Studied by 3 peopleAll of the following are known side effects of corticosteroid use EXCEPT
increased CRP
This class of drugs is known to displace folate.
chemotherapeutics
How many kilocalories are in 4 oz of 40-proof schnapps?
128 kcal
Which indicator of protein status has the longest half-life?
Albumin
Low albumin in a critically ill patient is caused by
illness, injury, and inflammation.
Which medication class primarily functions to increase insulin secretion?
Sulfonylureas
Chylomicrons are synthesized in the:
enterocyte
In what form is dietary fat absorbed from the lumen of the intestine?
Micelle
Apolipoprotein B (apoB) is contained in
LDL cholesterol
If you were teaching a patient to reduce the saturated fat in his diet, which of the following would you instruct him to avoid?
Coconut and palm oil
Out of the terms below, which is correctly defined?
Pharmaceutical phase refers to the physical properties of the drug
What might be a cause for weight gain when taking a certain drug?
Serotonin receptor is blocked, which is associated with satiety.
A person taking Digoxin to treat heart failure should avoid which of the following foods/drinks that contains glycyrrhiza?
Black Licorice
Which of the following is an effect of fluid status on drug distribution in the body?
Edema or fluid retention in the body necessitates that drugs be distributed to a larger volume, so dosage may need to be increased
Which of the following is not true about a DNI?
A drug could cause the same impact alone
Why is natural licorice a concern for some patients?
Triggers cortisol release causing Na reabsorption and retention
Coumadin (warfarin) acts against which vitamin?
Vitamin K
Which of the following raises drug blood levels through inhibiting metabolism of antihyperlipidemic HMG CoA Reductase inhibitors by cytochrome P450 3A4 isoenzymes located in hepatic cells and enterocytes.
Grapefruit
What is the difference between Furosemide (Lasix) and Spironolactone?
Furosemide increases excretion of potassium (K-wasting) while Spironolactone increases reabsorption of potassium (K-sparing).
An RDN sees a patient who is taking Zocor, a statin, to manage their hyperlipidemia. The patient describes a typical breakfast to the RDN of a glass of cranberry juice, a large banana, a large grapefruit, a piece of toast with jelly, and two eggs scrambled with spinach. Which drug-nutrient interaction should the RDN warn the patient of and why?
This breakfast contains grapefruit. Certain compounds in grapefruit inhibit enzymes in the intestine that are responsible for breaking down Zocor leading to higher toxicity of the drug.
Which of the following are all effects of corticosteroids?
Weight gain, calcium depletion via reduced absorption and increased excretion, edema, decreased sodium excretion
What type of drug may put a patient at higher risk for osteoporosis?
Proton-Pump Inhibitor
Monoamine oxidase inhibitors (MAOI) cause which of the following when high levels of tyramine are consumed?
Vasoconstriction
Which of the following categories of food-drug interactions describe the physical and chemical properties of a drug?
Pharmaceutical phase
Which drug is matched incorrectly with its drug class?
Furosemide - HMG - CoA Reductase Inhibitors
A pt is receiving clonazepam, a sorbitol-containing medication. What symptom is the pt most likely to report?
diarrhea
Which of the following lab values could correctly indicate a pre-DM diagnosis?
Fasting plasma glucose 100 mg/dL to 125 mg/dL
Which of the following is a characteristic of Type 1 Diabetes Mellitus (T1DM)?
Autoimmune attack on the beta cells of the pancreas
Which describes T1DM?
Pancreas produces little or no insulin
Which of the following statements best describes T2DM?
Insulin resistance, pancreas produces sufficient insulin
Which of the following is true regarding Type 1 Diabetes Mellitus but not Type 2?
75% of people develop this type before age 30
Which of the following category of diabetes is also referred to as "immune-mediated" diabetes?
Type 1 Diabetes Mellitus
Type 1 Diabetes is due to:
Destruction of beta-cells, leading to insulin insufficiency
Which of the following does not contribute to hyperglycemia?
decreased glucagon secretion
How is gestational diabetes related to future risk of developing DM?
Women who have been diagnosed with gestational diabetes have a 35% to 60% chance of developing diabetes in the next 10-20 years.
What is the most accurate differentiation between Type 1 and Type 2 Diabetes Mellitus?
T1DM occurs when the body does not make enough insulin while T2DM occurs when the body cannot use insulin properly.
Which is NOT associated with Type 1 Diabetes?
Obesity
Which is NOT true of type 2 diabetes?
pancreas produces little or no insulin
How many total people have been diagnosed with diabetes in the United States?
34.2 million
Prevalence of Diabetes Mellitus differs on ethnicity, in which group is prevalence the highest?
American Indian/Alaska Native
Type 1 diabetes accounts for ___ percent of total diabetes diagnoses, and the onset of symptoms is ___.
5-10%, rapid
Which of the following are TRUE regarding the differences in Type 1 Diabetes Mellitus and Type 2 Diabetes Mellitus?
T1DM is an autoimmune disease and T2DM is a strong association of family history
Which of the following characteristics is FALSE regarding Type 1 Diabetes Mellitus?
Occurs only with old age
What does the lab value, "A1C" measure and what is the "target" value for a pt with DM?
D. A1C measures average blood glucose levels over a span of 3 months with a target value of 7%.
The presence or absence of which of the following in the blood can differentiate between T1 and T2DM?
C-peptide
Which of the following is NOT a symptom of Diabetes Mellitus (Types 1 or 2)?
Hypoacidosis
Which of the following is NOT an insulin-dependent tissue?
Adipose
What is another way to write Glycosylated hemoglobin?
A1C
What is the normal blood glucose range for fasting blood glucose?
<100
What are the criteria for the diagnosis of diabetes?
