Nokea
Metformin is a primary choice of drug to treat hyperglycemia in type 2 diabetes because it:
- A. Substitutes for insulin usually secreted by the pancreas
- B. Decreases glycogenolysis by the liver
- C. Increases the release of insulin from beta cells
- D. Decreases peripheral glucose utilization
Correct Answer: B
Rationale: Metformin reduces hepatic glucose output (glycogenolysis), key in type 2 diabetes; it doesn't mimic insulin or increase release .
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Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels include:
- A. Dwayne hasn't been taking his carbamazepine because it causes insomnia.
- B. Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance.
- C. Dwayne was not originally prescribed the correct amount of carbamazepine.
- D. Carbamazepine is probably not the right antiseizure medication for Dwayne.
Correct Answer: B
Rationale: Carbamazepine induces its own metabolism (auto-induction), reducing levels over time.
Select the first choice drug for acute gout:
- A. Colchicine
- B. Indomethacin
- C. Allopurinol
- D. Dexamethasone
Correct Answer: B
Rationale: Indomethacin, an NSAID, is the first-line treatment for acute gout due to its rapid anti-inflammatory action; colchicine is an alternative, while allopurinol is for prophylaxis.
Glibenclamide and chlorpropamide:
- A. Are well absorbed in Gl tract
- B. Increase release of endogenic insulin by pancreatic beta cells
- C. Is used as hormone replacement therapy for diabetes mellitus
- D. Is for internal use only
Correct Answer: B
Rationale: Glibenclamide and chlorpropamide increase endogenous insulin release from beta cells.
You need to infuse 1,200 mL of a medication over 6 hours with a drop factor of 10 gtt/mL. Calculate the flow rate in drops per minute.
- A. 30 gtt/min
- B. 33 gtt/min
- C. 40 gtt/min
- D. 50 gtt/min
Correct Answer: B
Rationale: Flow rate = (1,200 mL 10 gtt/mL) ÷ (6 60) = 12,000 ÷ 360 = 33.33 gtt/min, rounded to 33 gtt/min (same as Q4).
Which of the following is the indication for glucocorticoid prescribing?
- A. Cataract
- B. Prevention of respiratory distress
- C. Hypofunction of thyroid gland
- D. Hypocalcemia
Correct Answer: B
Rationale: Glucocorticoids prevent respiratory distress, such as in neonatal respiratory distress syndrome.