NURS 676 Week 6 Quiz - Questions With Detailed
Solutions
Benefits of transdermal estrogen Right Ans - • total dose of estrogen is
greatly reduced (because the liver is bypassed).
• Less N/V
• Blood levels of estrogen fluctuate less
• lower risk for DVT, pulmonary embolism, and stroke
Type 1 diabetes diagnosis Right Ans - -fasting plasma glucose >/= 126
mg/dL
-random plasma glucose >/= 200mg/dL PLUS symptoms
- Oral glucose tolerance test (OGTT): 2-h plasma glucose >/= 200mg/dL
-hemoglobin A1C 6.5 or higher
Which cells produce insulin Right Ans - Beta cells of the islets of
Langerhans in pancreas
Type 1 diabetes management Right Ans - 1. diet
2. self-monitoring of blood glucose (SMBG)
3. Physical activity
4. Insulin replacement
What is given to manage hypertension in diabetics Right Ans - ACEIs or
ARBs
-reduces risk for diabetic nephropathy
what is given to manage dyslipidemia in diabetics Right Ans - Statins
Type 1 diabetes complications Right Ans - Diabetic Ketoacidosis (DKA)
heart disease, renal failure, blindness, neuropathy, amputations, impotence,
stroke
Diabetic Ketoacidosis (DKA) pathophysiology Right Ans - when insulin is
not present to move glucose into cells for energy, the body begins to
metabolize fat; fatty acid metabolism results in the formation of ketone
,bodies; ketone bodies are acidic and produce metabolic acidosis, diuresis, and
electrolyte loss
Type 2 diabetes management Right Ans - 1. lifestyle changes PLUS
metformin
2. add a second drug (thiazolidinedione, DPP-4 inhibitor, SGLT-2 inhibitor, or
GLP-1 receptor agonist
3. 3 drug combo
4. Insulin & GLP-1 receptor agonist
Metformin Right Ans - Biguanide
MOA:
1. inhibits glucose production in liver
2. reduces glucose absorption in the gut
3. sensitizes insulin receptors in target tissues--increases glucose uptake
NOT METABOLIZED
SE: GI, lactic acidosis
-Type II, prevention, PCOS, Gestational
Meglitinides (Glinides) Right Ans - -stimulate pancreatic insulin release
-shorter acting than sulfonylureas and are taken w/ each meal
repaglinide and nateglinide
Thiazolidinediones (TZDs) Right Ans - Glitazones
MOA:
-decrease insulin resistance, increasing glucose uptake by muscle and fat
-decrease glucose production by liver
SE: hypoglycemia when there is excessive insulin, HF, bladder cancer,
fractures in women, ovulation
Dipeptidyl Peptidase-4 (DPP-4) Inhibitors Right Ans - Gliptins
, - enhance actions of incretin hormones to stimulate glucose-dependent insulin
and suppress glucagon release by inhibiting DPP-4
-DPP-4 is an enzyme that inactivates incretin hormones
AE: hypoglycemia and pancreatitis
Incretin Hormones (GIP and GLP-1) Right Ans - (1) stimulate glucose-
dependent release of insulin (2) suppress postprandial release of glucagon
Glucagon Right Ans - increases glucose production in the liver
sodium-glucose cotransporter 2 (SGLT-2) inhibitor Right Ans - "-gliflozin"
SGLT-2 accounts for 90% of glucose reabsorption in the kidney
blocks reabsorption of filtered glucose, increasing urinary excretion of glucose
AE: hypoglycemia, UTI, vulvovaginal infection, dehydration
glucagon-like peptide-1 (GLP-1) receptor agonist Right Ans - incretin
mimetics
-slow gastric emptying
-stimulate glucose-dependent release o insulin
-inhibit postprandial release of glucagon
-suppress appetite
AE: hypoglycemia, renal impairment, fetal harm, pancreatitis
Sulfonylureas Right Ans - glipizide, glyburide, glimepiride -stimulate
release of insulin from pancreatic islet
>> bind with/block ATP-sensitive potassium channels in cell membrane,
which causes influx of calcium, leading to insulin release
AE: hypoglycemia
C-peptide Right Ans - Product of proinsulin cleavage
indicates pancreas is still making some insulin
Solutions
Benefits of transdermal estrogen Right Ans - • total dose of estrogen is
greatly reduced (because the liver is bypassed).
