Diabetes + Insulins

Question 1

Which cells in the pancreas produce insulin?
a. Alpha cells
b. Beta cells
c. Delta cells
d. Gamma cells

Answer 1

The correct answer is: b. Beta cells.

Question 2

Which hormone is produced by alpha cells in the pancreas?
a. Insulin
b. Glucagon
c. Somatostatin
d. Epinephrine

Answer 2

The correct answer is: b. Glucagon.

Question 3

Somatostatin is produced by which type of pancreatic cells?
a. Alpha cells
b. Beta cells
c. Delta cells
d. Gamma cells

Answer 3

The correct answer is: c. Delta cells.

Question 4

What severe condition is caused by a lack of insulin?
a. Hypoglycemia
b. Hyperglycemia
c. Hyperinsulinemia
d. Hypoinsulinemia

Answer 4

The correct answer is: b. Hyperglycemia.

Question 5

Untreated severe hyperglycemia can lead to all of the following complications EXCEPT:
a. Retinopathy
b. Nephropathy
c. Neuropathy
d. Hypotension

Answer 5

The correct answer is: d. Hypotension.

Question 6

Which of the following is a cardiovascular complication caused by untreated hyperglycemia?
a. Hypertension
b. Bradycardia
c. Retinopathy
d. Hypoglycemia

Answer 6

The correct answer is: a. Hypertension.

Question 7

Lack of insulin and untreated hyperglycemia can cause which of the following ocular complications?
a. Cataracts
b. Retinopathy
c. Glaucoma
d. Myopia

Answer 7

The correct answer is: b. Retinopathy.

Question 8

Which complication associated with hyperglycemia affects the kidneys?
a. Nephropathy
b. Hepatopathy
c. Neuropathy
d. Retinopathy

Answer 8

The correct answer is: a. Nephropathy.

Question 9

Hyperglycemia can lead to nerve damage known as:
a. Retinopathy
b. Nephropathy
c. Neuropathy
d. Myopathy

Answer 9

The correct answer is: c. Neuropathy.

Question 10

How many people worldwide are affected by diabetes?
a. 120 million
b. 150 million
c. 180 million
d. 200 million

Answer 10

The correct answer is: c. 180 million.

Question 11

True or False: Diabetes is a single disease characterized by high blood glucose levels.
a. True
b. False

Answer 11

The correct answer is: b. False.

Question 12

What characterizes diabetes as a group of syndromes?
a. High insulin production
b. High blood pressure
c. Elevation in glucose blood level and insufficient insulin secretion
d. High cholesterol levels

Answer 12

The correct answer is: c. Elevation in glucose blood level and insufficient insulin secretion.

Question 13

Type 1 diabetes is classified as:
a. Non-insulin dependent
b. Insulin dependent
c. Medication-induced
d. Genetic-induced

Answer 13

The correct answer is: b. Insulin dependent.

Question 14

Which type of diabetes is non-insulin dependent?
a. Type 1 diabetes
b. Type 2 diabetes
c. Gestational diabetes
d. Genetic-induced diabetes

Answer 14

The correct answer is: b. Type 2 diabetes.

Question 15

Gestational diabetes occurs:
a. In children
b. In elderly patients
c. During pregnancy
d. Due to genetic factors

Answer 15

The correct answer is: c. During pregnancy.

Question 16

What is a potential consequence of gestational diabetes?
a. Affects liver function
b. Affects fetal development
c. Causes high blood pressure
d. Causes kidney failure

Answer 16

The correct answer is: b. Affects fetal development.

Question 17

Diabetes can be induced by factors other than type 1 or type 2 conditions. These factors include:
a. Genetic factors or medication
b. Lack of physical activity
c. Overeating
d. High cholesterol levels

Answer 17

The correct answer is: a. Genetic factors or medication.

Question 18

Type 1 diabetes most commonly affects individuals in which stage of life?
a. Infancy
b. Puberty or early adulthood
c. Middle age
d. Elderly

Answer 18

The correct answer is: b. Puberty or early adulthood.

