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PODA II Exam 4 - Diabetes and Bones

Total questions: 77

Worksheet time: 19hrs 15mins

Name
Class
Date
1.

WOTF statements about Lispro (insulin analogue) is correct?

a)

A lysine-Proline sequence at the end of the insulin A chain reversed

b)

A lysine-Arginine sequence at the end of the insulin B chain reversed

c)

A lysine-Arginine sequence at the end of the insulin A chain reversed

d)

A lysine-Alanine sequence at the end of the insulin A chain reversed

e)

A lysine-Proline sequence at the end of the insulin B chain reversed

2.

WOTF statements about Lispro (insulin analog) is/are correct?

a)

A lysine-Proline sequence at the end of the insulin B chain reversed

b)

Lispro is a long-acting insulin analog

c)

Lispro differs from human insulin in the replacement of the B3 amino acid asparagine with lysine

d)

Lispro is a rapid-acting insulin analog

e)

A lysine-Aspartic acid sequence at the end of the insulin B chain reversed

3.

WOTF insulin analogues is/are rapid-acting analog?

a)

Insulin glargine

b)

Insulin detemir

c)

Insulin glulisine

d)

Insulin ultralente

e)

Insulin protamine complex

4.

WOTF insulin analogs contains myristic acid (fatty acid)?

a)

Insulin glargine

b)

Insulin Lispro

c)

Insulin determir

d)

Insulin glulisine

e)

Insulin ultralente

5.

WOTF insulin preparations contains Zn2+?

a)

Insulin glargine

b)

Insulin lispro

c)

Insulin protamine complex

d)

Insulin glulisine

e)

Insulin ultralente insulin

6.

WOTF statements about insulin glargine is correct?

a)

Two extra arginine molecules attached at the end of the B chain to increase the isoelectric point

b)

Two extra arginine molecules attached at the end of the B chain to increase acidity

c)

Two extra arginine molecules attached at the end of the B chain to increase lipophilicity

d)

Two extra arginine molecules attached at the end of the B chain to promote albumin binding

e)

Two extra arginine molecules attached at the end of the B chain to decrease the isoelectric point

7.

WOTF statements about insulin aspart is/are correct?

a)

A lysine-proline sequence at the end of the insulin B chain reversed

b)

Aspart is a long-acting insulin analog

c)

Aspart differs from human insulin in the replacement of the B3 amino acid asparagine with lysine

d)

Aspart is a rapid-acting insulin analog

e)

Aspart incorporates an amino-acid change (Pro B28 to Asp) that also creates charge repulsion

8.

WOTF compounds is to stimulate the release of insulin from beta cells?

a)

Biguanide

b)

Sulfonylureas

c)

Alpha-glucosidase

d)

Insulin determir

e)

Ultralente insulin

9.

WOTF compounds is insulin sensitizer (enhance insulin sensitivity)?

a)

Biguanide

b)

Sulfonylureas

c)

Alpha-glucosidase

d)

Insulin detemir

e)

Ultralente insulin

10.

WOTF compounds inhibits alpha-glucosidase?

a)

Biguanide

b)

Sulfonylureas

c)

Acarbose

d)

Insulin detemir

e)

Ultralente insulin

11.

Which of these compounds is/are alpha-glycosidase inhibitor?

a)
b)
c)
12.

To which class of compounds does this structure belong?

a)

Thiazolidnediones

b)

Biguanides

c)

Nucleosides

d)

Carbohydrates

e)

Sulfonylureas

13.

To which class of compounds does this structure belong?

a)

Thiazolidnediones

b)

Biguanides

c)

Nucleosides

d)

Carbohydrates

e)

Sulfonylureas

14.

The structure is somatostatin. Which region of the structure is essential to its activity?

a)

Region B

b)

Region C

c)

Region A

d)

Region A & C

e)

Region B & C

15.