• Less N/V
• Blood levels of estrogen fluctuate less
• lower risk for DVT, pulmonary embolism, and stroke
Type 1 diabetes diagnosis Right Ans - -fasting plasma glucose >/= 126
mg/dL
-random plasma glucose >/= 200mg/dL PLUS symptoms
- Oral glucose tolerance test (OGTT): 2-h plasma glucose >/= 200mg/dL
-hemoglobin A1C 6.5 or higher
Which cells produce insulin Right Ans - Beta cells of the islets of
Langerhans in pancreas
Type 1 diabetes management Right Ans - 1. diet
2. self-monitoring of blood glucose (SMBG)
3. Physical activity
4. Insulin replacement
What is given to manage hypertension in diabetics Right Ans - ACEIs or
ARBs
-reduces risk for diabetic nephropathy
what is given to manage dyslipidemia in diabetics Right Ans - Statins
Type 1 diabetes complications Right Ans - Diabetic Ketoacidosis (DKA)
heart disease, renal failure, blindness, neuropathy, amputations, impotence,
stroke
Diabetic Ketoacidosis (DKA) pathophysiology Right Ans - when insulin is
not present to move glucose into cells for energy, the body begins to
metabolize fat; fatty acid metabolism results in the formation of ketone
,bodies; ketone bodies are acidic and produce metabolic acidosis, diuresis, and
electrolyte loss
Type 2 diabetes management Right Ans - 1. lifestyle changes PLUS
metformin
2. add a second drug (thiazolidinedione, DPP-4 inhibitor, SGLT-2 inhibitor, or
GLP-1 receptor agonist
3. 3 drug combo
4. Insulin & GLP-1 receptor agonist
Metformin Right Ans - Biguanide
MOA:
1. inhibits glucose production in liver
2. reduces glucose absorption in the gut
3. sensitizes insulin receptors in target tissues--increases glucose uptake
NOT METABOLIZED
SE: GI, lactic acidosis
-Type II, prevention, PCOS, Gestational
Meglitinides (Glinides) Right Ans - -stimulate pancreatic insulin release
-shorter acting than sulfonylureas and are taken w/ each meal
repaglinide and nateglinide
Thiazolidinediones (TZDs) Right Ans - Glitazones
MOA:
-decrease insulin resistance, increasing glucose uptake by muscle and fat
-decrease glucose production by liver
SE: hypoglycemia when there is excessive insulin, HF, bladder cancer,
fractures in women, ovulation
Dipeptidyl Peptidase-4 (DPP-4) Inhibitors Right Ans - Gliptins
, - enhance actions of incretin hormones to stimulate glucose-dependent insulin
and suppress glucagon release by inhibiting DPP-4
-DPP-4 is an enzyme that inactivates incretin hormones
AE: hypoglycemia and pancreatitis
Incretin Hormones (GIP and GLP-1) Right Ans - (1) stimulate glucose-
dependent release of insulin (2) suppress postprandial release of glucagon
Glucagon Right Ans - increases glucose production in the liver
sodium-glucose cotransporter 2 (SGLT-2) inhibitor Right Ans - "-gliflozin"
SGLT-2 accounts for 90% of glucose reabsorption in the kidney
blocks reabsorption of filtered glucose, increasing urinary excretion of glucose
AE: hypoglycemia, UTI, vulvovaginal infection, dehydration
glucagon-like peptide-1 (GLP-1) receptor agonist Right Ans - incretin
mimetics
-slow gastric emptying
-stimulate glucose-dependent release o insulin
-inhibit postprandial release of glucagon
-suppress appetite
AE: hypoglycemia, renal impairment, fetal harm, pancreatitis
Sulfonylureas Right Ans - glipizide, glyburide, glimepiride -stimulate
release of insulin from pancreatic islet
>> bind with/block ATP-sensitive potassium channels in cell membrane,
which causes influx of calcium, leading to insulin release
AE: hypoglycemia
C-peptide Right Ans - Product of proinsulin cleavage
indicates pancreas is still making some insulin
