Question 1

As a physician assistant,you have the responsibility to educate patients and families regarding diabetes treatment.When you have a patient taking a biguanide,what specific information should you share regarding the intake of alcohol?

Accepted Answer

A) Drinking alcohol will increase the risk of hyperglycemia. 
B) Drinking alcohol will increase the risk of hypoglycemia. 
C) Drinking alcohol will have no effect. 
D) Drinking alcohol is not tolerated while taking a biguanide.

Question 2

What instructions would you give to a newly diagnosed diabetic patient you have just started on insulin?

Accepted Answer

A) Measure blood glucose every morning and report to you every 2 weeks. 
B) Measure blood glucose twice daily and report to you weekly. 
C) Measure blood glucose three times daily and report to you weekly. 
D) Measure blood glucose every other day and report to you every 2 weeks.

Question 3

As a surgical physician assistant student,you are taking care of a patient with T2DM who is undergoing an emergency appendectomy.She is currently maintained on the meglitinide repaglinide (Prandin).You speak to the anesthesiologist,who informs you the patient will be started on insulin before surgery.Based on this information,what will you expect to occur in regards to her Prandin dosage?

Accepted Answer

A) Discontinued Prandin 
B) Increased dose of Prandin by double 
C) Decreased dose of Prandin by one-half 
D) No change in the Prandin dose because the insulin will self-regulate

Question 4

You are currently caring for a 55-year-old male who was diagnosed with diabetes 9 months ago.You would consider him to be in glycemic control when his HbA1c is at which of the following levels:

Accepted Answer

A) 6%. 
B) 8%. 
C) 10%. 
D) 12%.

Question 5

According to the American Diabetes Association (ADA)algorithm regarding use of insulin for type 2 diabetes mellitus (T2DM),if a patient's HgbA1c is not around 7% at the end of 3 months of therapy,which of the following actions would be considered appropriate?

Accepted Answer

A) Continue current insulin dose;recheck HbA1c in 1 month 
B) Continue current insulin dose;recheck HbA1c in 3 months 
C) Completely revamp insulin dose 
D) Continue with same insulin but increase all doses,a.m.and p.m. 
E) Continue with same insulin but decrease all doses,a.m.and p.m.

Question 6

What is the main reason that metformin does not usually cause hypoglycemia in patients with T2DM?

Accepted Answer

A) Metformin stimulates insulin release from pancreatic beta cells. 
B) Metformin decreases glucose production in the liver. 
C) Metformin suppresses glucagon production. 
D) Metformin slows inactivation of peptide 1 and dipeptidyl-peptidase 4.

Question 7

When treating a patient with T1DM for severe hypoglycemia,which condition is considered a contraindication for administering glucagon?

Accepted Answer

A) Pheochromocytoma 
B) Acute pancreatitis 
C) History of gastroparesis 
D) Cirrhosis 
E) Congestive heart failure

Question 8

You are caring for a 55-year-old male who is 5'9" and 225 lbs and was recently diagnosed with T2DM.He has no other comorbidities at this time and is on no medication.Today's visit is to discuss your suggested management of his problem.His recent HbA1c level was 6%.Based on this brief history,which of the following treatments are you most likely to suggest for this patient?

Accepted Answer

A) Begin oral hypoglycemic metformin 
B) Begin with two different oral hypoglycemics 
C) Start immediately on insulin,short and long acting 
D) Treat with diet only 
E) Begin oral hypoglycemic sulfonylureas

Question 9

The primary physiological problem in T2DM includes:

Accepted Answer

A) Destruction of pancreatic beta cells. 
B) Secondary disease such as pancreatitis. 
C) Insulin resistance in tissues. 
D) Decreased insulin production.

Question 10

The incidence of T2DM in the pediatric and adolescent population has been dramatically rising.Knowing this,what is the best practice for treating this population when diet,exercise,and metformin treatment have been unsuccessful?

Accepted Answer

A) Add chlorpropamide 
B) Add insulin 
C) Add a sulfonylurea 
D) Refer to a pediatrician 
E) Refer to a pediatric endocrinologist

Question 11

You have been caring for a patient with T2DM and have decided to begin insulin therapy.What general rule is important to remember when prescribing insulin to a T2DM patient?

Accepted Answer

A) A T2DM patient should never be given insulin. 
B) Insulin dose should be lower than dose given to a T1DM patient. 
C) Insulin dose should be higher than dose given to a T1DM patient. 
D) T2DM should only receive fast-acting insulin. 
E) T2DM should only receive long-acting insulin.

Question 12

The primary cause of type 1 diabetes mellitus (T1DM)is:

Accepted Answer

A) Overproduction of insulin by the pancreatic beta cells. 
B) Overproduction of insulin by pancreatic alpha cells. 
C) Overdestruction of insulin by pancreatic beta cells. 
D) Overdestruction of insulin by pancreatic alpha cells.