Question 19

What is the cause of absolute insulin deficiency in Type 1 diabetes?
a. Insulin resistance
b. Massive β-cell necrosis
c. Overproduction of insulin
d. High glucose intake

Answer 19

The correct answer is: b. Massive β-cell necrosis.

Question 20

Type 1 diabetes is associated with an autoimmune process directed against which cells?
a. Alpha cells
b. Delta cells
c. Beta cells
d. Gamma cells

Answer 20

The correct answer is: c. Beta cells.

Question 21

The autoimmune process in Type 1 diabetes may be triggered by which factors?
a. Physical injury
b. Virus invasion or chemical toxins
c. High-fat diet
d. Excessive exercise

Answer 21

The correct answer is: b. Virus invasion or chemical toxins.

Question 22

Which of the following is a common symptom of Type 1 diabetes?
a. Hyperactivity, Inattention, and depression.
b. Polydipsia, polyuria, and weight loss
c. Weight gain, hypoglycemia, and hyperuricemia.
d. Muscle cramps, muscle rigidity, and tremors.

Answer 22

The correct answer is: b. Polydipsia, polyuria, and weight loss.

Question 23

A life-threatening complication of Type 1 diabetes is:
a. Hypertension
b. Ketoacidosis
c. Hypoglycemia
d. Hyperthyroidism

Answer 23

The correct answer is: b. Ketoacidosis.

Question 24

To control hyperglycemia and ketoacidosis, Type 1 diabetes requires:
a. Oral hypoglycemic agents
b. Diet and exercise only
c. Exogenous insulin
d. Herbal supplements

Answer 24

The correct answer is: c. Exogenous insulin.

Question 25

Maintaining the accepted level of glycosylated hemoglobin (HbA1c) is important to avoid: a. Short-term fatigue b. Long-term complications c. Immediate hypoglycemia d. Sudden weight gain

Answer 25

The correct answer is: b. Long-term complications.

Question 26

Type 1 diabetes patients can neither maintain normal insulin secretion levels nor respond to variations in: a. Blood pressure b. Circulating glucose and amino acid c. Body temperature d. Heart rate

Answer 26

The correct answer is: b. Circulating glucose and amino acid.

Question 27

What type of diabetes is most common? a. Type 1 b. Type 2 c. Gestational diabetes d. Secondary diabetes

Answer 27

The correct answer is: b. Type 2.

Question 28

Type 2 diabetes is influenced by which of the following factors? a. Genetic factors b. Aging c. Obesity and peripheral insulin resistance d. All of the above

Answer 28

The correct answer is: d. All of the above.

Question 29

Metabolic alterations in Type 2 diabetes are generally: a. Severe b. Milder than Type 1 diabetes c. Non-existent d. Worse than Type 1 diabetes

Answer 29

The correct answer is: b. Milder than Type 1 diabetes.

Question 30

Which of the following is NOT a characteristic of Type 2 diabetes? a. Ketoacidosis b. Milder metabolic alterations than Type 1 diabetes c. Retention of some β-cell function d. Variable insulin secretion insufficient to maintain glucose homeostasis

Answer 30

The correct answer is: a. Ketoacidosis.

Question 31

In Type 2 diabetes, the pancreas retains: a. No β-cell function b. Some β-cell function c. Excessive β-cell function d. Irregular α-cell function

Answer 31

The correct answer is: b. Some β-cell function.

Question 32

What happens to the β-cell mass in Type 2 diabetes over time? a. It increases b. It remains the same c. It becomes gradually reduced d. It fluctuates without a clear pattern

Answer 32

The correct answer is: c. It becomes gradually reduced.

Question 33

The major cause of Type 2 diabetes is: a. Overproduction of insulin b. Lack of sensitivity of target organs to insulin c. Excessive glucose intake d. High physical activity

Answer 33

The correct answer is: b. Lack of sensitivity of target organs to insulin.

