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DR. SMITH ENDO EXAM 3, PPTX 3-4

Total questions: 65

Worksheet time: 56mins

Name
Class
Date
1.

The excess macrovascular risk is associated more with dyslipidemia and hypertension.

a)

True

b)

False

2.

What are the goals of diabetes treatment?

a)

Reduce the risk of microvascular complications.

b)

Reduce the risk of macrovascular complications.

c)

Reduce mortality

d)

Reduce the risk of

happiness

3.

What diseases are found in microvascular complications?

a)

Retinopathy

b)

Nephropathy

c)

Neuropathy

d)

CV

4.

What diseases are found in macrovascular complications?

a)

Cerebrovascular

b)

CV

c)

PVD

d)

Neuropathy

5.

Which of the following are INDIVIDUALIZED THERAPY CONSIDERATIONS?

a)

Disease progression (beta cell function preservation)

b)

Patient preferred administration route (ex. oral, injectable)

c)

Amount of A1C lowering needed to reach goal

d)

Side effect profile and patient’s tolerability

e)

Co

existing conditions

6.

What are the treatment guidelines according to the American Diabetes Association (ADA)?

a)

Emphasis on detection and diagnosis of diabetes and pre-diabetes.

b)

Focus on lifestyle changes.

c)

Prevention and management of complications.

d)

HBA1c goal of <7%

e)

Cost of medications is not a priority.

7.

What are the treatment guidelines according to the American Asspciation of Clinical Endocrinologists (AACE)?

a)

Diagnosis and treatment of pre-diabetes.

b)

Focus on risk factor management.

c)

Individualize glycemic goals and pharmacotherapy.

d)

Cost of medications is not a priority.

e)

Avoid therapies that can cause

hypoglycemia and HbA1c goal ≤ 6.5%.

8.

What is the best treatment recommendation for a patient with hypertension and diabetes?

Initial BP> 140/90 mmHg and <160/100 mmHg

a)

ACEi

b)

ARB

c)

CCB

d)

Diuretic

9.

What is the best treatment recommendation for a patient with hypertension and diabetes?

Initial BP ≥ 160/100 mmHg

a)

ACEi or ARB and CCB or Diuretic

b)

ACEi or ARB

c)

CCB or Diuretic

d)

ARB

10.

Which of the following are Lifestyle Therapy?

a)

Nutrition

b)

Physical Activity

c)

Sleep

d)

Smoking Cesation

11.

Which of the following corresponds to an overall diabetes care?

a)

Detect presence of complications

b)

Classify diabetes

c)

Formulate a management plan

d)

Review risk factor control

e)

Review previous treatment

12.

There are two main techniques in the Glycemic Control Assessment. What are these two techniques?

a)

Self monitoring of blood glucose

b)

A1C monitoring

c)

BG monitoring

d)

Meals monitoring

13.

Which of the following is included in self-monitoring of blood glucose?

a)

Help guide treatment decisions

b)

Proper ongoing education is a must

c)

Technique evaluation may help improve readings

d)

At least 2x/year in patients meeting treatment goals

14.

Which of the following is a A1c motinoring?

a)

At least 2x/year in patients meeting treatment goals

b)

Perform quarterly in those whose therapy has changed or are not

meeting goals

c)

Proper ongoing education is a must

d)

Help guide treatment decisions

15.

Which of the following is a Lifestyle changes?

a)

Type 1: Balanced diet to maintain a healthy weight

b)

Type 2: Caloric restriction to promote weight loss

c)

150 minutes/week of moderate exercise

d)

75 minutes/week of moderate exercise

16.

Which of the following would be an easy patient counseling?

a)

Pay attention to cholesterol and blood pressure

b)

Get your vaccines, eye exam

and feet exams

c)

Exercise

d)

Replace meals

17.

Glucagon is secreted, opposing the actions of insulin.

Stimulates hepatic glucose production and

prevents hypoglycemia

a)

Fasting state

b)

Fed state

18.

An increase in glucose causes insulin to be secreted.

Increases glucose uptake by muscles and decreases hepatic glucose production

a)

Fed state

b)

Fasting state

19.

Gut hormones are also secreted, causing insulin secretion

-Glucagon like peptide 1 ( GLP 1 ) & Glucose dependent insulin releasing peptide (GIP)

-Inactivated by dipeptidyl peptidase IV ( DPP IV )

a)

Fed state

b)

Fasting state

20.

What is the first-line dual therapy if you have A1c ≥ 8.5%?

a)

Lifestyle changes

b)

Metformin

c)

Glipizide

d)

Glimepiride

21.

What is the % A1c required for insulin treatment?

a)

A1c >10%

b)

A1c <10%

c)

A1c ≥7.5%

22.

