___________

a)

Incretins

b)

Glucagon

c)

Secretin

d)

Gastrin

7.

What is the role of incretins (GLP-1) in insulin and glucagon?

a)

Increase insulin

& Decrease glucagon

b)

Decrease insulin

& Increase glucagon

c)

Increase insulin

d)

Decrease glucagon

8.

What is the role of incretins (GIP) in insulin and glucagon?

a)

In

b)

Increase glucagon

c)

Increase insulin & Decrease glucagon

d)

Decrease insulin

9.

•Isolated from the saliva of the Gila Monster

•39 a.a. polypeptide (53% same AA as GLP-1)

•t1/2 = 2-4 hours

•Bid or Q7d

a)

Exenatide (Byetta)

b)

Liraglutide (Victoza)

c)

Dulaglutide (Trulicity)

d)

Semaglutide ( Ozempic)

10.

Anti-diabetic Drugs: Peptides

GLP-1 Agonists

a)

Natide + Glutide

b)

Gliptins

c)

Glinides

d)

Gliflozins

11.

•Fatty acid molecule at one position of the GLP-1

•t1/2 = 11-15 hours

•Once daily

a)

Liraglutide (Victoza)

b)

Exenatide (Byetta)

c)

Dulaglutide (Trulicity)

d)

Semaglutide (Ozempic)

12.

•GLP-1 analog with amino acid substitution

•t1/2 = 4days

•Q7d

a)

Dulglutide (trulicity)

b)

Semaglutide (Ozempic)

c)

Exenatide (Byetta)

d)

Liraglutide (Victoza)

13.

•GLP-1 analog with  stearic diacid substitution at Lys26 for t1/2 & introduction of amino α-aminobutyric at position 8 acid for DPP4-stability

•t1/2 = ~ 1 week

•Q7d

a)

Semaglutide (Ozempic)

b)

Dulaglutide (Trulicity)

c)

Liraglutide (Victoza)

d)

Exenatide (Byetta)

14.

What are the adverse effects of GLP-1 Agonist?

a)

Fullness

b)

Nausea/vomiting

c)

GERD

d)

decreased appetite

e)

increased appetite

15.

Which of the following GLP-1 agonist is fused to a fatty molecule to increase it’s half life?

a)

Duraglutide

b)

Detemir

c)

Liraglutide

d)

Pramlintide

16.

Which of the following are Non-peptides (orally) antidiabetic drugs?

a)

DPP4Is

b)

Sulfonyl ureas

c)

Biguanides

d)

Insulin

e)

GLP-1

17.

What is the role of the DPP4Is drugs?

a)

• Increases endogenous incretin levels

b)

•Decreases plasma glucose

c)

•Increases plasma glucose

d)

• Decreases endogenous incretin levels

18.

What are the adverse effects of DPP4Is ?

a)

Nausea

b)

Nasopharyngitis

c)

Dizziness

d)

Weight gain

19.

Which oral antidiabetic drug DPP-4 inhibitors is highly metabolized?

a)

Saxagliptin

b)

Sitagliptin

c)

Linagliptin

d)

Alogliptin

20.

Which group in oral antidiabetic drugs DPP-4 inhibitors is mainly responsible for longer DOA?

a)

-CN

b)

-C=O

c)

-NH2

21.

Following functional group in Saxagliptin is responsible for its pseudoirreversible nature

a)

Hydroxyl

b)

Amine of β–amino acid

c)

Peptide/amide (-CO-NH)

d)

Cyano

22.

What is the difference between first-generation and second-generation oral (antidiabetic drugs sulfonylureas)?

a)

•First Generation-Small substitution

b)

•Second Generation-Bulky substitution

c)

•Second Generation-Small substitution

d)

•First Generation-Bulky substitution

23.

Bulkier substituents on ___ increase molecular affinity for SUR1 receptors and cause β cells to ________.

a)

R1, secrete insulin

b)

R2, secrete insulin

c)

R1, secrete glucagon

d)

R2, secrete insulin

24.