Question 34

The treatment goal for Type 2 diabetes is to: a. Cure the disease b. Prevent long-term complications c. Eliminate the need for insulin d. Increase insulin resistance

Answer 34

The correct answer is: b. Prevent long-term complications.

Question 35

As Type 2 diabetes progresses, what typically happens to β-cell function? a. It improves b. It remains stable c. It declines d. It fluctuates

Answer 35

The correct answer is: c. It declines.

Question 36

In the later stages of Type 2 diabetes, achieving satisfactory serum glucose levels often requires: a. Increased physical activity b. Insulin therapy c. Reduced carbohydrate intake d. No treatment

Answer 36

The correct answer is: b. Insulin therapy.

Question 37

True regarding insulin administration: a. It can be taken orally. b. It is degraded in the kidney if taken orally. c. It is degraded in the GIT if taken orally. d. It is degraded in the liver if taken orally.

Answer 37

The correct answer is: c. It is degraded in the GIT if taken orally.

Question 38

True regarding the synthesis of insulin: a. It is synthesized as insulin directly. b. It is synthesized as a precursor called pro-insulin. c. It does not require any cleavage to become active. d. It is synthesized by the α cells of the pancreas.

Answer 38

The correct answer is: b. It is synthesized as a precursor called pro-insulin.

Question 39

The process by which insulin becomes active involves: a. No change in its structure. b. Addition of a phosphate group. c. Proteolytic cleavage of pro-insulin. d. Cleavage of the A chain.

Answer 39

The correct answer is: c. Proteolytic cleavage of pro-insulin.

Question 40

Insulin and C peptide are secreted by: a. The α cells of the pancreas. b. The δ cells of the pancreas. c. The β cells of the pancreas. d. The γ cells of the pancreas.

Answer 40

The correct answer is: c. The β cells of the pancreas.

Question 41

A better index of insulin levels is provided by measuring: a. Blood glucose levels. b. Circulating insulin directly. c. Circulating C peptide. d. Glycogen levels.

Answer 41

The correct answer is: c. Circulating C peptide.

Question 42

Insulin secretion is primarily regulated by: a. Certain amino acids. b. Blood glucose. c. Gastrointestinal hormones. d. Autonomic mediators.

Answer 42

The correct answer is: b. Blood glucose.

Question 43

Which of the following is NOT a regulator of insulin secretion? a. Blood glucose. b. Certain amino acids. c. Gastrointestinal hormones. d. Lipid levels.

Answer 43

The correct answer is: d. Lipid levels.

Question 44

Which of the following statements about insulin secretion is true? a. Autonomic mediators have no effect on insulin secretion. b. Insulin secretion is not influenced by gastrointestinal hormones. c. Certain amino acids regulate insulin secretion. d. Blood glucose is the least important regulator of insulin secretion.

Answer 44

The correct answer is: c. Certain amino acids regulate insulin secretion.

Question 45

The first step in the regulation of insulin secretion involves: a. Phosphorylation of glucose by glucokinase. b. Inhibition of Ca++ influx. c. Depolarization of the cell membrane. d. ATP degradation.

Answer 45

a. Phosphorylation of glucose by glucokinase.

Question 46

Following glucose phosphorylation in the pancreas, the next step is: a. Increased K+ influx. b. Inhibition of K+ efflux. c. Increased ATP degradation. d. Decreased intracellular Ca++ secretion.

Answer 46

b. Inhibition of K+ efflux.

Question 47

The inhibition of K+ efflux in the β cells leads to: a. Hyperpolarization of the cell membrane. b. Depolarization of the cell membrane. c. Increased K+ influx. d. Decreased ATP production.

Answer 47

The correct answer is: b. Depolarization of the cell membrane.

Question 48

Depolarization of the β cell membrane results in: a. Decreased ATP production. b. Increased ATP degradation. c. Increased intracellular Ca++ secretion. d. Decreased intracellular Ca++ secretion.

Answer 48

The correct answer is: c. Increased intracellular Ca++ secretion.