WOTF statements concerning oxytocin is false?

a)

Oxytocin is a peptide of nine amino acids

b)

Oxytocin is a cyclic peptide

c)

Oxytocin contains a ring that encompasses a disulfide bridge

d)

Oxytocin is natural hormone

e)

Oxytocin is a semi-synthetic analog of natural hormone

16.

The structure is vasopressin. Which of the following statement is FALSE regarding the above structure?

a)

Vasopressin is a cyclic peptide

b)

Vasopressin contains a ring that encompasses a disulfide bridge

c)

Vasopressin is a peptide of 12 amino acids

d)

Vasopressin is a natural hormone

e)

Vasopressin is an antidiuretic hormone

17.

WOTF is a somatostatin analog that inhibits adrenocorticotropic hormone?

a)

Somatulin

b)

Signifor

c)

Octreotide

d)

Sandostatin

e)

Lanreotide

18.

WOTF statements about gastrin is FALSE?

a)

Its secretion is elevated in a patient with Zollinger-Ellison syndrome

b)

It is produced in the stomach

c)

It control glucagon secretion from the pancreas

d)

It is produced by the alpha cells of the Islet of Langerhans

e)

It increases acid secretion in the stomach

19.

A patient who is severely allergic to alogliptin should NOT be treated with which of the following?

a)

Diabeta

b)

Acarbose

c)

Oseni

d)

Janumet

e)

Toujeo

20.

WOTF is LEAST LIKELY to be observed as an adverse effect of Invokana?

a)

Hypotension

b)

Increased urination

c)

Weight loss

d)

Hypokalemia

e)

Hypercholesterolemia

21.

WOTF is MOST LIKELY to produce its antidiabetic effect by inhibiting dipeptidylpeptidase-IV? (SATA)

a)

Nucala

b)

Jardiance

c)

Januvia

d)

Nesina

e)

Symlin

22.

WOTF statements about micronase is FALSE?

a)

The onset of action is about 2-4 hours

b)

It is a micronized preparation of glyburide

c)

It is administered on a QD-BID basis

d)

Its duration of actions is 16-24 hours

e)

It has a half life of 10 hours

23.

WOTF is LEAST LIKELY to be observed as an adverse effect of glyburide?

a)

Photosensitivity

b)

Hypersensitivity

c)

Thrombocytosis

d)

Rash and Pruritus

e)

Cholestatic jaundice

24.

WOTF statements about Precose is FALSE?

a)

It should be taken with the first bite of the meal

b)

it produces a 0.3-1% drop in A1c

c)

Its usual dose is 25 - 100 mg QD

d)

It is administered enterally

e)

It is a alpha-glucosidase inhibitor

25.

The chances of hypoglycemia resulting from therapy with glipizide are increased by all of the following EXCEPT:

a)

Prolonged exercise

b)

Increased caloric intake

c)

Concurrent ingestion of another oral hypoglycemic agent

d)

Old age

e)

Alcohol ingestion

26.

A pharmacist should question a prescription that calls for the parenteral administration of which of the following incretinomimetics products?

a)

Trulicity

b)

Rybelsus

c)

Tanzeum

d)

Ozempic

e)

Victoza

27.

Which of the following is NOT matched with the correct percent drop in A1c that it produces?

a)

Exenatide 0.33%

b)

Semaglutide 1.5%

c)

Liraglutide 0.7-0.8%

d)

Albiglutide 0.78%

e)

Dulaglutide 1.1%

28.

Glucophage is beneficial in WOTF situations? SATA

a)

Polycystic ovary syndrome

b)

Management of type 1 DM

c)

Management of type 2 DM

d)

Management of lymphoma

e)

Prevention of type 2 DM

29.

WOTF is LEAST LIKELY to be observed as a manifestation of metformin induced lactic acidosis?

a)

Myalgia

b)

Bradycardia

c)

Alkalosis

d)

Hypotension

e)

Hyperthermia

30.

Considering the MOA of insulin, WOTF is LEAST LIKELY to occur when insulin is administered to a diabetic patient?

a)

Autophosphorylation of insulin receptor substrate-1

b)

Inhibition of glycogenolysis

c)

Phosphorylation of mitogen-activated protein kinase

d)

Decrease production of ketone bodies

e)

Lipolysis

31.