The first-generation sulfonylurea oral antidiabetic drugs are less potent and have a higher chance of hypoglycemia.

a)

True

b)

False

25.

Sulfonylureas inhibit ______ clearance of insulin

a)

hepatic

b)

renal

c)

intestinal

26.

What is the mechanism of sulfonylureas?

a)

1. Bind to SUR1 subunit of K+/ATP channel

2. SUR1 = Sulfonylurea receptor

3. Inhibit K+ conductance

4. Promote depolarization

5. Ca2+ influx -> Insulin release

b)

1. Bind to SUR1 subunit of Ca++/ATP channel

2. SUR1 = Sulfonylurea receptor

3. Inhibit K+ conductance

4. Promote depolarization

5. K+ influx -> Insulin release

c)

1. Bind to SUR1 subunit of K+/ATP channel

2. SUR1 = Sulfonylurea receptor

3. Inhibit Ca++ conductance

4. Promote depolarization

5. Ca2+ influx -> Insulin release

27.

What are the adverse effects of Sulfonylureas ?

a)

Weight gain

b)

Cause sun sensitivity

c)

Hypoglycemia

28.

Which of the following drug can produce much longer hypoglycemic side effect as seen with SUs and therefore contraindicated in elderly?

a)

Chlorpropamide

b)

Glipizide

c)

Glyburide

d)

Glimepiride

29.

What are true about Substituted Benzoic Acids or ‘Glinides’ ?

a)

Non sulfonylurea hypoglycemic agent

b)

Structural and functional similarity to SUs

c)

Less problematic hypoglycemia

d)

sulfonamide

e)

Different binding site than SUs

30.

Which of the following drug is the most potent?

a)

Chlorpropamide

b)

Glipizide

c)

Glyburide

d)

Glimepiride

e)

Acetohexamide

31.

What classes of antidiabetic drugs can cause hypoglycemia?

a)

Insulin

b)

Amylin

c)

SUs

d)

Glinidines

32.

•Bind to the peroxisome proliferator-activated receptor (PPAR-γ)  receptors in fat cells and making the cells more responsive to insulin (aka insulin sensitizers)

a)

Thiazolidinediones (Glitazones)

b)

Sulfonyl Ureas (SUs)

c)

SGLT2 inhibitors (Gliflozins)

d)

Biguanides

33.

Which of the following drugs are Thiazolidinediones?

a)

Rosiglitazone (Avandia)

b)

Pioglitazone (Actos)

c)

Glimepiride (Amaryl)

d)

Glipizide (Glucotrol)

34.

____________ antidiabetic agent that lowers blood glucose by improving target cell response to insulin, without increasing pancreatic insulin secretion. It has a mechanism of action that is dependent on the presence of insulin for activity.

a)

Thiazolidinedione

b)

Biguanides

c)

Sulfonylureas

d)

DPP4Is

35.

What are the adverse effects of Thiazolidinedione?

a)

Increase in liver transaminases

b)

Decrease in liver transaminases

c)

Weight gain

d)

Fluid retention and edema

e)

lose weight

36.

Reabsorbs 10% of glucose in kidneys

a)

SGLT1

b)

SGLT2

37.

Reabsorbs 90% of glucose in kidneys-Important target

a)

SGLT2

b)

SGLT1

38.

Which of the following drugs are Substituted Benzoic Acids?

a)

Repaglinidine (Prandin)

b)

Nateglinide (Starlix)

c)

Metformin (Glucophage)

d)

Glimepiride (Amaril)

39.

Which of the following drugs are DPP4Is?

a)

Sitagliptin (Januvia)

b)

Alogliptin (Nesine)

c)

Repaglinide (Prandin)

d)

Nateglinide (Starlix)

40.

Which of the following drugs are SGLT2 INHIBITORS?

a)

Canagliflozin (Invokana)

b)

Dapagliflozin (Farxiga)

c)

Glimepiride (Amaryl)

d)

Empagliflozin (Jardiance)

41.

SGLT2 inhibitors (gliflozins) have a _____________.

a)

low risk of hypoglycemia

b)

High risk of hypoglycemia

42.

