Exam 2- OEQ

Question 1

Kid is taking several drugs. Routine drug monitoring reveals a drop in platelet levels from 320k –> 160k. What med is most likely to contribute to the dose-related thrombocytopenia?

Answer 1

Valproic acid (Depakote)

Question 2

Which of the following antiepileptic medications is considered a controlled substance?

Answer 2

Phenobarbital (luminal)

Question 3

Which of the following antiepileptic medication is known to cause significant amount of cognitive impairments and risk of nephrolithiasis if patient is not adequately hydrated:

Answer 3

Topiramate (Topamax)

Question 4

Patient treated for focal seizures with dyscognitive features and 2nd generalization with Carbamezapine. Patient is stable after two weeks with no seizures but seizures increase in frequency after 4 weeks of Carbamezapine use. Drug level is at 5.6mg/L what is the explanation?

Answer 4

Autoinduction by carbamezapine

Question 5

Which of the following is a RAPID-acting insulin?

Answer 5

Insulin lispro

Question 6

Rapid acting insulins:

Answer 6

1. lispro
2. aspart
3. glulisine

LAG

Question 7

A 42yoF has T2DM and takes the following meds:

-canagliflozin
-metformin
-insulin glargine
-dulaglutide
-artovastatin
-lisinopril
-hydrochlorothyazide
-metoprolol XL

She has history of heart failure, which of these drugs is preferred in patients with heart failure?

Answer 7

Canagliflozin

Question 8

10yoF with T1DM, what diabetes treatments would you expect her to use?

Answer 8

Basal-bolus insulin

Question 9

Basal insulin injection total/day:

Answer 9

4

Question 10

Which of the following oral anti-diabetic agents is most likely to cause hypoglycemia?

Answer 10

Glyburide

Question 11

Laboratory diagnostic tests for DM:

Answer 11

1. HgbA1C
2. Oral glucose tolerance test
3. Fasting plasma glucose

Question 12

What is the primary mechanism of canagliflozin:

Answer 12

Blocks the sodium glucose co-transporter-2 in the proximal tubules to inhibit glucose reabsorption

Question 13

Which of the following insulin types is listed from shortest acting to longest acting?

Answer 13

Humulin R
NPH
Insulin degludec

Question 14

Short acting insulin:

Answer 14

Humulin R
Novalin R

Question 15

Which of the following is a macrovascular complication of DM?

Answer 15

atherosclerotic CAD

Question 16

Macrovascular DM:

Answer 16

Brain, heart, extremities (peripheral vascular disease)

Question 17

Microvascular DM:

Answer 17

eyes, kidneys, nerves, gums

Question 18

Whcih of the following statements is true related to the increased prevalence of xerostomia in patients with DM?

Answer 18

1. Decreased production of saliva is caused by complications of DM
2. Medications used to treat DM cause dry mouth as side effect

Question 19

What is the main difference between type 1 and type 2 DM?

Answer 19

Type 1 dm is caused by autoimmune destruction of pancreatic beta cells resulting insulin deficiency while Type 2 dm is caused by insulin resistance

Question 20

Hypoglycemia should be treated when glucose is:

Answer 20

Less than 70mg/dL

Question 21

Patient undergoing surgery, has well controlled dm, instructed to not eat past midnight, which dm medication should he not take the morning of his surgery?

Answer 21

Insulin lispro (rapid acting)

Question 22

Calcium and vitamin D supplement is reccomended for patients taking which antidiabetic meds?

Answer 22

Valproic acid (Depakote)

Question 23

The following statements for basal-bolus insulin are true except:

Answer 23

Basal-bolus regimens involve the use of only one type of insulin

Question 24

What is the primary MOA for Exenatide?

Answer 24

Stimulates GLP1 receptors to increase insulin secretion, decrease glucagon secretion and slow gastric emptying

Question 25

65yoM with istory of type-2 DM who presents to dental office for cleaning and has some hypoglycemic symptoms with a blood glucose of 64, what should you have him do?

Answer 25

Drink 4 oz of juice

Question 26

Dulaglutide is reccommended for patients with DM who also have additional goals for:

Answer 26

-reducing risk of CKD -reducing risk of ASCVD & risk factors for it -weightloss

Question 27

What adverse effect is commonly associated with metformin?

Answer 27

Nausea and loose stools

Question 28

Which medication stimulates beta cells in the pacrease causing increased insulin secretion?

Answer 28

Glipizide

Question 29

What medication masks the usual signs and symptoms of hypoglycemia?

Answer 29

Metoprolol XL

Question 30

Patients taking oxcarbazepine are at risk for inducing subsequent seizures due to a condition called:

Answer 30

SIADH

Question 31

Whcih of the following sets of lab orders would be most appropriate when conducting therapeutic drug monitoring for valproic acid:

Answer 31

Liver function test & Platelet test

Question 32

What is Levetiracetam (Keppra) used for?

Answer 32

Mood changes

Question 33

Patient taking amitriptyline with percocet (oxycodone) can exhibit which of the following?

Answer 33

Oversedation

Question 34

Patient with sulfa allergy, which anti-epileptic drug should be avoided?

Answer 34

Zonisamide (Zonegran)

Question 35

What kind of seizure occurs when patient zones out for 10 seconds and regains consciousness immediately after?

Answer 35

Absence

Question 36

Patient presents to ER with following symptoms: diaphoresis, hyperflexia, low grade fever and tremors. Patient reports he took a Tranylcypromine (Parnate) + Tramadol (Ultram). What is likely adverse drug reaction?

Answer 36

Serotonin syndrome

Question 37

Tripeptide mechanisms of action?

Answer 37

GLP-Agonist GIP

Question 38

Mechanism of action of Exenatide:

Answer 38

Stimulates GLP-1 receptors in the pancreas to increase insulin secretion, decreased glucagon and slow gastric emptying

Question 39

Additional benefits with diabetes drugs:

Answer 39

Weightloss

Question 40

Can cause hypoglycemia as a monotreatment for DM-2:

Answer 40

Glipizide

Question 41

Vasoconstriction for local anesthesia, what concern does it have with people with DM?

Answer 41

HYPERglycemia stimulates hepatic glucose production in the liver

Question 42

What lab test should be done for patient on keppra?

Answer 42

Renal function test keppra=kidney