SARAH MICHELLE BOARD REVIEW 2026 FULL
PRACTICE EXAM WITH VERIFIED SOLUTIONS
◉ Why does Metformin need to be stopped prior to having any
procedure with contrast? Answer: Contrast dye is harsh on the
kidneys, need to be sure that there is pause with that Metformin so
that their kidneys are not seriously injured.
◉ Long term usage of Metformin can lead to what deficiency?
Answer: B12 deficiency anemia
◉ How does Metformin impact weight? Answer: Metformin is
weight NEUTRAL, some patient even will have weight loss with this
drug
◉ Does Metformin cause hypoglycemia? Answer: NO, Metformin
works in the body by inhibiting glucose production in the liver. Due
to that there are no issues with hypoglycemia
◉ What are some examples of SGLT-2 inhibitors? Answer: All the -
flozin's
Empagiflozin
,◉ What is the MOA for SGLT-2 inhibitors? Answer: Reduce
absorption of glucose in the renal tubules, the patient will urinate
out the extra glucose
◉ What lab should be assessed prior to prescribing SGLT-2
inhibitors? Answer: Renal function
◉ Does SGLT-2 inhibitors cause hypoglycemia? Answer: SGLT-2
inhibitors have a LOW risk for hypoglycemia
◉ What education is required for patients who are on SGLT-2
inhibitors? Answer: Staying hydrated and reporting any new urinary
issues
◉ What patients are NOT good candidates for SGLT-2 inhibitors?
Answer: Patients who cannot make it to the bathroom in time
Patients with frequent UTIs or yeast infections already
◉ What is a major perk to SGLT-2 inhibitors? Answer: They are
cardio-protective- they have shown to reduce overall risk of
mortality associated with coexisting cardiac conditions, and they
may even prevent future cardiac issues.
◉ What diabetes medication classes are cardioprotective? Answer:
SGLT-2 inhibitors and GLP-1 agonists
,◉ What are examples of DPP-4 inhibitors? Answer: Alt he -gliptins
Sitagliptin
◉ What is the MOA of DPP-4 inhibitors? Answer: Increase insulin
production/decrease glucagon secretion
Impacts fasting and postprandial glucose levels
◉ DPP-4 inhibitors are contraindicated in patients with a history of
what condition? Answer: Pancreatitis
◉ What are examples of sulfonylureas? Answer: All the ide's
glipizide, glyburide, glimepiride
◉ What is the MOA of sulfonyureas? Answer: Cause the pancreases
to secrete insulin, but do NOT reduce insulin resistance
◉ What is a major consideration with sulfonyureas, especially
within the elderly population? Answer: These cause hypoglycemia
and put the elderly at increased risk for falls
◉ What are examples of Thiazolidinediones (TZDs)? Answer: All the
zone's
, Pioglitazone (Actos)
◉ How does TZDs work? Answer: Lower your insulin resistance,
they are insulin sensitizers
◉ What are the side effects of TZDs? Answer: Toxicity to the liver-
need to monitor LFTs
Toxic in patients with heart failure
Causes weight gain and peripheral edema
◉ What patients are TZD's contraindicated in? Answer: Heart failure
patients
◉ What are some examples of Alpha-glucosidase inhibitors?
Answer: Acarbose (Precose)
Miglitol (Glyset)
◉ How do alpha-glucose dose inhibitors work? Answer: Inhibit
glucosidase in the small intestines
◉ What are common side effects of alpha-glucosidase inhibitors, and
what patients should NOT take this drug? Answer: Tend to see lots of
GI side effects
C/I in patients with chronic bowel disease of any kind
PRACTICE EXAM WITH VERIFIED SOLUTIONS
◉ Why does Metformin need to be stopped prior to having any
procedure with contrast? Answer: Contrast dye is harsh on the
kidneys, need to be sure that there is pause with that Metformin so
that their kidneys are not seriously injured.
◉ Long term usage of Metformin can lead to what deficiency?
Answer: B12 deficiency anemia
◉ How does Metformin impact weight? Answer: Metformin is
weight NEUTRAL, some patient even will have weight loss with this
drug
◉ Does Metformin cause hypoglycemia? Answer: NO, Metformin
works in the body by inhibiting glucose production in the liver. Due
to that there are no issues with hypoglycemia
◉ What are some examples of SGLT-2 inhibitors? Answer: All the -
flozin's
Empagiflozin
,◉ What is the MOA for SGLT-2 inhibitors? Answer: Reduce
absorption of glucose in the renal tubules, the patient will urinate
out the extra glucose
◉ What lab should be assessed prior to prescribing SGLT-2
inhibitors? Answer: Renal function
◉ Does SGLT-2 inhibitors cause hypoglycemia? Answer: SGLT-2
inhibitors have a LOW risk for hypoglycemia
◉ What education is required for patients who are on SGLT-2
inhibitors? Answer: Staying hydrated and reporting any new urinary
issues
◉ What patients are NOT good candidates for SGLT-2 inhibitors?
Answer: Patients who cannot make it to the bathroom in time
Patients with frequent UTIs or yeast infections already
◉ What is a major perk to SGLT-2 inhibitors? Answer: They are
cardio-protective- they have shown to reduce overall risk of
mortality associated with coexisting cardiac conditions, and they
may even prevent future cardiac issues.
◉ What diabetes medication classes are cardioprotective? Answer:
SGLT-2 inhibitors and GLP-1 agonists
,◉ What are examples of DPP-4 inhibitors? Answer: Alt he -gliptins
Sitagliptin
◉ What is the MOA of DPP-4 inhibitors? Answer: Increase insulin
production/decrease glucagon secretion
Impacts fasting and postprandial glucose levels
◉ DPP-4 inhibitors are contraindicated in patients with a history of
what condition? Answer: Pancreatitis
◉ What are examples of sulfonylureas? Answer: All the ide's
glipizide, glyburide, glimepiride
◉ What is the MOA of sulfonyureas? Answer: Cause the pancreases
to secrete insulin, but do NOT reduce insulin resistance
◉ What is a major consideration with sulfonyureas, especially
within the elderly population? Answer: These cause hypoglycemia
and put the elderly at increased risk for falls
◉ What are examples of Thiazolidinediones (TZDs)? Answer: All the
zone's
, Pioglitazone (Actos)
◉ How does TZDs work? Answer: Lower your insulin resistance,
they are insulin sensitizers
◉ What are the side effects of TZDs? Answer: Toxicity to the liver-
need to monitor LFTs
Toxic in patients with heart failure
Causes weight gain and peripheral edema
◉ What patients are TZD's contraindicated in? Answer: Heart failure
patients
◉ What are some examples of Alpha-glucosidase inhibitors?
Answer: Acarbose (Precose)
Miglitol (Glyset)
◉ How do alpha-glucose dose inhibitors work? Answer: Inhibit
glucosidase in the small intestines
◉ What are common side effects of alpha-glucosidase inhibitors, and
what patients should NOT take this drug? Answer: Tend to see lots of
GI side effects
C/I in patients with chronic bowel disease of any kind