Which of the following medications is recommended if the patient has CKD or HF?

a)

Use SGLT2 inhibitor

(empagliflozin or canagliflozin)

b)

Use GLP 1 agonist

(liraglutide, semaglutide,

exenatide)

c)

Use DPP-4 inhibitors (Sitagliptin,saxagliptin,linagliptin,alogliptin)

d)

Use TZD (glitazoness, rosiglitazones, pioglitazone)

23.

Which Box Warning is associated with metformin?

a)

Lactic acidosis

b)

Ghost stool

c)

Black tongue

d)

Hypoglycemia

24.

Which of the following is a side effect of metformin?

a)

abdominal cramping

b)

B12 deficiency

c)

Hypoglycemia

d)

Weight gain

25.

Which of the following are a contraindication to metformin?

a)

eGFR < 30 mL/min/1.73 m 2

b)

metabolic acidosis

c)

T2DM

d)

DKA

26.

What is the mechanism of action of biguanide?

a)

decreases

hepatic glucose

production and intestinal

absorption of glucose,

increases insulin

sensitivity.

b)

Stimulate insulin

secretion to

decrease post

prandial glucose.

c)

Delay the breakdown and absorption of complex

CHOs and sucrose  ppBG

d)

Stimulate insulin

secretion

27.

What is the mechanism of action of Meglitinides?

a)

Stimulate insulin

secretion to

decrease post

prandial glucose.

b)

Stimulate insulin

secretion

c)

Peroxisome Proliferator

Activated Receptor Gamma

agonist increase insulin

sensitivity (increases uptake /

utilization of glucose)

d)

Reduce reabsorption of glucose

and increase urinary glucose

excretion

28.

Which of the following medications is a Meglitinides?

a)

Repaglinide (Prandin)

b)

Nateglinide (Starlix)

c)

Glimepiride (Amaryl)

d)

Glipizide (Glucotrol)

29.

Which of the following is a contraindication for Repaglinide?

a)

use of Repaglinide with Gemfibrozil

b)

DKA

c)

TDM

30.

Which of the following are side effects of Meglitinides?

a)

Hypoglycemia

b)

Weight gain

c)

URTI

d)

Headache

31.

Which meglitinides do you take 15-30 minutes before each meal (TID)?

a)

Repaglinide

b)

Nateglinide

c)

Rosiglitazone

d)

Liraglutide

32.

Which meglitinides do you take 1-10 minutes before each meal (TID)?

a)

Regaglinide

b)

Nateglinide

c)

Liraglutide

d)

Glipizide

33.

If you plan to skip a meal, you should skip the dose of Meglinitides to avoid Hypoglycemia.

a)

True

b)

False

34.

What is the% reduction in A1c using Meglitinide?

a)

0.5-1%

b)

1%

c)

0.5%

d)

1-1.5%

35.

What is the mechanism of action of a-glucosidase inhibitors (AGI)?

a)

Delay the breakdown and absorption of complex

CHOs and sucrose  ppBG

b)

Stimulate insulin

secretion

c)

Peroxisome Proliferator

Activated Receptor Gamma

agonist increase insulin

sensitivity (increases uptake /

utilization of glucose)

d)

Reduce reabsorption of glucose

and increase urinary glucose

excretion

36.

Which of the following medications is an α-glucosidase inhibitors (AGI)?

a)

Acarbose (Precose)

b)

Meglitol (Diastabol)

c)

Pioglitazone (Actos)

d)

Glimepiride (Amaryl)

37.

What are the side effects of a-glucosidade inhibitors (AGI)?

a)

Diarrhea

b)

Abdominal pain

c)

Elevated serum transaminases

d)

Heat

38.

Which of the following medications decreases the concentration of Digoxin by 19-28%?

a)

Meglitol

b)

Acarbose

c)

Rosiglitazone

d)

Glimepiride

39.

Which of the following medications decreases the bioavailability of Propranolol by 40% and that of Ranitidine by 60%?

a)

Meglitol

b)

Acarbose

c)

Pioglitazone

d)

Glipizide

40.

Which of the following is an interaction of α-glucosidase inhibitors (AGI)?

a)

May reduce digestive enzymes

b)

May reduce intestinal adsorbents

c)

May reduced Charcoal

d)

May reduce Amylase, pancreatin

41.

Which of the following is a contraindication to the α-glucosidase inhibitor?

a)

Inflammatory bowel disease and short bowel syndrome

b)

Cirrhosis

c)

SCr > 2.0 mg/dl

d)

Colonic ulceration

42.

Initial dose is 25 mg po TID

May initiate at 25 mg qday and increase

Doses should be given with first bite of meal

Doses may be adjusted at 4 8 week intervals

Max daily doses are 50 mg TID for patients ≤

60 kg and 100mg TID for patients > 60 kg

Available as 25, 50, and 100 mg tablets

a)

Acarbose(Precose)

b)

Meglitol (Diastabol)

c)

Pioglitazone (Actos)

d)

Sitagliptina (Januvia)

43.