Question 49

The final result of increased intracellular Ca++ secretion in the β cells is: a. Decreased insulin secretion. b. Increased insulin secretion. c. Inhibition of ATP production. d. Hyperpolarization of the cell membrane.

Answer 49

The correct answer is: b. Increased insulin secretion.

Question 50

Insulin increases: a. Glucose uptake. b. Glycogenolysis. c. Gluconeogenesis. d. Lipolysis.

Answer 50

The correct answer is: a. Glucose uptake.

Question 51

Insulin's effect on glycogen synthesis is: a. Decreased. b. Increased. c. Unaffected. d. Only in the liver.

Answer 51

The correct answer is: b. Increased.

Question 52

Insulin decreases: a. Glycolysis in muscles. b. Lipogenesis. c. Gluconeogenesis in the liver. d. Glycogen synthesis.

Answer 52

The correct answer is: c. Gluconeogenesis in the liver.

Question 53

The effect of insulin on glycolysis in muscles is: a. Decreased. b. Increased. c. Unaffected. d. Only in the liver.

Answer 53

The correct answer is: b. Increased.

Question 54

Insulin promotes: a. Glycogen breakdown. b. Conversion of carbohydrates to fat (lipogenesis). c. Increased lipolysis. d. Decreased glucose uptake.

Answer 54

b. Conversion of carbohydrates to fat (lipogenesis).

Question 55

Insulin's effect on lipolysis is: a. Increased. b. Decreased. c. Unaffected. d. Only in muscles.

Answer 55

The correct answer is: b. Decreased.

Question 56

Insulin increases: a. Amino acid uptake and protein synthesis. b. Protein degradation. c. Lipolysis. d. Gluconeogenesis.

Answer 56

The correct answer is: a. Amino acid uptake and protein synthesis.

Question 57

Insulin preparations vary primarily in: a. Their routes of administration. b. Their times of onset and durations of activity. c. Their side effects. d. Their color and appearance.

Answer 57

The correct answer is: b. Their times of onset and durations of activity.

Question 58

The variation in insulin preparations is due to: a. Differences in the dosage. b. Differences in the administration frequency. c. Differences in the amino acid sequences of the polypeptides and the type of formulation. d. Differences in the storage conditions.

Answer 58

The correct answer is: c. Differences in the amino acid sequences of the polypeptides and the type of formulation.

Question 59

Insulins like lispro, aspart, and glulisine have: a. Slower onset and longer duration of action. b. Faster onset and shorter duration of action. c. No difference in action compared to regular insulin. d. Faster onset and longer duration of action.

Answer 59

The correct answer is: b. Faster onset and shorter duration of action.

Question 60

The reason for the faster onset and shorter duration of action of insulins like lispro, aspart, and glulisine is: a. They aggregate and form complexes. b. They do not aggregate or form complexes. c. They are administered in higher doses. d. They are taken orally.

Answer 60

The correct answer is: b. They do not aggregate or form complexes.

Question 61

Long-acting insulins such as glargine and detemir: a. Have shorter duration of action compared to regular insulin. b. Show prolonged, flat levels of the hormone following injection. c. Are used only in emergency situations. d. Are taken orally.

Answer 61

The correct answer is: b. Show prolonged, flat levels of the hormone following injection.

Question 62

Which of the following insulin preparations can be given intravenously in emergencies? a. Insulin aspart b. Insulin glulisine c. Insulin lispro d. Regular insulin

Answer 62

The correct answer is: d. Regular insulin

Question 63

Which of the following insulin preparations is a rapid-acting insulin? a. Insulin glargine b. Insulin lispro c. Insulin detemir d. Insulin degludec

Answer 63

The correct answer is: b. Insulin lispro

Question 64

Which of the following is NOT a rapid-acting insulin? a. Insulin glargine b. Insulin aspart c. Insulin lispro d. Insulin glulisine

Answer 64

The correct answer is: a. Insulin glargine

Question 65

True regarding rapid-acting insulin preparations: a. They slowly lower blood glucose. b. They rapidly lower blood glucose. c. They do not affect blood glucose levels. d. They have no effect on blood glucose levels.

