CDE Exam Study Guide Questions & Answers 100% Accurate!

Pramlintide - 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 - ANSWERReduce 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 - ANSWERCan'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 - ANSWERLDL: 100-129 Total: 200-239 HDL: >40 What are HGM-CoA Reductase Inhibitors? - ANSWERStatins Fuel Homeostasis Stage 1 - ANSWERFed state - 0-3.8hr Insulin inhibits breakdown of glycogen and TG reservoirs Fuel Homeostasis Stage 2 - ANSWERPost-Absorptive State - 4-15.9hr Insulin levels decrease, glucagon levels rise Fuel Homeostasis Stage 3 - ANSWEREarly 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 - ANSWERPreliminary 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 - ANSWERSecondary 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 - ANSWERMen: >40in Women: >30in Metabolic Activity of Abdominal Fat - ANSWERMore capillaries, influx of FFA. In liver, FFA's cause insulin resistance, and FFA can be used as fuel, thus raising BG