Plasma glucose >200 mg/dL
When can you expect to detect glucose in the urine?
when blood glucose levels are >250 mg/dL
Which statement is not true regarding glycosylated hemoglobin?
It only reflects blood glucose levels over a few days
Which of the following non-insulin dependent tissues is not at risk for microvascular damage during times of high blood glucose?
Red blood cells
Which of the following is true about the diagnostic criteria for DM?
DM1 and DM2 have the same criteria for dx
Which of the following is NOT a diagnostic criteria for diabetes?
No classic symptoms of hyperglycemia or hyperglycemic crisis, but a random plasma glucose ≥100 mg/dL
Which of the following A1C ranges indicates pre-DM?
5.7% to 6.4%
Which of the following conditions cause a rapid spike of BG in the morning following hypoglycemia in the middle of the night?
Somogyi Effect
Which hepatic receptor expression is reduced when a high saturated fat diet is consumed?
B-100
Which of the following is not considered a type of cardiovascular disease?
Angina
Which medication used to treat CVD is generally most effective at lowering LDL levels?
HMG CoA Reductase Inhibitors (statins)
Endogenous cholesterol metabolism is best described by which of the following statements:
The hepatic B100 receptor removes LDL from circulation
Which of the following is not included in the group of diseases that is CVD?
Diabetes
Which category is NOT one of Life's Simple 7 as related to CVD?
stress
Which Lipoprotein is made in the liver?
VLDL
What would be included in medical management for CVD?
Statins, Resins, Nicotinic acid, Fibrates
Which of the following is the umbrella term for a group of diseases involving networks of blood vessels around the heart?
CVD
Which is not one of the 3 central emphases of Life's simple 7?
Only focus on treatment of hospitalized CVD patients. (Life's simple 7 is a concept of cardiovascular health representing a new focus for the AHA. It emphasizes population level health promotion because healthy lifestyles in all domains are uncommon throughout the US population.)
Chylomicrons are primarily composed of what?
Dietary triglycerides
What is the definition of Atherosclerosis?
Development of fatty streaks in arteries which develop into fibrous plaques and decrease blood flow
What is the difference between mortality and morbidity?
mortality is the underlying cause of death and morbidity is the incidence of disease
In 2019, what was the largest factor contributing to CVD mortality?
High blood pressure
Which of the following is not a side effect of bile acid sequestrants?
Increased risk of diabetes
If a patient gets their blood glucose levels checked before breakfast each morning and they are consistently over 200 mg/dl so you decide to check their levels each night between 2 and 4AM, and they are around 175 mg/dl, what is likely the cause?
Dawn Phenomenon - the patients' blood glucose levels are constantly rising throughout the night due to the body's natural hormones.
Which of the following is true regarding the second phase of insulin's role in the body?
It is sustained until normal glycemia returns
What is the target A1C goal?
<7% (53 mmol/mol)
Which of the following factors would indicate a less stringent management approach for A1C?
An unmotivated, non adherent patient that is incapable of self care
Which of the following is NOT a characteristic of basal insulin?
represents what is known as the "burst" of insulin
What describes the Somogyi effect?
Secretion of counter regulatory hormones yields hepatic glucose production
Which of the following is considered a long lasting insulin?
Lantus®
which of the following happens with the Dawn phenomenon but not the Somogyi effect?
The patients blood sugar rises slowly the entire night resulting in hyperglycemia upon waking
The "onset" of insulin action is best defined as
time it takes before the insulin takes effect
What is not the effect of insulin as an anti-catabolic hormone?
Decrease muscle protein synthesis
If your patient is hyperglycemic in the morning, what should be done first?
Check BG at 3am for 2-3 days in a row to determine if there is a pattern before changing insulin routine
Which of the following is an effect of insulin?
Decreases production of glucose from non-sugar substances in the liver, inhibiting gluconeogenesis
What is an acute complication regarding insulin?
Hypoglycemia occurs when injecting too much insulin before bed or not eating enough before bed with the insulin, causing blood sugar levels to lower. This causes a release in hormones that raise blood sugar levels in the morning.
Which type of insulin would be the best to be taken before eating a meal to account for food eaten?
Humalog
Which of the following type of insulin is described as "peakless"?
Lantus
Which of the following is a short acting insulin with a peak time of 2-5 hours and covers insulin needs for meals eaten within 30-60 minutes?
Regular (humulin, novolin)
This description of insulin is rapid- or short-acting and used to match the carbohydrate consumed or elevated blood glucose
Bolus
Which of the following is not an anabolic or anti-catabolic role of insulin?
Increased proteolysis
Insulin is anabolic hormone, meaning it "builds things up." Which of the following is NOT a function of this anabolic nature?
Increased lipolysis
Which of the following insulin is not rapidly acting?
Lente
What is the primary medication used in DM2 and briefly explain how it works.
Biguanides - Metformin: It decreases hepatic glucose production. As a biguanides class, it decreases glucose output and insulin resistance.
Which of the following T2DM medications delay gastric emptying (increase the time food spends in the stomach)?
DPP-4 Inhibitors
Which of the following are examples of injectable T2DM medications?
Amylin (suppresses appetite and exerts a positive effect on the control of body weight) and Byetta (not the same as insulin and should be used in conjunction with sulfonylurea, TZD, or metformin)
What is the consequence of insulin resistance on skeletal muscle?
Decreased glucose uptake
What is the primary function of SGLT-2 Inhibitors?
Blocks glucose reabsorption by the kidney
Which of the following statements is false regarding the regulation of blood glucose?
The release of insulin from the pancreas causes an increase in glucose production from the liver.
Which of the following enhances the responsiveness of the liver, muscle, and fat cells' to insulin?
TZDs
Which of the following oral agent decreases hepatic glucose output?
Biguanide
Note
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