Exam #7 Unit 21

Which of the following choices is recommended for the treatment of hypoglycemia if the patient is unconscious and lacks a swallowing reflex? Answers: a. Intravenous dextrose (50%) b. Cake icing c. Fruit juice d. Glucose gel

Intravenous dextrose (50%)

Which of the following statements is true of metformin? Answers: a. Lactic acidosis is a common, but benign side effect. b. It is a member of the -glucosidase inhibitor group of antidiabetic agents. c. It decreases hepatic and peripheral insulin sensitivity, resulting in increased hepatic glucose production. d. It lowers blood glucose but, used alone, does not produce hypoglycemia.

It lowers blood glucose but, used alone, does not produce hypoglycemia

Diabetes is the major cause of blindness in adults. Answers: True False

True

Contributing factors to gangrene in the extremities of diabetic patients include: Answers: a. poor eyesight. b. poor circulation. c. reduced sensation in the extremities. d. all of the above. e. none of the above.

all of the above

Which of the following types of medications can react with sulfonylureas to produce a decrease in serum glucose levels? Answers: a. Penicillin b. Aspirin c. Methotrexate d. Mepivacaine

Aspirin

Which of the following statements is true of pramlintide (Symlin)? Answers: a. It is an oral dipeptidyl-peptidase-4 (DPP-4) inhibitor. b. Use leads to decreased caloric intake and potential weight loss. c. It is approved for type I diabetes as an adjunct treatment in patients who use mealtime insulin therapy and who have failed to achieve desired glucose control despite optimal insulin therapy. d. Both a and b are true. e. Both b and c are true.

Both b and c are true

Which of the following statements is true regarding systemic complications of diabetes? Answers: a. Hypolipidemia is common in patients with diabetes. b. Neuropathy is a complication of diabetes. c. Gangrene can occur in peripheral extremities. d. Both a and b are true. e. Both b and c are true.

Both b and c are true

The hemoglobin A1C level should be more than 50% to reduce the incidence and progression of microvascular complications in patients with diabetes. Answers: True False

False

Which oral antidiabetic agent requires administration for 6 to 14 weeks to achieve maximal therapeutic effect? Answers: a. Glimepiride b. Rosiglitazone c. Tolbutamide d. Metformin e. Exenatide

Rosiglitazone

Which form of insulin has a faster onset of action as a consequence of exchanging two amino acids in its structure? Answers: a. NPH insulin b. Lispro insulin c. Protamine zinc insulin d. Prompt zinc insulin e. Pork insulin

Lispro insulin

The primary goal of treating diabetes is to maintain hemoglobin A1C levels: Answers: a. at a level of 40%. b. as high as possible. c. at zero. d. as close to normal as possible (<7%).

as close to normal as possible (<7%).

Type I and type II diabetics are at greater risk for caries. This risk is attributed to the higher concentration of glucose in their saliva. Answers: a. Both statements are true. b. Both statements are false. c. The first statement is false; the second statement is true. d. The first statement is true; the second statement is false.

The first statement is true; the second statement is false.

Which of the following statements is true concerning oral surgical procedures for the adult patient with diabetes? Answers: a. The procedure should be performed after lunch, and the patient has taken regular diabetes medication. b. The procedures should be performed to 2 hours after the patient has eaten a normal breakfast and has taken regular antidiabetes medication. c. The procedure should be performed before breakfast, and the patient should have taken regular diabetes medication. d. The procedure should be performed after lunch, and the patient should skip regular diabetes medication.

The procedures should be performed to 2 hours after the patient has eaten a normal breakfast and has taken regular antidiabetes medication

Which of the following statements is the mechanism of action of nonsulfonylurea secretagogues such as repaglinide (Prandin) and nateglinide (Starlix)? Answers: a. They increase hepatic and peripheral insulin sensitivity, resulting in decreased hepatic glucose production. b. They are competitive, reversible inhibitors of GI tract enzymes: intestinal -glucosidase and pancreatic -amylase. c. They increase the insulin sensitivity of adipose tissue, skeletal muscle, and the liver. d. They bind to adenosine triphosphate (ATP) sensitive potassium channels on beta cells and increase insulin resistance.

They bind to adenosine triphosphate (ATP) sensitive potassium channels on beta cells and increase insulin resistance.

Insulin resistance develops because of prolonged _____ and resulting _____. Answers: a. hyperglycemia; hyperinsulinemia b. hypoglycemia; hypoinsulinemia c. hypoglycemia; hyperinsulinemia d. hyperglycemia; hypoinsulinemia

hyperglycemia; hyperinsulinemia

The most common adverse reaction associated with any insulin product is: Answers: a. intestinal stasis. b. hypoglycemia. c. hyperglycemia. d. bradycardia.

hypoglycemia

Acarbose (Precose) slows the breakdown of ingested carbohydrates so that postprandial hyperglycemia is reduced. Answers: True False

True

More people are diagnosed with type II diabetes in the United States than are diagnosed with type I diabetes. Answers: True False

True

The glycosylated hemoglobin test more accurately measures the patient's overall serum glucose control than the serum glucose test. Answers: True False

True

More and more cases of type II diabetes are being reported in persons younger than 20 years because of: Answers: a. environmental changes and global warming. b. an increased incidence of autoimmune disorders. c. a much more sedentary lifestyle and lack of exercise. d. illicit use of legal drugs.

a much more sedentary lifestyle and lack of exercise.

The mechanism of action of the sulfonylureas includes _____ of the release of insulin from the beta cells of the pancreas, _____ of glucose from the liver and serum glucagon levels, and a(n) _____ in the sensitivity of the target tissues to insulin. Answers: a. inhibition; reduction; reduction b. stimulation; increase; reduction c. stimulation; reduction; increase d. stimulation; increase; increase e. stimulation; reduction; reduction

stimulation; reduction; increase

The U.S. Food and Drug Administration (FDA) recommends checking serum alanine aminotransferase (ALT) levels before starting therapy with _____ and periodically thereafter. Answers: a. -glucosidase inhibitors b. thiazolidinediones c. nonsulfonylurea secretagogues d. biguanides

thiazolidinediones

Human insulin is made from pork insulin by: Answers: a. gene splicing in Escherichia coli. b. recombinant DNA synthesis. c. transpeptidation. d. transamination. e. glycosylation.

transpeptidation

Which of the following symptoms of hypoglycemia can be explained by glucose deprivation of the brain rather than the adrenal glands: (1) blurred vision, (2) incoherent speech, (3) sweating, (4) tachycardia? Answers: a. 1, 2 b. 1, 2, 3, 4 c. 3, 4 d. 1, 2, 3

1, 2

Which of the following oral antidiabetic agents is a bile-acid sequestrant used to lower low-density lipoprotein (LDL) cholesterol? Answers: a. Colesevelam b. Glucagon c. Pramlintide d. DPP-4s

Colesevelam