All of the following are indications of insulin EXCEPT:

a)

Diabetic ketoacidosis

b)

Type 1 diabetes melitus

c)

Diabetes insipidus

d)

Gestational diabetes mellitus

e)

Hyperkalemia

32.

The long-acting insulin, insulin glargine, is a component of WOTF products? (SATA)

a)

Toujeo

b)

Tresiba

c)

Xultophy

d)

Lantus

e)

Levemir

33.

WOTF is NOT matched with the correct classification of its contents?

a)

Qtern: biguanide + SGLT-2 inhibitor

b)

Kombiglyze: DPP-IV inhibitor + biguanide

c)

Steglujan: DPP-IV inhibitor + SGLT-2 inhibitor

d)

Synjardy: Biguanide + SGLT-2 inhibitor

e)

Xigduo: SGLT-2 inhibitor + biguanide

34.

OBA: Insulin-protamine complex (NPH) is prepared by adding stoichiometric amounts of the _____ polypeptide protamine to regular insulin.

a)

Neurtral

b)

Negatively charged

c)

Valine rich

d)

Glycine rich

e)

Positively charged

35.

OBA: Insulin glargine was the first genetically engineered, long-acting insulin analog. In this molecule, the C-terminal end of the B chain is extended with two arginine residues and substitution of A21 asparagine by glycine; this increases the positive charge on the molecule and elevates the isoelectric point of insulin from pH 5.4 toward neutral (7.0). This, insulin glargine

a)

crystallizes in the subcutaneous injection site

b)

Ionized in the subcutaneous injection site

c)

Soluble in the subcutaneous injection site

d)

Freely soluble in the subcutaneous injection site

36.

OBA: Acarbose is a/an

a)

Bacterial secondary metabolite

b)

Synthetic compound

c)

Plant secondary metabolite

d)

Viral secondary metabolite

e)

Fungal secondary metabolite

37.

OBA: Gonadotropin-releasing hormone (GnRH) is a

a)

Decapeptide

b)

Octapeptide

c)

Pentapeptide

d)

Hexapeptide

e)

Nonapeptide

38.

OBA: Leuprolide acetate is a/an:

a)

Somatostatin analog

b)

Hexapeptide

c)

Synthetic nonapeptide

d)

Natural hormone

39.

OBA: Menotropins are natural products that are obtained from the:

a)

Urine of postmenopausal women

b)

Urine of pregnant woman

c)

Urine of pregnant cows

d)

Urine of pregnant horses

40.

OBA: WOTF statements concerning oxytocin is FALSE?

a)

Oxytocin is a natural hormone

b)

Oxytocin is a peptide of nine amino acids

c)

Oxytocin is a cyclic peptide

d)

Oxytocin is an antidiuretic hormone

e)

Oxytocin contains a ring that encompasses a disulfide bridge

41.

OBA: WOTF is BEST classified as an incretinomimetic agent?

a)

Byetta

b)

Creon

c)

Orinase

d)

Galvus

e)

GlucaGen

42.

OBA: Pancreatic polypeptide secretion from pancreatic F cells is absent in individuals with WOTF conditions?

a)

Zollinger-Ellison syndrome

b)

Cushing syndrome

c)

Von Willebrand disease

d)

Prader-Willi syndrome

e)

Addison's disease

43.

SATA: The binding of insulin to the insulin receptor-tyrosine kinase subtype results in the phosphorylation of WOTF?

a)

Mitogen-activated protein kinase

b)

Protein kinase B

c)

Phosphatidyl inositol-3 kinase

d)

Growth factor receptor-binding protein 2

e)

Phosphoenolpyruvate carboxykinase

44.

OBA: WOTF produces its antidiabetic effect by inhibiting sodium-glucose transporter-2?

a)

Saxagliptin

b)

Empagliflozin

c)

Amylin

d)

Rosiglitazone

e)

Acarbose

45.

