NR565 Final QUESTIONS WITH DETAILED
VERIFIED ANSWERS (100% CORRECT) /ALREADY
GRADED A+
What labs are used to diagnose hypo/hyper thyroid? - Correct Answer-TSH, T3, and T4.
High TSH = hypo and low TSH = hyper. Opposites.
Timeframe for re-check of labs after starting levothyroxine - Correct Answer-6-8 weeks
(long half-life). Yearly after stable.
Signs and symptoms of hypothyroidism - Correct Answer-Dry hair, puffy face, goiter in
the neck, slow heartbeat, weight gain, constipation, infertility, increased risk of
miscarriages, irregular menstrual cycle, cold intolerance.
Drug of choice for hypothyroidism - Correct Answer-Levothyroxine (Synthroid)
§ Signs and symptoms of hyperthyroidism - Correct Answer-Hair loss, bulging eyes,
goiter, rapid heartbeat, weight loss, diarrhea, menstrual periods loss often or longer.
Drug of choice for hyperthyroidism - Correct Answer-Methimazole (Tapazole)
Treatment of thyroid storm - Correct Answer-high doses of potassium iodide or strong
iodine solution are given to suppress thyroid hormone release. Methimazole is given to
suppress thyroid hormone synthesis. Beta blocker given to reduce HR. additional
measures include sedation, cooling, and giving glucocorticoids and IV fluids.
Result of not treating hypothyroidism during pregnancy: - Correct Answer-Permanent
neuro-psychological deficits in the child. Decrease IQ/neuropsychological function. First
trimester.
Medication to treat symptoms of hyperthyroidism (notice this is treating symptoms and
not the hyperthyroidism itself): - Correct Answer-Beta blockers (tachycardia) -
propranolol/atenolol most popular.Non-radioactive iodine. ADJUNCTIVE THERAPY.
Drug/Food/Supplement interactions with levothyroxine: - Correct Answer-Do not take
antacids, Calcium or Iron, how to take it (morning 30-60 min b4 eat.
,How to confirm a diagnosis of DM prior to beginning treatment: - Correct Answer-
Fasting plasma glucose above 126. A random plasma glucose of over 200 plus
symptoms of diabetes, an oral glucose tolerance test of two hours, plasma glucose of
over 200, or a A1C higher than 6.5.
A1c general goals - Correct Answer-<7, patients that experience severe
hypoglycemia/have a limited life expectancy may have an A1C goal of <8.
A1c older adults - Correct Answer-<8, those with multiple coexisting chronic illnesses,
cognitive impairment, or functional dependence should have less stringent glycemic
goals such as <8.0-8.5.
When should insulin be considered? - Correct Answer-For treatment of persistent
hyperglycemia starting at a threshold of >180.
Early introduction of insulin should be considered if there is evidence of ongoing weight
loss, if symptoms of hyperglycemia are present, or whenA1C levels >10% or BGS >300
At what time interval should A1c be re-checked?
How often should an A1C be monitored when stable or when unstable? - Correct
Answer-Every 2-3 months and max of 4 times a year. If <7, every 6 months.
At least two times a year if meeting goals and quarterly if meds have changed or not
meeting goals.
Action of Insulin - Correct Answer-Anabolic, energy conservation, promotes cellular
growth and division.
Pioglitazone contraindications: - Correct Answer-Heart failure (severe = no, mild =
caution) and bladder cancer. Causes fluid retention.
GLP-1 (abbreviation and examples) - Correct Answer-Glucagonlike Peptide -
Subcutaneous injections - Dulaglutide (Trulicity), Semaglutide (Ozempic), Liraglutide
(Victoza).
SGLT2i (abbreviation and examples) - Correct Answer-Sodium Glucose Cotransporter 2
Inhibitors - Canagliflozin (Invokana), Dapagliflozin (Farxiga), Empagliflozin (Jardiance).
DPP4-I (abbreviation and examples) - Correct Answer-Dipeptidyl Peptidase-4 Inhibitors
- Sitagliptin, Saxagliptin, Linagliptin, Alogliptin.