Which of the following cannot be used with a-glucosidase inhibitors to treat hypoglycemia?

a)

Soft drinks

b)

candy

c)

table sugar

d)

Fructose

e)

Glucose tablets

44.

Which of the following drugs belongs to the first generation of sulfonylureas?

a)

Acetohexamide (Dymelor)

b)

Chlorpropamide (Diabinase)

c)

Tolazamide (Tolinase)

d)

Tolbutamide (Orinase)

e)

Glimepiride(Amaryl)

45.

Which of the following medications are all renally excreted or eliminated and avoid or adjust dose in renal impairment?

a)

1st

Generation

Sulfonylureas

b)

a-glucosidase inhibitors

c)

Sulfonylureas

d)

DPP4 inhibitors

46.

Glipizide (Glucotrol), Glimepiride (Amaryl), Glyburide

(Micronized formulation = Glynase)

Which of the following is the class of these drugs?

a)

Sulfonylureas

b)

a-glucosidase inhibitors

c)

1st

Generation

Sulfonylureas

d)

Thiazolidinediones

47.

What is the mechanism of action of Sulfonylureas?

a)

Stimulate insulin

secretion

b)

Reduce reabsorption of glucose

and increase urinary glucose

excretion

c)

: Prevents the

breakdown of DPP4 enzyme

which causes increase in insulin

release & decrease glucagon

secretion

d)

Increase insulin

secretion, decrease glucagon

secretion, and slows gastric

emptying, increases satiety

48.

Which of the following is a contraindication to Sulfonylureas?

a)

Sulfa Allergy

b)

DKA

c)

T1DM

d)

T2DM

49.

Which of the following is a side effect of sulfonylureas?

a)

Hypoglycemia

b)

weight gain

c)

nausea

d)

weight loss

50.

_______ can leave a ghost tablet in the stool

a)

Glucotrol XL

b)

Glynase

c)

Amaryl

d)

Glyburide

51.

_____ is not preferred in renal impairment

a)

Glyburide

b)

Amaryl

c)

Glucotrol

d)

Glucotrol xl

52.

5 mg daily (titrate by 2.5 5 mg every few days).

Doses > 15 mg should be BID. Max 40 mg/day.

a)

Glipizide IR

b)

Glipizide XL

53.

5 mg daily (titrate to max dose 20 mg/ day)

a)

Glipizide XL

b)

Glipizide IR

c)

Glyburide

54.

1-2 mg daily (max dose 8 mg/day)

a)

Glimepiride

b)

Glipizide IR

c)

Glyburide

d)

Glipizide XL

55.

2.5-5 mg daily (increase by 2.5 mg weekly; max

dose 20 mg/day)

a)

Glyburide

b)

Glynase

c)

Glimepiride

d)

Glipizide XL

56.

1.5-3 mg daily (increase by 1.5 mg weekly; max 12

mg/day)

a)

Glynase

b)

Glimepiride

c)

Glipizide IR

d)

Glipizide XL

57.

Which of the following medications is a Thiazolidinediones?

a)

Pioglitazone (Actos)

b)

Rosiglitazone (Avandia)

c)

Glipizide

(Glucotrol)

d)

Glimepiride (Amaryl)

58.

What is the mechanism of action for Thiazolidinediones?

a)

Peroxisome Proliferator

Activated Receptor Gamma

agonist increase insulin

sensitivity (increases uptake /

utilization of glucose)

b)

Stimulate insulin

secretion

c)

Reduce reabsorption of glucose

and increase urinary glucose

excretion

59.

Which Box Warning is associated with Thiazolidinediones?

a)

May cause or exacerbate HF

b)

Increased risk of leg/foot amputation

c)

Lactic acidosis

d)

Acute pancreatitis

60.

Which of the following is a side effect of Thiazolidinediones?

a)

Hepatic failure

b)

Edema

c)

Risk of fractures

d)

weight gain

61.

Which Thiazolidinediones has a dose of 15-30 mg daily [Max 45 mg daily] and in class I / II for HF starts at 15mg?

a)

Pioglitazone (Actos)

b)

Rosiglitazone (Avandia)

c)

Glimepiride (Amaryl)

d)

Glipizide (Glucottol)

62.

Which Thiazolidinediones has a dose of 4-8 mg daily?

a)

Pioglitazone (Actos)

b)

Rosiglitazone (Avandia)

c)

Glimepiride (Amaryl)

d)

Sitagliptine (Januvia)

63.

Thiazolidinediones can be taken with or without food.

a)

True

b)

False

64.

Which of the following is a contraindication for Thiazolidinediones?

a)

Class III/IV HF

b)

Class I/II HF

c)

Sulfa allergy

d)

DKA

65.

Metformin is effective at reducing macrovascular risk in obese patients.

a)

True

b)

False

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