OBA: WOTF is NOT matched with the correct percent A1c?

a)

Symlin 0.33%

b)

Victoza 0.78%

c)

Actos 1.0-1.5%

d)

Glucotrol 0.8%

e)

Diabeta 1.5-2.0%

46.

OBA: WOTF statements about Tradjenta is FALSE?

a)

It has a concentration-dependent capability to bind to plasma

b)

Food decreases its GI absorption and clinical effectiveness

c)

It has a half-life of about 131 hours

d)

In renal dysfunction, it is not necessary to adjust its dosage

e)

It is mostly excreted unchanged

47.

SATA: WOTF aids or causes insulin resistance?

a)

Obesity

b)

Leptin

c)

Increased intracellular cholesterol

d)

Decreased release of IL-6

e)

Elevated levels of serum free fatty acid

48.

OBA: WOTF statements about Glucagon is FALSE?

a)

It antagonizes insulin

b)

It inhibits lipolysis

c)

It promotes gluconeogenesis

d)

It is a counterregulatory hormone

e)

It can be produced in GI cells

49.

SATA: WOTF is an insulin preparation that is administered by inhalation?

a)

Afrezza

b)

InsuJet

c)

Linjeta

d)

Apidra

e)

Exubera

50.

OBA: A medical team wants to use a combination of a long-acting insulin and liraglutide to manage Mr. Zu's diabetes mellitus. WOTF should the pharmacist recommend?

a)

Bydureon

b)

Adlyxin

c)

Xultophy

d)

Toujeo

e)

Basaglar

51.

OBA: WOTF is NOT a physiologic effect of incretins?

a)

Increased glucose-dependent insulin secretion

b)

Decreased appetite

c)

Decreased gastric empyting

d)

Decrease glucagon effect

e)

Decreased satiety

52.

SATA: WOTF statements about Ozempic and Trulicity is FALSE?

a)

Both of them can be administered subcutaneously

b)

Ozempic can also be administered orally while Trulicity cannot

c)

Ozempic produces a smaller percent A1c reduction than Trulicity

d)

Ozempic is less likely than Trulicity to reduce cardiovascular risks

e)

Both of them are incretinomimetics

53.

WOTF is LEAST LIKELY to be observed as an adverse effect of Invokana?

a)

Hypotension

b)

UTI

c)

Weight loss

d)

Hydration

e)

Lightheadedness

54.

OBA: The adverse effects of Glucophage include all of the following EXCEPT:

a)

Lactic acidosis

b)

Weight Gain

c)

Dysgeusia

d)

Diarrhea

e)

Vitamin B12 depletion

55.

OBA: WOTF produces its antidiabetic effect by inhibiting dipeptidylpeptidase-IV?

a)

Nesina

b)

Diabinese

c)

Jardiance

d)

Glynase

e)

Admelog

56.

SATA: WOTF is NOT an adverse effect of sulfonylureas?

a)

Weight loss

b)

Hypoglycemia

c)

Diabetes insipidus

d)

Dizziness, Insomnia, Somnolence

e)

Photosensitivity and Hypersensitivity

57.

OBA: WOTF is NOT matched with its correct contents?

a)

Glyxambi: Empagliflozin + Linagliptin

b)

Qtern: Dapagliflozin + Saxagliptin

c)

Segluroment: (Ertugliflozin + Metformin)

d)

Oseni: Valdagliptin + Pioglitazone

e)

Soliqua: Insulin glargine + lixisenatide

58.

OBA: The structure of insulin can best be described as:

a)

a glycoprotein

b)

two peptide chains linked by disulfide bridges

c)

a single peptide chain with disulfide bridges

d)

a glycolipid

e)

a sulfonylurea

59.

OBA: In the preparation insulin glargine (Lantus) two arginine amino acids are added to the structure of insulin. The result of this is

a)

improved elimination

b)

decreased toxicity

c)

extended half-life due to precipitation at the injection site

d)

enhanced solubility

e)

increased protein binding

60.