What drug is the combination with sitagliptin (Steglujan®) and metformin (Segluromet®) ?

a)

Ertugliflozin (Steglatro)

b)

Canagliflozin (Invokana)

c)

Dapafliflozin (Farxiga)

43.

Which of the following drugs is biguanide?

a)

Metformin (Glucophage)

b)

Glipizide (Glucotrol)

c)

Glyburide (Micronaze)

44.

Which of the following is true about Buguanides?

a)

Highly polar, basic drug

b)

Almost 100% eliminated by kidneys

c)

Eliminated by active tubular secretion (OCT)

d)

Almost 60% eliminated by kidneys

45.

What are the role of Biguanides?

a)

Insulin sensitizer

b)

No effect on insulin levels

c)

Not hypoglycemic

d)

can cause hypoglycemic

46.

What are the mechanisms of action of biguanides by the liver?

a)

decrease gluconeogenesis

b)

decrease glycogenolysis

c)

increase gluconeogenesis

d)

increase glycogenolysis

47.

What are the mechanisms of action of biguanides by the Muscle?

a)

increase glucose uptake

b)

decrease lipolysis

c)

decrease gluconeogenesis

d)

decrease glycogenolysis

48.

What are the mechanisms of action of biguanides by the Fat?

a)

increase glucose uptake

b)

decrease lipolysis

c)

decrease glucose uptake

d)

decrease gluconeogenesis

49.

What are the adverse effects of Biguanides?

a)

nausea, diarrhea

b)

lactic acidosis

c)

dizziness

50.

__________releases glucose from larger carbohydrates

a)

α-Glucosidase

b)

Biguanides

c)

GLP-1 Agonist

d)

Amylin Agonists

51.

Which of the following are true about of Acarbose (Precose) ?

a)

•-O- replaced with –NH-

b)

•Sugar ring changed to cyclohexene

c)

•Highly absorbed

d)

•Not absorbed as such

e)

•Drug excreted in feces (51%)

52.

Which of the following are true about of Miglitol (Glyse)t ?

a)

•Sugar monomer like structure

b)

•Highly absorbed

c)

•Excreted unchanged in urine

d)

•Drug excreted in feces (51%)

53.

Which of the following drugs are α-Glucosidase Inhibitors?

a)

Acarbose (Precose)

b)

Miglitol (Glyset)

c)

Glimepiride (Amaryl)

d)

Glipizide (Glucotrol)

54.

A patient on alpha-glucosidase inhibitor is experiencing hypoglycemia. What should be given?

a)

Fruit juice

b)

Glucose tab

c)

Lactose

55.

What classes of antidiabetic drugs not cause hypoglycemia?

a)

GLP-1 agonists

b)

Metformin

c)

•SGLT2 inhibitors

d)

•Alpha-glucosidase inhibitors

e)

Thiazolidinedione

56.

What oral anti-diabetic drugs cause weight loss?

a)

Amylin

b)

GLP-1 agonist

c)

Metformin

d)

DPP4 inhibitor

57.

What oral anti-diabetic drugs cause weight neutral?

a)

Metformin

b)

DPP4 INHIBITORS

c)

Sulfonylureas

d)

Meglinitides

58.

What oral anti-diabetic drugs cause weight gain?

a)

Sulfonylureas

b)

Meglinitides

c)

Thiazolidinedione

d)

Metformin

59.

Miglitol is an example of

a)

α–glucosidase inhibitor

b)

DPP-4 inhibitor

c)

Amylin Analogue

d)

GLP-1 agonist

60.

Metformin belongs to which of the following class of anti-diabetics?

a)

Buguanides

b)

Sulfonylureas

c)

Glitazone

d)

Gliptins

61.

Which of the following statements is not applicable to metformin?

a)

Insulin sensitizer

b)

Not hypoglycemic

c)

Can cause weight gain

d)

No effect on insulin levels

62.

Which of the following is true about Hexamer?

a)

long term stability

b)

storage form in body

c)

can not storage form in body

d)

low term stability

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