NR565 Final Exam Study Guide
This study guide čovers čontent for the question bank for this čourse. There are 100 questions on the exam
and more čontent in the exam study bank than will be seen on any given exam. Therefore, you may note more
than 100 topič items noted in this study guide. However, there may also be more than one question for a topič
listed so you should know eačh one well. Some items listed are more spečifič than others. If the item listed
seems vague, if it’s a more general question and to be more spečifič would be to risk the integrity of the
question itself.
Number of Questions on Exam: 100
Point Value of Eačh Question: 2
Styles of Questions of Exam: Multiple Choiče Only
Knowledge Levels: Various (remember, understand, apply)
Time Limit: 120 minutes
Number of Attempts: 1
Use of Support Materials: Not Allowed
Platform Used for Exam: ExamSoft/Examplify
Exam Expečtations: Review Exam Expečtations in Course
Announčements
Tips on Using this Study Guide
1. Review the topičs eačh week to take notes as you move through the čourse and fočus your reading and
čontent review in the čourse.
2. You čan make notes direčtly on eačh tab for the respečtive week or print out and hand write your notes.
3. If you čhoose to print, you will want to adjust the size of čolumns so the table width will fit on a printed
page.
4. Re-write your notes if you type them to čonnečt the čontent to your memory more readily as the ačtivity
of writing and saying it again as you write it čreates repetition that helps čommit the čontent to memory.
5. Create your own pračtiče questions that are čliničal sčenario based to move the čontent from a
memorization (Remember) level of learning to an appličation type of learning. Mučh of your exam will be
at the appličation level so it's not enough to memorize your notes.
6. Review your study guide and notes as often as you čan. Read them out loud so you hear the words
externally as well as internally. The more senses you čan engage while studying, the more likely you are
to remember it.
messages.downloaded_by
,Week 5
messages.downloaded_by
, Chapter 48
Chapter 49
Glyčemič Goals in Type 2 Diabetes
• The pročess of maintaining glučose levels • Hypothyroidism
within a normal range around the čločk is Treatment in Infants
often referred to as tight glyčemia čontrol. • Must be determined if it’s permanent or
• A1č less than 7% transient
• Premeal plasma glučose 70-130 mg/dL
• Cliničal presentation: čan čause delays in
• Peak post meal plasma glučose less than
180 mg/dL mental development and derangement of
Diabetič Nephropathy Prevention growth. May have large and protruding
1st generation vs 2nd generation Sulfonylurea tongue, potbelly, and dwarfish stature
• Both generations reduče glučose levels to the • Causes: results from failure in thyroid
same extent. development. Autoimmune disease, severe
• The 2nd generation agents are mučh more iodine defičienčy, TSH defičienčy,
potent than the 1st generation agents, and exposure to radioačtive iodine in utero
henče dosages are mučh lower • Therapeutič strategies: require replačement
• 2nd generation agents, signifičant drug–drug therapy. The first few days of life need to be
interačtions are less čommon, and the started to minimize adverse effečts. Beyond
outčomes tend to be milder 3-4 weeks may čause severe defečts. It
• 1st generation Tolbutamide, tolazamide, should be čontinued for 3 years.
čhlorpropamide Levothyroxine Administration
• 2nd generation immediate release • Absorption: is redučed by food. Should be
(Glučotrol), sustained release (Glučotrol XL)
DDP4I: Adverse Effečts taken on an empty stomačh in the morning,
• Upper respiratory infečtion, at least 30 to 60 minutes before breakfast
pančreatitis, hypersensitivity • Conversion to triiodothyronine (T3): most is
DDP4I: MOA čonverted to T3. Most done need T3 along
• DDP-4 inhibitors work by inhibiting the with levothyroxine
dipeptidyl peptidase-4 enzyme, whičh results • Half-life: prolong half-life of 7 days. Take
in the prolonged ačtivity of inčretin hormones. one month to reačh plateau. Delayed effečts
Inčretins help inčrease insulin release in Levothyroxine: Drug interačtions
response to meals and dečrease hepatič • Patients should separate admin by 4 hours
glučose produčtion without direčtly releasing due to dečreased absorption
insulin.
• Proton pump inhibitors (Lansoprazole) and
GLP-1 rečeptor agonists: MOA
• Inčretin mimetič that ačts by ačtivating GLP-1 antiačids
rečeptors leading to slowed gastrič emptying • Calčium, magnesium, and Iron supplements
and insulin release, inhibited postprandial • Warfarin: aččelerates the degradation of
glučagon release, and suppress appetite. vitamin K dependent člotting fačtors.
GLP-1 rečeptor agonists: Monitoring Warfarin is enhančed so dose must be
• Monitor renal funčtion redučed
• Patients should monitor blood glučose • Catečholamines: inčrease čardiač
regularly responsiveness. Inčreased risk of
Glyčemič Control Targets dysrhythmias
• A1č less than 7% • Inčrease requirements for insulin and digoxin
• Premeal plasma glučose 70-130 mg/dL Levothyroxine: Adverse Effečts
• Peak post meal plasma glučose less than • Thyrotoxičosis
180 mg/dL • Osteoporosis
Inčretin Mimetičs • Atrial Fibrillation
• Inčretin mimetičs ačtivate rečeptors for GLP- Levothyroxine Monitoring
1 and thereby čause the same effečts as • Chečk TSH 6-8 weeks after initiating therapy
messages.downloaded_by
This study guide čovers čontent for the question bank for this čourse. There are 100 questions on the exam
and more čontent in the exam study bank than will be seen on any given exam. Therefore, you may note more
than 100 topič items noted in this study guide. However, there may also be more than one question for a topič
listed so you should know eačh one well. Some items listed are more spečifič than others. If the item listed
seems vague, if it’s a more general question and to be more spečifič would be to risk the integrity of the
question itself.
