DM practice questions

Question 1

Which diabetes drug has the side effects of GI issues and B12 malabsorption?
a) Metformin
b) Glipizide
c) Pioglitazone
d) Dulaglutide (trulicity)
e) Dapagliflozin (Farxiga)

Answer 1

a) Metformin

Question 2

What is the optimal dosing for Metformin (PO)?
a) 1000 mg Qday
b) 1000 mg BID
c) 500 mg Qday
d) 500 mg BID

Answer 2

b) 1000 mg BID

Question 3

Which carries a high risk of hypoglycemia, so should be given 30 min before eating?
a) Metformin
b) Glipizide
c) Pioglitazone
d) Dulaglutide (trulicity)
e) Dapagliflozin (Farxiga)

Answer 3

b) Glipizide

Question 4

Which drugs should you avoid with bladder cancer? Select all that apply
a) Metformin
b) Glipizide
c) Pioglitazone
d) Dulaglutide (trulicity)
e) Dapagliflozin (Farxiga)

Answer 4

c) Pioglitazone
e) Dapagliflozin (Farxiga)

Question 5

Which of the GLP-1 RAs can be dosed SQ once a week? Select all that apply
a) Dulaglutide (Trulicity)
b) Exenatide (Byetta)
c) Liraglutide (Victoza)
d) Semaglutide (Ozempic)

Answer 5

a) Dulaglutide (Trulicity)
d) Semaglutide (Ozempic)

Question 6

Which of the following can reduce the effects of OCPs?
a) Metformin
b) Glipizide
c) Pioglitazone
d) Dulaglutide (trulicity)

Answer 6

d) Dulaglutide (trulicity)

Question 7

Which GLP-1 RA does NOT have a risk of retinopathy or gallbladder disease?
a) Dulaglutide (Trulicity)
b) Exenatide (Byetta)
c) Liraglutide (Victoza)
d) Semaglutide (Ozempic)

Answer 7

a) Dulaglutide (Trulicity)

Question 8

Which of the GLP-1 RAs may NOT reduce cardiovascular mortality & slow progression of chronic kidney disease?
a) Dulaglutide (Trulicity)
b) Exenatide (Byetta)
c) Liraglutide (Victoza)
d) Semaglutide (Ozempic)

Answer 8

b) Exenatide (Byetta)

Question 9

Which DPP-4 is associated with new or worsening heart failure? (hint: Dr. Lewis hates this med)
a) Linagliptin (Tradjenta)
b) Saxagliptin (Onglyza)
c) Sitagliptin (Januvia)

Answer 9

b) Saxagliptin (Onglyza)

Question 10

Which DPP-4 does NOT have CYP3A4 drug interactions?
a) Linagliptin (Tradjenta)
b) Saxagliptin (Onglyza)
c) Sitagliptin (Januvia)

Answer 10

c) Sitagliptin (Januvia)

Question 11

Match the SGL2s with their adverse effects
a) Canagliflozin (Invokana) = BBB for amputations. Dapagliflozin (Farxiga) = increase risk of bladder CA.

b) Canagliflozin (Invokana) = increase risk of bladder CA. Dapagliflozin (Farxiga) = BBB for amputations

Answer 11

a) Canagliflozin (Invokana) = BBB for amputations. Dapagliflozin (Farxiga) = increase risk of bladder CA.

Question 12

What drug has a BBB for CHF?
a) Metformin
b) Glipizide
c) Pioglitazone
d) Dulaglutide (trulicity)

Answer 12

c) Pioglitazone

Question 13

Which group of drugs blocks glucose reabsorption in the kidneys and increases urinary excretion of glucose?
a) DPP-4s
b) GLP-1 RAs
c) Sulfonylureas
d) SGL2s

Answer 13

d) SGL2s

Question 14

When should you d/c Metformin?
a) If eGFR < 45 mL/min/1.73m2
b) If eGFR < 30 mL/min/1.73m2
c) If initiating insulin
d) FHx of medullary thyroid carcinoma

