NR566 FINAL EXAM/ ADVANCED PHARMACOLOGY FOR CARE OF
FAMILY/ 400 QUESTIONS & ANSWERS / |ALREADY GRADED
A+(100% CORRECT)
• What diabetic medications come with a concern of hypoglycemia? -
(CORRECT ANSWER) insulin
sulfonylureas
amylin analogues
meglitinides
• What labs are used to diagnose thyroid issues? - (CORRECT ANSWER) Total T3, Free T3, Total T4, Free
T4, TSH
• Whats the timeframe for re-check of labs after starting levothyroxine? - (CORRECT ANSWER) 6 weeks
until euthyroid is achieved, then yearly.
• Patient presents with a pale and puffy face, expressionless, cold dry skin, brittle hair, hair loss, low heart
rate, low temperature, lethargy, fatigue, and complaining of intolerance to cold. - (CORRECT ANSWER)
Hypothyroidism
• Guidelines for confirming a diagnosis of diabetes - (CORRECT ANSWER) Casual plasma glucose >/= 200
2 hours post-load plasma glucose in an oral glucose tolerance test >/= 200
A1C greater than 6.5%
Fasting glucose >/= 126
• Classic symptoms of diabetes - (CORRECT ANSWER) polyuria, polydipsia, unexplained weight loss
• Mechanism of action of sulfonylureas - (CORRECT ANSWER) Stimulate beta cells of the pancreas to
secrete more insulin.
• Mechanism of action of TZDs - (CORRECT ANSWER) Enhances insulin sensitivity in muscle tissue and
reduce glucagon production in the liver.
• Mechanism of action of DPP-4i - (CORRECT ANSWER) enhance actions of incretin hormones which
results in increased insulin secretion and decreased glucagon.
• Mechanism of action of GLP-1 - (CORRECT ANSWER) Augment effects of incretin hormone GLP-1.
Increase insulin production and inhibit postprandial glucagon release and increases satiety.
• Mechanism of action of SGLT2i - (CORRECT ANSWER) Block glucose reabsorption by the kidneys in the
proximal nephron and increase the release of glucose in the urine.
• Patient presents with a rapid heart rate, dysrhythmias, angina, nervousness, insomnia, rapid thought flow,
rapid speech, weakened skeletal muscles, muscle atrophy, increased metabolism, increased body temp
and intolerance to heat. Skin is warm and moist. Appetite has been increased. They have experienced
unexpected weightloss. - (CORRECT ANSWER) Hyperthyroidism
• What are the two main types of hyperthroidism? - (CORRECT ANSWER) Grave's disease and toxic
nodular goiter
• What is the treatment of thyroid storm? - (CORRECT ANSWER) PTU, high doses of potassium iodide or
strong iodine solutions
Methimazole is given to suppress thyroid hormone synthesis
Metoprolol is given to reduce heart rate.
• What can result if hypothyroidism isn't treated during pregnancy? - (CORRECT ANSWER) Can decrease
IQ and other aspects of neuropsychological function. This is largely limited to the first trimester because
the fetus is unable to produce it's own thyroid hormone at the time.
, • What medication can treat the symptoms of hyperthyroidism? - (CORRECT ANSWER) Metoprolol can
treat tachycardia
• What drugs can reduce the absorption of levothyroxine? -
(CORRECT ANSWER) Histamine 2 (H2) receptor blockers (cimetidine, Tagamet)
Proton pump inhibitors (lansoprazole, prevacid)
Sucralfate (Carafate)
Cholestyramine (questrant)
Colestipol (colestid)
Alumin-containing antacid (Maazlox, Mylanta)
Calcium supplements (Tums, Oscal)
Iron supplements (ferrous sulfate)
Magnesium salts
Orlistate (xenicol)
• What drugs accelerate levothyroxine? - (CORRECT ANSWER) phenytoin (Dilantin)
Carbamazapine (tegretol, carbatrol)
Rifampin (rifadin)
Sertraline (zoloft)
Phenobarbital
• What should you worry about if you prescribe you patient levothyroxine and they're taking warfarin? -
(CORRECT ANSWER) Levothyroxine accelerates the degradation of vitamin-K dependent clotting factors.
Therefore, the effect of warfarin are enhance.
• What should you worry about if you prescribe levothyroxine to a patient who is taking digoxin or insulin? -
(CORRECT ANSWER) Levothyroxine and increase the requirements for insulin and digoxin. therefore,
dosages of these two medications may need to be increased.
• Whats the ratio of basal insulin to rapid-acting insulin in total daily dose (TDD)? - (CORRECT ANSWER)
Basal insulin is 50% and bolus insulin is 50%
• Carbohydrate to insulin ration for calculating basal insulin with regular insulin? - (CORRECT ANSWER)
450/TDD
• Carbohydrate to insulin ratio for calculating basal insulin with rapid-acting insulin - (CORRECT ANSWER)
500/TDD
• Which patients are at risk for methylxanthines toxicity? - (CORRECT ANSWER) Patients with liver
dysfunction.
Patients who were once smokers but have quit because marijuana and tobacco can increase clearance to
50-80% in adults. Even those exposed to secondhand smoke.
