CDE Exam Study Guide: Questions With Expert
Solutions
Pramlintide Correct Answer - (Symlin) 1) slows the rate of
digestion from stomach to intestines 2) lowers the amount of
glucose produced by the liver 3) triggers the feeling of fullness after
eating.
Pramlintide Dosing Correct Answer - Reduce mealtime insulin
by 50%, then initiate at 15mcg immediately prior to meals. Then
increase to 30, 45, or 60mcg when no clinically significant nausea
has occurred for at least 3 days.
Pramlintide Contraindications/Considerations Correct Answer -
Can't be mixed with insulins
May delay absorption of co-administered oral meds (take those 1hr
prior or 2hr after Symlin)
Not used for pts on anticholinergics or others that will slow gastric
emptying
Cannot be used in pts with confirmed gastroparesis
Increased risk of hypoglycemia with ACE-I, MAOI, Fluoxetine, and
sulfa abx.
Target Cholesterol Levels for High-Risk patients Correct Answer -
LDL: 100-129
Total: 200-239
HDL: >40
, What are HGM-CoA Reductase Inhibitors? Correct Answer -
Statins
Fuel Homeostasis Stage 1 Correct Answer - Fed state - 0-3.8hr
Insulin inhibits breakdown of glycogen and TG reservoirs
Fuel Homeostasis Stage 2 Correct Answer - Post-Absorptive
State - 4-15.9hr
Insulin levels decrease, glucagon levels rise
Fuel Homeostasis Stage 3 Correct Answer - Early Starvation
State - 16-47.9hr
Lactate makes up half of gluconeogenic substrate. Insulin is
suppressed and counter-regulatory hormones are stimulated.
Fuel Homeostasis Stage 4 Correct Answer - Preliminary
Prolonged Starvation State (48hr - 23.9 days)
BG comes from hepatic and renal gluconeogenesis. Insulin is
markedly suppressed by 60hr, and glucagon, cortisol, growth
hormone, and epinephrine are stimulated.
Fuel Homeostasis Stage 5 Correct Answer - Secondary
Prolonged Starvation State (24-40 days)
BG originates from hepatic/renal gluconeogenesis still, but rate of
glucose use by brain diminishes and rate of hepatic gluconeogenesis
slows.
Central Obesity Waist Size Correct Answer - Men: >40in
Women: >30in
Solutions
Pramlintide Correct Answer - (Symlin) 1) slows the rate of
digestion from stomach to intestines 2) lowers the amount of
glucose produced by the liver 3) triggers the feeling of fullness after
eating.
Pramlintide Dosing Correct Answer - Reduce mealtime insulin
by 50%, then initiate at 15mcg immediately prior to meals. Then
increase to 30, 45, or 60mcg when no clinically significant nausea
has occurred for at least 3 days.
Pramlintide Contraindications/Considerations Correct Answer -
Can't be mixed with insulins
May delay absorption of co-administered oral meds (take those 1hr
prior or 2hr after Symlin)
Not used for pts on anticholinergics or others that will slow gastric
emptying
Cannot be used in pts with confirmed gastroparesis
Increased risk of hypoglycemia with ACE-I, MAOI, Fluoxetine, and
sulfa abx.
Target Cholesterol Levels for High-Risk patients Correct Answer -
LDL: 100-129
Total: 200-239
HDL: >40
, What are HGM-CoA Reductase Inhibitors? Correct Answer -
Statins
Fuel Homeostasis Stage 1 Correct Answer - Fed state - 0-3.8hr
Insulin inhibits breakdown of glycogen and TG reservoirs
Fuel Homeostasis Stage 2 Correct Answer - Post-Absorptive
State - 4-15.9hr
Insulin levels decrease, glucagon levels rise
Fuel Homeostasis Stage 3 Correct Answer - Early Starvation
State - 16-47.9hr
Lactate makes up half of gluconeogenic substrate. Insulin is
suppressed and counter-regulatory hormones are stimulated.
Fuel Homeostasis Stage 4 Correct Answer - Preliminary
Prolonged Starvation State (48hr - 23.9 days)
BG comes from hepatic and renal gluconeogenesis. Insulin is
markedly suppressed by 60hr, and glucagon, cortisol, growth
hormone, and epinephrine are stimulated.
Fuel Homeostasis Stage 5 Correct Answer - Secondary
Prolonged Starvation State (24-40 days)
BG originates from hepatic/renal gluconeogenesis still, but rate of
glucose use by brain diminishes and rate of hepatic gluconeogenesis
slows.
Central Obesity Waist Size Correct Answer - Men: >40in
Women: >30in