, TZD (abbreviation and examples) - Correct Answer-Thiazolidinediones - Rosiglitazone
& Pioglitazone
Which drug class should be considered for diabetes prior to insulin? - Correct Answer-It
is recommended that a GLP-1 be considered before starting insulin. Metformin first
always unless contraindicated.
Ratio of basal insulin to rapid-acting insulin in total daily dose (TDD) of insulin - Correct
Answer-Basal and bolus insulin replacement encompasses approximately 50% of the
total daily insulin dose (TDD)
Example: TDD = patient's weight in kg (80kg) x 0.6 units = 48 units. That means 24
units of the TDD is the basal insulin dose and the other 24 units is rapid-acting.
How is total daily dose (TDD) of insulin calculated - Correct Answer-TDD is calculated
by taking the total weight in kg and multiply by 0.6 units.
Know the carbohydrate-to insulin ratio when calculating basal insulin - Correct Answer-
Mealtime dose is calculated using the 450 rule for regular insulin and 500 rule for rapid
acting insulin then divide by TDD. The answer (rounded) = the ratio of 1:the # answer.
That means that if the meal is 60g of carbs, 60 divided by the # in answer = # of units of
rapid-acting insulin.
GLP-1 MOA - Correct Answer-slows gastric emptying, stimulates glucose dependent
insulin release, and suppresses glucagon release and reduces appetite
DPP-4i MOA - Correct Answer-Enhance the activity of incretins and thereby increase
insulin release, reduce glucagon
TZD MOA - Correct Answer-Decreases insulin resistance and increase glucose uptake
by muscle and adipose tissue
Sulfonylureas MOA - Correct Answer-promote insulin secretion by the pancreas.
HYPOGLYCEMIA
SGLT2i MOA - Correct Answer-Kidney tubules.
Which diabetic medication(s) come with a concern of hypoglycemia? - Correct Answer-
Insulin, meglitinides, sulfonylureas, amylin analogues
VERIFIED ANSWERS (100% CORRECT) /ALREADY
GRADED A+
What labs are used to diagnose hypo/hyper thyroid? - Correct Answer-TSH, T3, and T4.
High TSH = hypo and low TSH = hyper. Opposites.
Timeframe for re-check of labs after starting levothyroxine - Correct Answer-6-8 weeks
(long half-life). Yearly after stable.
Signs and symptoms of hypothyroidism - Correct Answer-Dry hair, puffy face, goiter in
the neck, slow heartbeat, weight gain, constipation, infertility, increased risk of
miscarriages, irregular menstrual cycle, cold intolerance.
Drug of choice for hypothyroidism - Correct Answer-Levothyroxine (Synthroid)
§ Signs and symptoms of hyperthyroidism - Correct Answer-Hair loss, bulging eyes,
goiter, rapid heartbeat, weight loss, diarrhea, menstrual periods loss often or longer.
Drug of choice for hyperthyroidism - Correct Answer-Methimazole (Tapazole)
Treatment of thyroid storm - Correct Answer-high doses of potassium iodide or strong
iodine solution are given to suppress thyroid hormone release. Methimazole is given to
suppress thyroid hormone synthesis. Beta blocker given to reduce HR. additional
measures include sedation, cooling, and giving glucocorticoids and IV fluids.
Result of not treating hypothyroidism during pregnancy: - Correct Answer-Permanent
neuro-psychological deficits in the child. Decrease IQ/neuropsychological function. First
trimester.
Medication to treat symptoms of hyperthyroidism (notice this is treating symptoms and
not the hyperthyroidism itself): - Correct Answer-Beta blockers (tachycardia) -
propranolol/atenolol most popular.Non-radioactive iodine. ADJUNCTIVE THERAPY.
Drug/Food/Supplement interactions with levothyroxine: - Correct Answer-Do not take
antacids, Calcium or Iron, how to take it (morning 30-60 min b4 eat.