Question 13

The primary mechanism of action for alpha-glucosidase inhibitors includes:

Accepted Answer

A) Increased production of insulin. 
B) Increased production of glucagon. 
C) Decreased absorption of carbohydrates in the GI tract. 
D) Decreased gastric emptying.

Question 14

Which antihypoglycemic medication has restricted use due to an increase in U.S.Food and Drug Administration (FDA)-reported cardiovascular events?

Accepted Answer

A) biguanide (Metformin) 
B) rosiglitazone (Avandia) 
C) acarbose (Precose) 
D) sitagliptin (Januvia)

Question 15

Which major organ is primarily involved in the etiology of T2DM?

Accepted Answer

A) Pancreas 
B) Liver 
C) Heart 
D) Kidney

Question 16

You have just evaluated a patient that has been recently diagnosed with T2DM.You choose to start this patient on metformin (Glucophage).Which instruction is most appropriate to give this patient regarding dosing and instructions?

Accepted Answer

A) Take 500 mg once daily in the evening. 
B) Take 850 mg once daily in the evening before eating. 
C) Take 850 mg once daily in the evening after eating. 
D) Take 500 mg twice daily with meals. 
E) Take 500 mg twice daily before meals.

Question 17

An established patient in your practice is coming to see you for ongoing treatment of T2DM.She is a 59-year-old female who is currently on repaglinide (Prandin)0.5 mg daily.However,her recent HbA1c level was 9%.What changes,if any,would you make in her medication dose at this time?

Accepted Answer

A) No changes at this time;wait and check HbA1c in 2 weeks. 
B) Decrease her dose to 0.25% daily. 
C) Increase her dose to 3 mg daily in divided doses. 
D) Increase her dose to 4 mg daily in divided doses. 
E) Increase her dose to 6 mg in the morning.

Question 18

The GLP-1 agonist exenatide (Byetta)is administered in which manner?

Accepted Answer

A) 5 mg po twice daily 30 minutes prior to morning and evening meals 
B) 5 mg po twice daily 60 minutes prior to morning and evening meals 
C) 5 mcg SQ twice daily 30 minutes prior to morning and evening meals 
D) 5 mcg SQ twice daily 60 minutes prior to morning and evening meals

Question 19

What percentage of Americans older than age 20 is at risk for complications from diabetes?

Accepted Answer

A) 25% 
B) 35% 
C) 55% 
D) 75%

Question 20

Which of the following is considered a common side effect of sulfonylureas?

Accepted Answer

A) Occasional intolerance to heat 
B) Headaches 
C) Constipation 
D) Weight gain 
E) Weight loss

Exam 13: Drugs Used in the Treatment of Diabetes Mellitus

As a physician assistant,you have the responsibility to educate patients and families regarding diabetes treatment.When you have a patient taking a biguanide,what specific information should you share regarding the intake of alcohol?

What instructions would you give to a newly diagnosed diabetic patient you have just started on insulin?

You are currently caring for a 55-year-old male who was diagnosed with diabetes 9 months ago.You would consider him to be in glycemic control when his HbA1c is at which of the following levels:

According to the American Diabetes Association (ADA) algorithm regarding use of insulin for type 2 diabetes mellitus (T2DM) ,if a patient's HgbA1c is not around 7% at the end of 3 months of therapy,which of the following actions would be considered appropriate?

What is the main reason that metformin does not usually cause hypoglycemia in patients with T2DM?

When treating a patient with T1DM for severe hypoglycemia,which condition is considered a contraindication for administering glucagon?

The primary physiological problem in T2DM includes:

The incidence of T2DM in the pediatric and adolescent population has been dramatically rising.Knowing this,what is the best practice for treating this population when diet,exercise,and metformin treatment have been unsuccessful?

You have been caring for a patient with T2DM and have decided to begin insulin therapy.What general rule is important to remember when prescribing insulin to a T2DM patient?

The primary cause of type 1 diabetes mellitus (T1DM) is:

The primary mechanism of action for alpha-glucosidase inhibitors includes:

Which antihypoglycemic medication has restricted use due to an increase in U.S.Food and Drug Administration (FDA) -reported cardiovascular events?

Which major organ is primarily involved in the etiology of T2DM?

You have just evaluated a patient that has been recently diagnosed with T2DM.You choose to start this patient on metformin (Glucophage) .Which instruction is most appropriate to give this patient regarding dosing and instructions?

An established patient in your practice is coming to see you for ongoing treatment of T2DM.She is a 59-year-old female who is currently on repaglinide (Prandin) 0.5 mg daily.However,her recent HbA1c level was 9%.What changes,if any,would you make in her medication dose at this time?

The GLP-1 agonist exenatide (Byetta) is administered in which manner?

What percentage of Americans older than age 20 is at risk for complications from diabetes?

Which of the following is considered a common side effect of sulfonylureas?