Answer 14

b) If eGFR < 30 mL/min/1.73m2

Question 15

Which drug class can lead to really bad genital yeast infections & UTIs?
a) DPP-4s
b) GLP-1 RAs
c) Sulfonylureas
d) SGL2s

Answer 15

d) SGL2s

Question 16

Which drug may cause significant flatulence?
a) Acarbose
b) Nateglinide
c) Colesevelam
d) Tirzepatide (Mounjaro)

Answer 16

a) Acarbose

Question 17

You have a patient on Glipizide (Glucotrol). What should you not use it with?
a) Acarbose
b) Nateglinide
c) Colesevelam
d) Tirzepatide (Mounjaro)

Answer 17

b) Nateglinide

Question 18

T/F: Insulin has the biggest risk out of all the DM drugs for weight gain and hypoglycemia

Answer 18

True

Question 19

Which of the following is NOT a bolus insulin?
a) Insulin lispro
b) Insulin aspart
c) Insulin glulisine
d) Insulin glargine
e) Insulin human

Answer 19

d) Insulin glargine

Question 20

Insulin lispro (Humalog), insulin aspart (NovoLog or Fiasp), and insulin glulisine (Apidra) all have what in common?
a) Rapid (lasts < 5 hours)
b) Regular (lasts < 8 hours)
c) Intermediate (lasts < 24 hours)
d) Long-acting (lasts ≈ 24 hours)

Answer 20

a) Rapid (lasts < 5 hours)

Question 21

You should administer rapid insulin ______ minutes prior to a meal, and regular insulin ______ minutes prior to a meal

Answer 21

15; 30

Question 22

What is unique about insulin human (Afrezza)?
a) It’s the main ultra-long acting insulin
b) It’s the only inhaled insulin
c) It can be administered regardless of meals
d) It’s compatible with Dexcom

Answer 22

b) It’s the only inhaled insulin

Question 23

You estimate __________ by dividing 550 by total daily units
a) Carb: Insulin ratio
b) Correction factor

Answer 23

a) Carb: Insulin ratio (correction factor is 1650 / totally daily dose in units)

Question 24

Pramlintide is an adjunct therapy for what?
a) T1DM
b) T2DM

Answer 24

a) T1DM

Question 25

How do you convert Novolin R to insulin degludec? a) Convert unit-per-unit b) Round each mealtime insulin dose up to the nearest 4 units and then convert unit-per-unit c) Add up total daily dose and start with 50% of total d) Give 70-80% of total daily dose e) Give 2/3 dose in AM and 1/3 dose in PM

Answer 25

c) Add up total daily dose and start with 50% of total

Question 26

A patient has an A1C that’s 2% above their goal. What do you do? a) Start 1 agent b) Start 2 agents c) Start 2-3 agents d) Start 4 agents

Answer 26

c) Start 2-3 agents If A1C >7.5%, start 2 agents. If A1C >9.0%, or 1.5% above goal, start 2-3 agents.

Question 27

When should you avoid sulfonylureas and glinides? Select all that apply a) If overweight/ obese b) If hypoglycemia risk c) If access/ cost is a concern

Answer 27

a) If overweight/ obese b) If hypoglycemia risk

Question 28

How do you convert Novolin 70/30 to Novolin N if the patient is on a once daily dose? a) Convert unit-per-unit b) Round each mealtime insulin dose up to the nearest 4 units and then convert unit-per-unit c) Add up total daily dose and start with 50% of total d) Give 70-80% of total daily dose e) Give 2/3 dose in AM and 1/3 dose in PM

Answer 28

d) Give 70-80% of total daily dose

Question 29

How do you convert Insulin aspart to Afrezza? a) Convert unit-per-unit b) Round each mealtime insulin dose up to the nearest 4 units and then convert unit-per-unit c) Add up total daily dose and start with 50% of total d) Give 70-80% of total daily dose e) Give 2/3 dose in AM and 1/3 dose in PM

Answer 29

b) Round each mealtime insulin dose up to the nearest 4 units and then convert unit-per-unit