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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A 43-year-old woman with Type-2 diabetes has been taking insulin with meals as well as metformin. Her blood glucose remains poorly controlled. Her doctor prescribes an additional drug, which is an analog of an endogenous peptide that enhances insulin secretion. What drug is this?
- A. Exenatide
- B. Glipizide
- C. Miglitol
- D. Pramlintide
Correct Answer: A
Rationale: Exenatide, a GLP-1 analog, enhances insulin secretion in a glucose-dependent manner, aiding type 2 diabetes control.
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.
Data in the electronic health record that the provider reviews prior to a patient encounter varies with the clinic setting. In an urgent care clinic, the provider should review:
- A. The patient's current diagnosis and history
- B. Drugs the patient is currently taking
- C. Any recent previous encounter for the same problem as this visit and what was done
- D. All of the above
Correct Answer: D
Rationale: In urgent care, reviewing diagnosis, medications, and prior encounters ensures comprehensive care.
Plasma concentration of drug at time 0 is 96(g/ml). If t½ is 2 hours concentration in plasma at 10 hours will be
- A. 48
- B. 24
- C. 12
- D. 3
Correct Answer: D
Rationale: In first-order kinetics, the concentration halves every half-life (t½ = 2 hours). At 10 hours (5 half-lives), 96 → 48 → 24 → 12 → 6 → 3 µg/ml.
In the blood glucocorticoids cause:
- A. Increase amount of eosinophles
- B. Lymphocytosis
- C. Increase amount of neutrophils
- D. Increase amount of basophiles
Correct Answer: C
Rationale: Glucocorticoids increase neutrophils while decreasing eosinophils and lymphocytes in the blood.