OBA: In the preparation insulin detemir (Levemir) the lysine at position B29 of insulin is modified with

a)

aspartic acid

b)

tyrosine

c)

valine

d)

myristic acid

e)

serine

61.

The MOA of _____ involves the inhibition of alpha-glycoside hydrolase?

a)

Prandin

b)

Precose

c)

Starlix

d)

Avandia

e)

Amaryl

62.

OBA: Acarbose is an oligosaccharide obtained from?

a)

Digitalis purpurea

b)

Actinomyces utahensis

c)

Atropa bellabonna

d)

Pilocarpus jaborandi

e)

Penicillum chrysogenum

63.

WOTF statements about micronase is FALSE?

a)

It is less potent than Glynase

b)

It has a slower onset than Glynase

c)

It has a shorter half-life than Glynase

d)

It is metabolized primarily by CYP3A4

e)

About 50% of the administered dose is excreted via the urinary system

64.

The MOA of Nesina involves the inhibition of WOTF?

a)

Sodium-glucose transporter-2

b)

Deiodinase

c)

Dipeptidylpeptidase-IV

d)

Alpha-Glucosidase

e)

Peptidase

65.

A medical team wants to use a combination of ertugliflozin and sitagliptin to treat Mr. Sof's T2DM, WOTF products should the pharmacist recommend?

a)

Steglujan

b)

Jentadueto

c)

Kombiglyze

d)

Kazano

e)

Glucovance

66.

WOTF statements if TRUE? Amaryl is effective in the management of T2DM (SATA)

a)

Increases the release of insulin from the pancreas

b)

Decreases GI absorption of glucose

c)

Inhibits gluconeogenesis

d)

Increases insulin sensitivity

e)

Increases renal excretion of glucose

67.

WOTF statements about linagliptin is FALSE?

a)

Its plasma protein-binding capability is saturable

b)

It has a half-life of 31 hours

c)

It is minimally excreted through the kidneys

d)

food dose not significantly affect its absorption

e)

It is a weak inhibitor of cytochrome P450 3A4

68.

WOTF is NOT an action or effect of Actos?

a)

stimulation of PPAR-GAMMA

b)

Increased HDL

c)

Increase insulin sensitivity

d)

Increased triglyceride levels

e)

Decreased hepatic gluconeogenesis

69.

WOTF is MOST LIKELY to be reversed by increased exposure to sunlight and ingestion of Rocaltrol?

a)

Rickets

b)

Osteomalacia

70.

WOTF is an indication of octreotide?

a)

Acromegaly

b)

Dumping & carcinoid syndrome

c)

Esophageal Variceal Bleeding

d)

AIDs Related Diarrhea

e)

VIPomas (vasoactive intestinal peptide tumor)

71.

If you take a higher dose of vitamin D, WOTF could you experience?

a)

Headache and fatigue

b)

Hypercalcemia

c)

Polyuria, polydipsia, Proteinuria

d)

Nausea and vomiting

e)

Calcification of organs

72.

WOTF is a PTH derivative that can be beneficial in osteoporosis patient?

a)

Tymlos

b)

Forteo

c)

Hectorol

d)

Zemplar

e)

Natpara

73.

What's the effect of PTH of Forteo on calcium?

a)

Hypercalcemia

b)

****

74.

Bisphosphonates give you a _____ calcium plasma

a)

Increase

b)

Decrease

75.

WOTF is a non-nitrogen containing bisphosphonate?

a)

Fosamax

b)

Actonel

c)

Zometa

d)

Skelid

e)

Boniva

76.

MOA of bisphosphonates. WOTF involves:

a)

Inhibition of the synthesis of geranyl

b)

Decrease in protein prenylation

c)

Increase in osteoclastic function

d)

Increase in osteoblastic function

e)

Increase in PTH secretion

77.

A pharmacist should question a prescription that calls for the IV administration of WOTF?

a)

Fosamax

b)

Boniva

c)

Zometa

d)

Oxydronate

e)

Pamidronate

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