1|Pag e
NR 565 FINAL EXAM|| LATEST 2024-2025 WITH
ALL QUESTIONS AND 1005 CORRECT ANSWERS
ALREADY GRADED A+|| LATEST AND COMPLETE
UPDATE 2024-2025 WITH EXPERT VERIFIED
SOLUTIONS|| ASSURED PASS!!!
what 3 labs are used for diagnosing thyroid dx
TSH
Free T4
Total 3
what is the time frame for rechecking labs after starting synthroid
6-8 weeks after initiation or dose adjustment
signs and symptoms of hypothyroidism
Fatigue, weight gain, cold intolerance, dry skin, hair loss, constipation.
signs sand symptoms of hyperthyroidism
Weight loss
heat intolerance
anxiety
tremors
palpitations
increased appetite.
what medication treats thyroid storm
beta blockers
,2|Pag e
anti thyroid drugs(methimazole & PTU)
corticosteroids
fluids
what is the first line treatment for hyperthyroidism
Methimazole
what happens when hypothyroidism is not treated during pregnancy
increased risk of miscarriage
pre term birth
developmental delays in child
Criteria for dx DM
Fasting plasma glucose greater than 126
Random plasma glucose greater than 200
Oral glucose tolerance test greater than 200
HgA1c at or greater than 6.5%
What drug class should be considered for DM before insulin
Biguanide (Metformin)
Action of Insulin
,3|Pag e
Synthesized in pancreas, primary metabolic action is anabolic. Promotes
conservation of energy and buildup of energy stores like glycogen.
MOA Sulfonylureas
by stimulating release of insulin from pancreatic islets. If pancreas is not capable
of insulin synthesis, they will not be effective. thus, cannot use on DM1 only DM2
Glinides MOA
by stimulating release of insulin from pancreatic islets. If pancreas is not capable
of insulin synthesis, they will not be effective. thus, cannot use on DM1 only DM2
Thiazolidinediones (TZD) MOA
Decrease glucose levels primarily by decreasing insulin resistance
Sodium Glucose Co-Transporter-2 (SGLT2) Inhibitors MOA
blocks reabsorption of filtered glucose and creates glucose urea. Action is primary
useful in DM2 when trying to improve glycemic control
dipeptidy peptidase 4 inhibitors (gliptins) (DPP-4) MOA
promote glycemic control by enhancing actions of incretin hormones. It modestly
decreases A1c
, 4|Pag e
Incretin hormone
gut peptide secreted after nutrient intake and stimulates insulin production.
Together with hyperglycemia, glucose dependent insulin tropic polypeptide and
GLP-1 are known as the incretin hormones from upper and lower gut. Together
they are responsible for incretin effect which is a 2-3 fold higher insulin secretory
response vs oral or IV glucose.
Note people with DM2 the incretin effect is diminished or no longer present.
Glucagon-like peptide 1 (GLP-1) MOA
by augmenting the effects of incretin hormones GLP-1 and other incretins are
released from cells of GI tract after a meal. Incretins activate receptors for GLP-1
and slow gastric emptying, stimulate glucose dependent release of insulin and
inhibits postprandial release of glucagon and suppresses appetite.
What drug class is most likely to cause hypoglycemia
Sulfonylureas, insulin, meglitinides, amylin analogues, Glinides, Glipins
Drug class less likley to cause hypoglycemia
Metformin, incretin mimetics, DPP-4, TZD
Biguanidies ex
metformin
NR 565 FINAL EXAM|| LATEST 2024-2025 WITH
ALL QUESTIONS AND 1005 CORRECT ANSWERS
ALREADY GRADED A+|| LATEST AND COMPLETE
UPDATE 2024-2025 WITH EXPERT VERIFIED
SOLUTIONS|| ASSURED PASS!!!
what 3 labs are used for diagnosing thyroid dx
TSH
Free T4
Total 3
what is the time frame for rechecking labs after starting synthroid
6-8 weeks after initiation or dose adjustment
signs and symptoms of hypothyroidism
Fatigue, weight gain, cold intolerance, dry skin, hair loss, constipation.
signs sand symptoms of hyperthyroidism
Weight loss
heat intolerance
anxiety
tremors
palpitations
increased appetite.
what medication treats thyroid storm
beta blockers
,2|Pag e
anti thyroid drugs(methimazole & PTU)
corticosteroids
fluids
what is the first line treatment for hyperthyroidism
Methimazole
what happens when hypothyroidism is not treated during pregnancy
increased risk of miscarriage
pre term birth
developmental delays in child
Criteria for dx DM
Fasting plasma glucose greater than 126
Random plasma glucose greater than 200
Oral glucose tolerance test greater than 200
HgA1c at or greater than 6.5%
What drug class should be considered for DM before insulin
Biguanide (Metformin)
Action of Insulin
,3|Pag e
Synthesized in pancreas, primary metabolic action is anabolic. Promotes
conservation of energy and buildup of energy stores like glycogen.
MOA Sulfonylureas
by stimulating release of insulin from pancreatic islets. If pancreas is not capable
of insulin synthesis, they will not be effective. thus, cannot use on DM1 only DM2
Glinides MOA
by stimulating release of insulin from pancreatic islets. If pancreas is not capable
of insulin synthesis, they will not be effective. thus, cannot use on DM1 only DM2
Thiazolidinediones (TZD) MOA
Decrease glucose levels primarily by decreasing insulin resistance
Sodium Glucose Co-Transporter-2 (SGLT2) Inhibitors MOA
blocks reabsorption of filtered glucose and creates glucose urea. Action is primary
useful in DM2 when trying to improve glycemic control
dipeptidy peptidase 4 inhibitors (gliptins) (DPP-4) MOA
promote glycemic control by enhancing actions of incretin hormones. It modestly
decreases A1c
, 4|Pag e
Incretin hormone
gut peptide secreted after nutrient intake and stimulates insulin production.
Together with hyperglycemia, glucose dependent insulin tropic polypeptide and
GLP-1 are known as the incretin hormones from upper and lower gut. Together
they are responsible for incretin effect which is a 2-3 fold higher insulin secretory
response vs oral or IV glucose.
Note people with DM2 the incretin effect is diminished or no longer present.
Glucagon-like peptide 1 (GLP-1) MOA
by augmenting the effects of incretin hormones GLP-1 and other incretins are
released from cells of GI tract after a meal. Incretins activate receptors for GLP-1
and slow gastric emptying, stimulate glucose dependent release of insulin and
inhibits postprandial release of glucagon and suppresses appetite.
What drug class is most likely to cause hypoglycemia
Sulfonylureas, insulin, meglitinides, amylin analogues, Glinides, Glipins
Drug class less likley to cause hypoglycemia
Metformin, incretin mimetics, DPP-4, TZD
Biguanidies ex
metformin