Answer 65

The correct answer is: b. They rapidly lower blood glucose.

Question 66

Insulin lispro has a more rapid absorption after SC injection than: a. Insulin isophane b. Insulin detemir c. Regular insulin d. Insulin glargine

Answer 66

The correct answer is: c. Regular insulin

Question 67

Which of the following statements about rapid-acting insulin preparations is correct? a. They are usually administered long before meals. b. They are usually administered long after meals. c. They are usually administered immediately before or following the meal. d. They are usually administered only at bedtime.

Answer 67

The correct answer is: c. They are usually administered immediately before or following the meal.

Question 68

Insulin lispro belongs to which pregnancy category? a. Category C b. Category B c. Category D d. None of the above.

Answer 68

The correct answer is: b. Category B

Question 69

The primary purpose of rapid-acting insulin preparations is to mimic the: a. Basal release of insulin b. Nocturnal release of insulin c. Prandial (mealtime) release of insulin d. Stress-induced release of insulin

Answer 69

The correct answer is: c. Prandial (mealtime) release of insulin

Question 70

True regarding the use of rapid-acting insulin preparations: a. They are used alone to assure proper glucose control. b. They are used along with a longer-acting insulin to assure proper glucose control. c. They are never used with other insulin types. d. They are only used in emergency situations.

Answer 70

The correct answer is: b. They are used along with a longer-acting insulin to assure proper glucose control.

Question 71

Neutral protamine Hagedorn (NPH) insulin is also known as: a. Insulin glargine b. Insulin detemir c. Insulin lispro d. Insulin isophane

Answer 71

The correct answer is: d. Insulin isophane

Question 72

NPH insulin should only be administered: a. Intravenously b. Intramuscularly c. Subcutaneously d. Orally

Answer 72

The correct answer is: c. Subcutaneously

Question 73

True regarding NPH insulin: a. It is a solution b. It is a suspension c. It is a powder d. It is a gel

Answer 73

The correct answer is: b. It is a suspension

Question 74

NPH insulin should never be given: a. Subcutaneously b. Orally c. Intramuscularly d. Intravenously

Answer 74

The correct answer is: d. Intravenously

Question 75

The pH of NPH insulin is: a. Acidic b. Neutral c. Basic d. Variable

Answer 75

The correct answer is: b. Neutral

Question 76

The delayed absorption of NPH insulin is due to the formation of: a. Highly soluble complex b. Less-soluble complex c. Neutral complex d. Acidic complex

Answer 76

The correct answer is: b. Less-soluble complex

Question 77

The formation of the less-soluble complex in NPH insulin is due to: a. Addition of zinc b. Addition of chloride ions c. Addition of protamine d. Addition of glucose

Answer 77

The correct answer is: c. Addition of protamine

Question 78

The duration of action of NPH insulin is: a. Short b. Long c. Intermediate d. Ultra-long

Answer 78

The correct answer is: c. Intermediate

Question 79

Intermediate-acting insulin is useful in treating all forms of diabetes except: a. Type 1 diabetes b. Type 2 diabetes c. Diabetic ketoacidosis or emergency hyperglycemia d. Gestational diabetes

Answer 79

The correct answer is: c. Diabetic ketoacidosis or emergency hyperglycemia

Question 80

Intermediate-acting insulin is usually given along with: a. Long-acting insulin for basal control b. Rapid- or short-acting insulin for mealtime control c. Oral hypoglycemic agents d. No additional medication

Answer 80

The correct answer is: b. Rapid- or short-acting insulin for mealtime control

Question 81

A similar compound to NPH insulin is: a. Insulin aspart b. Insulin detemir c. Neutral protamine lispro (NPL) insulin d. Insulin glargine

Answer 81

The correct answer is: c. Neutral protamine lispro (NPL) insulin

Question 82

Neutral protamine lispro (NPL) insulin is used only in combination with: a. Regular insulin b. Insulin glargine c. Insulin lispro d. Insulin aspart

