Nokea
Sodium-glucose-co-transporter-2 (SGLT-2) inhibitors were shown to reduce albuminuria and proteinuria by X%. What is X?
- A. 10--30
- B. 20-40
- C. 30-50
- D. 40-60
Correct Answer: C
Rationale: SGLT-2 inhibitors, used in type 2 diabetes, reduce albuminuria and proteinuria by 30-50%, as evidenced in trials like CREDENCE and DAPA-CKD. They lower glomerular hyperfiltration by inhibiting glucose and sodium reabsorption in the proximal tubule, decreasing intraglomerular pressure and thus protecting kidney function. This 30-50% reduction is significant in slowing chronic kidney disease (CKD) progression, a key benefit beyond glycemic control. Lower ranges (10-30%, 20-40%) underestimate this effect, while higher ranges (40-60%) may apply to specific subgroups but aren't the average. This renal protection makes SGLT-2 inhibitors a cornerstone in managing diabetic nephropathy, vital knowledge for physicians optimizing chronic disease outcomes.
You may also like to solve these questions
The following strategies can be used to help patients overcome the barriers and challenges faced in insulin therapy EXCEPT:
- A. Engage the patient in shared decision making
- B. Threaten the patient into adherence with insulin therapy
- C. Provide close supervision and follow-up when the patient is newly initiated on insulin therapy
- D. Offer measures to reduce weight gain through lifestyle and dietary advice, concomitant use of insulin with metformin, SGLT-2 inhibitors, GLPIRA
Correct Answer: B
Rationale: Insulin's hurdles yield to shared decisions, close watch, weight tricks, and goal setting empowering, not bullying. Threats tank trust and adherence, backfiring in chronic care where buy-in's king. Support beats scare tactics, aligning with diabetes' need for partnership, a strategy flop amid solid aids.
The following are true about education for insulin therapy EXCEPT:
- A. It can only be done by nurses
- B. Different subjects to be covered at different stages of insulin therapy
- C. Improves adherence to insulin therapy
- D. It takes time
Correct Answer: A
Rationale: Insulin teaching docs, educators join nurses, staged topics boost sticking, time and prep pay off; nurse-only's bunk. Nurses weave this chronic learning web, not solo.
Which of the following is FALSE about brain natriuretic peptide (BNP)?
- A. Plasma levels of BNP often correspond to the severity of underlying cardiac dysfunction and can provide relatively reliable prognostic information
- B. It is secreted in response by the atria and ventricles in response to stretching for increased wall tension
- C. Obesity, diuretics, ACE inhibitors, beta blockers, angiotensin receptor antagonists, and aldosterone antagonists can lead to falsely high levels of BNP
- D. Common conditions that may falsely elevate plasma BNP levels include age and significant renal dysfunction
Correct Answer: C
Rationale: BNP reflects cardiac dysfunction severity and wall tension response true. Age and renal dysfunction elevate BNP falsely true. However, obesity, diuretics, ACEi, beta blockers, ARBs, and MRAs lower BNP (obesity reduces secretion, drugs reduce tension), not raise it making this false. High BNP (>1,000 pg/mL) signals poor prognosis. This corrects BNP interpretation in chronic HF.
The pathophysiology of Asthma differs from COPD as:
- A. It is characterised by airflow limitation
- B. There is abnormal inflammatory response to exposure to noxious particles or gases
- C. The airflow limitation is reversible
- D. It is considered an obstructive lung disease
Correct Answer: C
Rationale: Asthma's twist reversible airflow block sets it apart from COPD's fixed choke. Both obstruct, inflame to triggers, but asthma's airways bounce back with puffs. Nurses spot this, a chronic split for treatment.
Spirometry is used to determine the severity of COPD and to monitor disease progression. This test measures
- A. The ratio of volume of air the patient can forcibly exhale in 1 second and forced vital capacity.
- B. The ratio of residual volume when patient has fully exhaled and forced vital capacity.
- C. The ratio of forced vital capacity and volume of air the patient can forcibly exhale in 6 seconds.
- D. The ratio of respiratory effort and respiratory rate.
Correct Answer: A
Rationale: Spirometry is the gold standard for COPD diagnosis and staging, measuring airflow obstruction. The ratio of forced expiratory volume in 1 second (FEVâ‚) to forced vital capacity (FVC) FEVâ‚/FVC quantifies limitation; a value <0.7 post-bronchodilator confirms COPD, with FEVâ‚ percentage grading severity (e.g., GOLD stages). Residual volume (RV) to FVC isn't standard in basic spirometry RV requires advanced testing (e.g., plethysmography) and reflects air trapping, not routine staging. FVC versus a 6-second exhale (FEV₆) approximates in some settings but isn't the clinical norm for COPD. Respiratory effort and rate aren't spirometric; they're observational. FEVâ‚/FVC's precision, per Deravin and Anderson (2019), tracks obstruction progression and guides therapy, making it foundational for assessing COPD's irreversible nature.