Patient taking cimetidine or fluroquinolone antibiotics.
FAMILY/ 400 QUESTIONS & ANSWERS / |ALREADY GRADED
A+(100% CORRECT)
• What diabetic medications come with a concern of hypoglycemia? -
(CORRECT ANSWER) insulin
sulfonylureas
amylin analogues
meglitinides
• What labs are used to diagnose thyroid issues? - (CORRECT ANSWER) Total T3, Free T3, Total T4, Free
T4, TSH
• Whats the timeframe for re-check of labs after starting levothyroxine? - (CORRECT ANSWER) 6 weeks
until euthyroid is achieved, then yearly.
• Patient presents with a pale and puffy face, expressionless, cold dry skin, brittle hair, hair loss, low heart
rate, low temperature, lethargy, fatigue, and complaining of intolerance to cold. - (CORRECT ANSWER)
Hypothyroidism
• Guidelines for confirming a diagnosis of diabetes - (CORRECT ANSWER) Casual plasma glucose >/= 200
2 hours post-load plasma glucose in an oral glucose tolerance test >/= 200
A1C greater than 6.5%
Fasting glucose >/= 126
• Classic symptoms of diabetes - (CORRECT ANSWER) polyuria, polydipsia, unexplained weight loss
• Mechanism of action of sulfonylureas - (CORRECT ANSWER) Stimulate beta cells of the pancreas to
secrete more insulin.
• Mechanism of action of TZDs - (CORRECT ANSWER) Enhances insulin sensitivity in muscle tissue and
reduce glucagon production in the liver.
• Mechanism of action of DPP-4i - (CORRECT ANSWER) enhance actions of incretin hormones which
results in increased insulin secretion and decreased glucagon.
• Mechanism of action of GLP-1 - (CORRECT ANSWER) Augment effects of incretin hormone GLP-1.
Increase insulin production and inhibit postprandial glucagon release and increases satiety.
• Mechanism of action of SGLT2i - (CORRECT ANSWER) Block glucose reabsorption by the kidneys in the
proximal nephron and increase the release of glucose in the urine.
• Patient presents with a rapid heart rate, dysrhythmias, angina, nervousness, insomnia, rapid thought flow,
rapid speech, weakened skeletal muscles, muscle atrophy, increased metabolism, increased body temp
and intolerance to heat. Skin is warm and moist. Appetite has been increased. They have experienced
unexpected weightloss. - (CORRECT ANSWER) Hyperthyroidism
• What are the two main types of hyperthroidism? - (CORRECT ANSWER) Grave's disease and toxic
nodular goiter
• What is the treatment of thyroid storm? - (CORRECT ANSWER) PTU, high doses of potassium iodide or
strong iodine solutions
Methimazole is given to suppress thyroid hormone synthesis
Metoprolol is given to reduce heart rate.
• What can result if hypothyroidism isn't treated during pregnancy? - (CORRECT ANSWER) Can decrease
IQ and other aspects of neuropsychological function. This is largely limited to the first trimester because
the fetus is unable to produce it's own thyroid hormone at the time.
, • What medication can treat the symptoms of hyperthyroidism? - (CORRECT ANSWER) Metoprolol can
treat tachycardia
• What drugs can reduce the absorption of levothyroxine? -
(CORRECT ANSWER) Histamine 2 (H2) receptor blockers (cimetidine, Tagamet)
Proton pump inhibitors (lansoprazole, prevacid)
Sucralfate (Carafate)
Cholestyramine (questrant)
Colestipol (colestid)
Alumin-containing antacid (Maazlox, Mylanta)
Calcium supplements (Tums, Oscal)
Iron supplements (ferrous sulfate)
Magnesium salts
Orlistate (xenicol)
• What drugs accelerate levothyroxine? - (CORRECT ANSWER) phenytoin (Dilantin)
Carbamazapine (tegretol, carbatrol)
Rifampin (rifadin)
Sertraline (zoloft)
Phenobarbital
• What should you worry about if you prescribe you patient levothyroxine and they're taking warfarin? -
(CORRECT ANSWER) Levothyroxine accelerates the degradation of vitamin-K dependent clotting factors.
Therefore, the effect of warfarin are enhance.
• What should you worry about if you prescribe levothyroxine to a patient who is taking digoxin or insulin? -
(CORRECT ANSWER) Levothyroxine and increase the requirements for insulin and digoxin. therefore,
dosages of these two medications may need to be increased.
• Whats the ratio of basal insulin to rapid-acting insulin in total daily dose (TDD)? - (CORRECT ANSWER)
Basal insulin is 50% and bolus insulin is 50%
• Carbohydrate to insulin ration for calculating basal insulin with regular insulin? - (CORRECT ANSWER)
450/TDD
• Carbohydrate to insulin ratio for calculating basal insulin with rapid-acting insulin - (CORRECT ANSWER)
500/TDD
• Which patients are at risk for methylxanthines toxicity? - (CORRECT ANSWER) Patients with liver
dysfunction.
Patients who were once smokers but have quit because marijuana and tobacco can increase clearance to
50-80% in adults. Even those exposed to secondhand smoke.
Patient taking cimetidine or fluroquinolone antibiotics.