,How to confirm a diagnosis of DM prior to beginning treatment: - Correct Answer-
Fasting plasma glucose above 126. A random plasma glucose of over 200 plus
symptoms of diabetes, an oral glucose tolerance test of two hours, plasma glucose of
over 200, or a A1C higher than 6.5.
A1c general goals - Correct Answer-<7, patients that experience severe
hypoglycemia/have a limited life expectancy may have an A1C goal of <8.
A1c older adults - Correct Answer-<8, those with multiple coexisting chronic illnesses,
cognitive impairment, or functional dependence should have less stringent glycemic
goals such as <8.0-8.5.
When should insulin be considered? - Correct Answer-For treatment of persistent
hyperglycemia starting at a threshold of >180.
Early introduction of insulin should be considered if there is evidence of ongoing weight
loss, if symptoms of hyperglycemia are present, or whenA1C levels >10% or BGS >300
At what time interval should A1c be re-checked?
How often should an A1C be monitored when stable or when unstable? - Correct
Answer-Every 2-3 months and max of 4 times a year. If <7, every 6 months.
At least two times a year if meeting goals and quarterly if meds have changed or not
meeting goals.
Action of Insulin - Correct Answer-Anabolic, energy conservation, promotes cellular
growth and division.
Pioglitazone contraindications: - Correct Answer-Heart failure (severe = no, mild =
caution) and bladder cancer. Causes fluid retention.
GLP-1 (abbreviation and examples) - Correct Answer-Glucagonlike Peptide -
Subcutaneous injections - Dulaglutide (Trulicity), Semaglutide (Ozempic), Liraglutide
(Victoza).
SGLT2i (abbreviation and examples) - Correct Answer-Sodium Glucose Cotransporter 2
Inhibitors - Canagliflozin (Invokana), Dapagliflozin (Farxiga), Empagliflozin (Jardiance).
DPP4-I (abbreviation and examples) - Correct Answer-Dipeptidyl Peptidase-4 Inhibitors
- Sitagliptin, Saxagliptin, Linagliptin, Alogliptin.
, TZD (abbreviation and examples) - Correct Answer-Thiazolidinediones - Rosiglitazone
& Pioglitazone
Which drug class should be considered for diabetes prior to insulin? - Correct Answer-It
is recommended that a GLP-1 be considered before starting insulin. Metformin first
always unless contraindicated.
Ratio of basal insulin to rapid-acting insulin in total daily dose (TDD) of insulin - Correct
Answer-Basal and bolus insulin replacement encompasses approximately 50% of the
total daily insulin dose (TDD)
Example: TDD = patient's weight in kg (80kg) x 0.6 units = 48 units. That means 24
units of the TDD is the basal insulin dose and the other 24 units is rapid-acting.
How is total daily dose (TDD) of insulin calculated - Correct Answer-TDD is calculated
by taking the total weight in kg and multiply by 0.6 units.
Know the carbohydrate-to insulin ratio when calculating basal insulin - Correct Answer-
Mealtime dose is calculated using the 450 rule for regular insulin and 500 rule for rapid
acting insulin then divide by TDD. The answer (rounded) = the ratio of 1:the # answer.
That means that if the meal is 60g of carbs, 60 divided by the # in answer = # of units of
rapid-acting insulin.
GLP-1 MOA - Correct Answer-slows gastric emptying, stimulates glucose dependent
insulin release, and suppresses glucagon release and reduces appetite
DPP-4i MOA - Correct Answer-Enhance the activity of incretins and thereby increase
insulin release, reduce glucagon
TZD MOA - Correct Answer-Decreases insulin resistance and increase glucose uptake
by muscle and adipose tissue
Sulfonylureas MOA - Correct Answer-promote insulin secretion by the pancreas.
HYPOGLYCEMIA
SGLT2i MOA - Correct Answer-Kidney tubules.
Which diabetic medication(s) come with a concern of hypoglycemia? - Correct Answer-
Insulin, meglitinides, sulfonylureas, amylin analogues