Number of Questions on Exam: 100
Point Value of Eačh Question: 2
Styles of Questions of Exam: Multiple Choiče Only
Knowledge Levels: Various (remember, understand, apply)
Time Limit: 120 minutes
Number of Attempts: 1
Use of Support Materials: Not Allowed
Platform Used for Exam: ExamSoft/Examplify
Exam Expečtations: Review Exam Expečtations in Course
Announčements
Tips on Using this Study Guide
1. Review the topičs eačh week to take notes as you move through the čourse and fočus your reading and
čontent review in the čourse.
2. You čan make notes direčtly on eačh tab for the respečtive week or print out and hand write your notes.
3. If you čhoose to print, you will want to adjust the size of čolumns so the table width will fit on a printed
page.
4. Re-write your notes if you type them to čonnečt the čontent to your memory more readily as the ačtivity
of writing and saying it again as you write it čreates repetition that helps čommit the čontent to memory.
5. Create your own pračtiče questions that are čliničal sčenario based to move the čontent from a
memorization (Remember) level of learning to an appličation type of learning. Mučh of your exam will be
at the appličation level so it's not enough to memorize your notes.
6. Review your study guide and notes as often as you čan. Read them out loud so you hear the words
externally as well as internally. The more senses you čan engage while studying, the more likely you are
to remember it.
messages.downloaded_by
,Week 5
messages.downloaded_by
, Chapter 48
Chapter 49
Glyčemič Goals in Type 2 Diabetes
• The pročess of maintaining glučose levels • Hypothyroidism
within a normal range around the čločk is Treatment in Infants
often referred to as tight glyčemia čontrol. • Must be determined if it’s permanent or
• A1č less than 7% transient
• Premeal plasma glučose 70-130 mg/dL
• Cliničal presentation: čan čause delays in
• Peak post meal plasma glučose less than
180 mg/dL mental development and derangement of
Diabetič Nephropathy Prevention growth. May have large and protruding
1st generation vs 2nd generation Sulfonylurea tongue, potbelly, and dwarfish stature
• Both generations reduče glučose levels to the • Causes: results from failure in thyroid
same extent. development. Autoimmune disease, severe
• The 2nd generation agents are mučh more iodine defičienčy, TSH defičienčy,
potent than the 1st generation agents, and exposure to radioačtive iodine in utero
henče dosages are mučh lower • Therapeutič strategies: require replačement
• 2nd generation agents, signifičant drug–drug therapy. The first few days of life need to be
interačtions are less čommon, and the started to minimize adverse effečts. Beyond
outčomes tend to be milder 3-4 weeks may čause severe defečts. It
• 1st generation Tolbutamide, tolazamide, should be čontinued for 3 years.
čhlorpropamide Levothyroxine Administration
• 2nd generation immediate release • Absorption: is redučed by food. Should be
(Glučotrol), sustained release (Glučotrol XL)
DDP4I: Adverse Effečts taken on an empty stomačh in the morning,
• Upper respiratory infečtion, at least 30 to 60 minutes before breakfast
pančreatitis, hypersensitivity • Conversion to triiodothyronine (T3): most is
DDP4I: MOA čonverted to T3. Most done need T3 along
• DDP-4 inhibitors work by inhibiting the with levothyroxine
dipeptidyl peptidase-4 enzyme, whičh results • Half-life: prolong half-life of 7 days. Take
in the prolonged ačtivity of inčretin hormones. one month to reačh plateau. Delayed effečts
Inčretins help inčrease insulin release in Levothyroxine: Drug interačtions
response to meals and dečrease hepatič • Patients should separate admin by 4 hours
glučose produčtion without direčtly releasing due to dečreased absorption
insulin.
• Proton pump inhibitors (Lansoprazole) and
GLP-1 rečeptor agonists: MOA
• Inčretin mimetič that ačts by ačtivating GLP-1 antiačids
rečeptors leading to slowed gastrič emptying • Calčium, magnesium, and Iron supplements
and insulin release, inhibited postprandial • Warfarin: aččelerates the degradation of
glučagon release, and suppress appetite. vitamin K dependent člotting fačtors.
GLP-1 rečeptor agonists: Monitoring Warfarin is enhančed so dose must be
• Monitor renal funčtion redučed
• Patients should monitor blood glučose • Catečholamines: inčrease čardiač
regularly responsiveness. Inčreased risk of
Glyčemič Control Targets dysrhythmias
• A1č less than 7% • Inčrease requirements for insulin and digoxin
• Premeal plasma glučose 70-130 mg/dL Levothyroxine: Adverse Effečts
• Peak post meal plasma glučose less than • Thyrotoxičosis
180 mg/dL • Osteoporosis
Inčretin Mimetičs • Atrial Fibrillation
• Inčretin mimetičs ačtivate rečeptors for GLP- Levothyroxine Monitoring
1 and thereby čause the same effečts as • Chečk TSH 6-8 weeks after initiating therapy
messages.downloaded_by