Answer 82

The correct answer is: c. Insulin lispro

Question 83

Which of the following is a premixed combination of human insulins? a. 30% NPH insulin and 70% insulin glargine b. 70% NPH insulin plus 30% regular insulin c. 50% NPH insulin and 50% insulin detemir d. 25% NPH insulin and 75% insulin lispro

Answer 83

The correct answer is: b. 70% NPH insulin plus 30% regular insulin

Question 84

Premixed combination of human insulins includes: a. 60% NPH insulin and 40% insulin aspart b. 40% NPH insulin and 60% insulin glargine c. 75% NPL insulin plus 25% insulin lispro d. 80% NPL insulin and 20% insulin detemir

Answer 84

The correct answer is: c. 75% NPL insulin plus 25% insulin lispro

Question 85

Which of the following describes a premixed combination of human insulins with equal parts? a. 60% NPH insulin plus 40% regular insulin b. 50% NPH insulin plus 50% regular insulin c. 40% NPH insulin plus 60% insulin lispro d. 30% NPH insulin plus 70% insulin glargine

Answer 85

The correct answer is: b. 50% NPH insulin plus 50% regular insulin

Question 86

True regarding intermediate-acting insulin preparations: a. They are used for immediate glucose control. b. They provide intermediate duration of action. c. They have the longest duration of action. d. They are never used in combination with other insulins.

Answer 86

The correct answer is: b. They provide intermediate duration of action.

Question 87

The isoelectric point of insulin glargine is: a. Higher than that of human insulin b. Equal to that of human insulin c. Lower than that of human insulin d. Variable compared to human insulin

Answer 87

The correct answer is: c. Lower than that of human insulin

Question 88

The lower isoelectric point of insulin glargine leads to: a. Faster absorption b. Precipitation at the injection site, thereby extending its action c. Reduced efficacy d. Increased solubility

Answer 88

The correct answer is: b. Precipitation at the injection site, thereby extending its action

Question 89

True regarding the onset of insulin glargine: a. It is slower in onset than NPH insulin b. It is faster in onset than NPH insulin c. It has the same onset as NPH insulin d. It has a rapid onset

Answer 89

The correct answer is: a. It is slower in onset than NPH insulin

Question 90

Insulin glargine is associated with: a. Short duration of action b. No hypoglycemic effect c. Prolonged hypoglycemic effect d. Rapid hypoglycemic effect

Answer 90

The correct answer is: c. Prolonged hypoglycemic effect

Question 91

The action profile of insulin glargine can be described as: a. Biphasic b. Flat with no peak c. Spiking d. Irregular

Answer 91

The correct answer is: b. Flat with no peak

Question 92

Insulin glargine must be administered: a. Intravenously b. Intramuscularly c. Orally d. Subcutaneously

Answer 92

The correct answer is: d. Subcutaneously

Question 93

Insulin detemir has a fatty-acid side chain that: a. Reduces its effectiveness b. Enhances association to albumin c. Increases its solubility in water d. Speeds up its absorption

Answer 93

The correct answer is: b. Enhances association to albumin

Question 94

The association of insulin detemir with albumin results in: a. Short-acting properties b. Medium-acting properties c. Rapid-acting properties d. Long-acting properties

Answer 94

The correct answer is: d. Long-acting properties

Question 95

True regarding insulin detemir's dissociation from albumin: a. It has slow dissociation from albumin b. It has rapid dissociation from albumin c. It does not dissociate from albumin d. It dissociates at the same rate as regular insulin

Answer 95

The correct answer is: a. It has slow dissociation from albumin

Question 96

The long-acting properties of insulin detemir are similar to: a. Insulin aspart b. Insulin lispro c. Insulin glargine d. NPH insulin

Answer 96

The correct answer is: c. Insulin glargine

Question 97

Insulin detemir is characterized by which of the following? a. Short duration of action b. Rapid peak of action c. Slow and prolonged duration of action d. Immediate onset of action

Answer 97

The correct answer is: c. Slow and prolonged duration of action