ADE PRACTICE TEST EXAM QUESTIONS AND EXAMS 2022 LATEST

AADE PRACTICE TEST EXAM QUESTIONS AND EXAMS 2022 LATEST 62-year-old patient with type 2 diabetes has noticed a 30-pound weight gain over the past 2 years. Which of the following drugs would most likely worsen her weight gain? Pramlintide Exenatide Rosiglitazone Saxagliptin - Correct Answer- C - Rosiglitazone is correct. Thiazolidinediones (pioglitazone and rosiglitazone) activate PPAR-gamma receptors in the body. Activation of these receptors results in mobilization of visceral fat and promotes deposition in subcutaneous adipose tissue. Pramlintide and exenatide (Answers A and B) tend to promote weight loss, while saxagliptin (Answer D) is weight neutral. A 62-year-old man with type 2 diabetes and chronic kidney disease presents for management of his diabetes. Recent laboratory values include the following: A1C 7.8%, serum creatinine 2.3 mg/dL. Which of the following DPP-4 inhibitors most appropriate for this patient? Sitagliptin Saxagliptin Linagliptin Alogliptin - Correct Answer- C - Linagliptin is correct. Linagliptin is the only agent in the DPP-4 inhibitor class that does not require dose reduction in patients with renal impairment. Sitagliptin (Answer A) and Saxagliptin (Answer B) require dose reductions with CrCl 50mL/min. Alogliptin (Answer D) requires dose reduction with CrCl 60mL/min. A 35-year-old patient with type 2 diabetes presents for follow-up of her glycemic control. Her current medications include: metformin 1g twice daily and glargine 46 units at bedtime with a recent A1C of 7.7% (goal 7%). She eats a granola bar for breakfast, has a sandwich and water at lunch, then a large evening meal. She denies symptoms of hypoglycemia. She weighs 156 pounds (BMI 26 kg/m^2) and her average preprandial self-monitored blood glucose levels are: 152 mg/dL at 8AM, 160 mg/dL at noon, 146 mg/dL at 6 PM, and 220 mg/dL at 10 PM. Her provider decides to start glulisine before the evening meal (at 6 PM). Which of the following would be the most appropriate recommendation for this patient? 1 unit 5 units 15 units 20 units - Correct Answer- B - 5 units is correct. Both the ADA and AACE guidelines recommend adding bolus insulin at a dose of either 10% of the current basal dose, or 0.1 units/kg, or 5 units. Subsequent dose adjustments can be made in 1 to 2 unit increments or 10% to 15% of the dose. Ketoacidosis in adolescents can be caused by the following except: Excessive intake of sweets Emotional disturbances Insulin omission Illness - Correct Answer- A is the correct answer. DKA is the result of a relative or absolute insulin deficiency and can be seen in the presence of a physical illness, severe emotional distress or if insulin is omitted. A 28-year-old woman with Type 1 diabetes for 10 years needs to re-calculate a correction bolus based on her new insulin regimen. Her current total daily dose (TDD) of insulin is 60 units. Which of the following best estimates the amount 1 unit of insulin will lower her blood glucose level? 3 mg/dL 8 mg/dL 25 mg/dL 30 mg/dL - Correct Answer- D - 30 mg/dL is correct. The Rule of 1800 (some providers recommend 1700 for patients on insulin pumps, or 1500 for patients injecting regular insulin) estimates the amount 1 unit of insulin will lower her blood glucose level. This patient takes a total daily dose (TDD) of 60 units (1800 divided by 60 units = 30 mg/dL). A general rule of thumb is that 1 unit of insulin will lower the blood glucose by 50 mg/dL. A 45-year-old man with type 2 diabetes recently started atorvastatin 40mg daily to lower his cholesterol. Which of the following is the most appropriate frequency to recheck the fasting lipid profile? 1 to 3 weeks 4 to 12 weeks 6 to 9 months Yearly - Correct Answer- B - 4 to 12 weeks is correct. The 2013 ACC/AHA Cholesterol Guidelines for ASCVD Risk Reduction in Adults recommends that a repeat fasting lipid panel be checked within 4 to 12 months after statin initiation or dose adjustment. Once patients the dose is stabilized, then follow-up can be set to every 3 to 12 months thereafter. How frequently should you engage in moderate physical activity for weight loss? Three times per week Every other day Daily Five times per week - Correct Answer- C is the correct answer. Activity levels of at least one to one and a half hours per day of moderate activity may be needed to achieve successful long term weight loss and maintenance. One of the most serious complications of type 2 diabetes in the older adult is: Hyperosmolar hyperglycemic state (HHS) Diabetic ketoacidosis (DKA) Nocturnal hyperglycemia Cataracts - Correct Answer- The correct answer is A. Because HHS develops slowly and does not cause gastrointestinal pain, it can be overlooked or misdiagnosed. Delayed treatment and comorbidities more common in the older adults result in a mortality rate of approximately 15%. A 56-year-old overweight African-American patient with diabetes, heart failure and hypertension presents for follow-up. He currently takes all of his medications in the morning. His provider recently read in the ADA guidelines that taking at least one antihypertensive at bedtime has been shown to reduce cardiovascular events and mortality. Which of the following antihypertensives should be moved to bedtime? Furosemide Candesartan Spironolactone Hydrochlorothiazide - Correct Answer- B - Candesartan is correct. Patients who maintain elevated blood pressure readings at night during sleep, called non-dippers, are at increased risk of cardiovascular events and mortality. Moving one or more antihypertensives to bedtime has been found to restore a normal blood pressure dipping pattern. Furosemide (Answer A), spironolactone (Answer C) and hydrochlorothiazide (Answer D) are diuretics which may disrupt sleep patterns due to urinary frequency. CONTINUES.....