AANP Adult GeroNtoloGy MArKS
orIeNted exAM QueStIoNS wIth
CorreCt
SolutIoNS AlreAdy GrAded
A+||100% GuArANteed
PASS!!!<<BrANd New VerSIoN>>
Biguanindes - ANSWER ✓ Metformin (Glucophage) decreases gluconeogenesis,
increases glycolysis and peripheral glucose uptake (increases insulin sensitivity
Sulfonylureas - ANSWER ✓ First generation: Tolbutamide (oranase),
chlorpropamide (diabinase), second generation: Glyburide (micronase, diabeta),
glipizide (glucotrol), glimeprode (amaryl); lowers blood sugar by stimulating the
release of insulin by the beta cells of the pancreas + causes tissues to take up and
store glucose more easily; first generation are low potency and short acting; second
generation are high potency and longer acting; adverse reactions: first generations:
hypoglycemia, nausea, heartburn, constipation, anorexia, agranulocytosis, allergic
skin reactions; second generation reactions: weight gain, hypoglycemia; first
generation: responsiveness may decrease over time; once daily with first meal;
monitor blood sugar; hard to detect hypoglycemia; second generation: less likely to
interact with other medications
Thiazolidinediones - ANSWER ✓ Rosiglitazone (avandia), pioglitazone (actos);
lowers BS by decreasing insulin resistance of the tissues; adverse reactions:
hypoglycemia, increased total cholesterol, weight gain, edema, anemia; skip dose
if meal skipped; no known drug interactions; monitor liver function; caution with
use in CAD; may precipitate HF
Bile Acid Sequestrant - ANSWER ✓ Colesevelam (Welchol) reduces hepatic
glucose production and may reduce intestinal absorption of glucose.
, Meglintinide - ANSWER ✓ Repaglinide (prandin) Nateglinide (starlix).
Stimulates release of insulin in response to glucose load (meal) which lowers blood
sugar, can cause hypoglycemia. Indicated for DM2 with posparandial
hyperglycem
ia. NSAIDS - ANSWER ✓ Inhibit prostaglandin and other chemical
mediator syntheses and other chemical mediator synthesis involved in
pain; antipyretic activity through action on the hypothalamic heat-
regulating center to reduce fever Mild/moderate pain, fever, arthritis,
and blood thinner. Take with food will cause GI ulcers, Do not give
this and aspirin together, stop taking 1 week before surgery.
Topical Nasal Decongestants - ANSWER ✓ Oxymetazoline Nasal Spray(Afrin)
Phenylephrine(Neo-Synephrine
Relieve the discomfort of nasal congestion that accompanies the common cold,
sinusitis, and allergic rhinitis
Can cause rebound congestion if used longer than 3 to 4 days.
Antihistamines - ANSWER ✓ Called histamine antagonists or H1 blockers; they
compete for receptor sites, thus preventing a histamine response.
Benadryl avoid with elderly use claritin instead. Zyrtec more potent and long
acting.
Decongestants - ANSWER ✓ pseudoephedrine and pheylephrin
robitussin, sudafed, allegra, afrin, nasonex
constrict blood vessels of nasal passages and limit blood flow, which causes
swollen tissues to shrink so that air can pass more freely through the passageway
CI with HTN, CAD (angina MI). Avoid mixing with stimulants
caffeine causes elevated bp palpitations, anxiety, arrythymias. dont
give within 14 days of MAOI and seligine (eldepryl).
, Aspirin - ANSWER ✓ Irrevesiable supresses platelet function for 7
days.
discontinue if c/o tinnitus (toxicity). 81/day for chronic use. Give post
MI/Stroke considered tertiary prevention. Avoid in children with viral
infections less than 16 years causes Reye's syndrome.
Hypothyroidism - ANSWER ✓ A disorder caused by a thyroid gland
that is slower and less productive than normal
The classic lab finding for hypothyroidism is a high TSH with low
free T4(no not confuse with total T4)
Tx with Levothyroxine (synthroid 25 mcg/day start low dose). Check
TSH levels 6-8 weeks.
Thyroid Cancer - ANSWER ✓ a single large nodule(>2.5 cm)on one
lobe of the thyroid gland. The 24 hour radioactive iodine
uptake(RAIU) test will show a cold nodule
Type 1 Diabetes - ANSWER ✓ form of diabetes mellitus that is an
autoimmune disease; results in the destruction of beta islet cells and a
complete deficiency of insulin on the body; usually occurs before age
30.
Type 2 Diabetes - ANSWER ✓ Diabetes of a form that develops
especially in adults and most often obese individuals and that is
characterized by high blood glucose resulting from impaired insulin
utilization coupled with the body's inability to compensate with
increased insulin production.
fasting glucose 100-125
A1C 5.7-6.4
2 hr ogtt 140-199
Dawn Phenomenon - ANSWER ✓ A nocturnal release of growth hormone, whic
may cause blood glucose level elevations before breakfast in the client with
diabetes mellitus. Treatment includes administering an evening dose of
intermediate acting insulin at 10 pm.
orIeNted exAM QueStIoNS wIth
CorreCt
SolutIoNS AlreAdy GrAded
A+||100% GuArANteed
PASS!!!<<BrANd New VerSIoN>>
Biguanindes - ANSWER ✓ Metformin (Glucophage) decreases gluconeogenesis,
increases glycolysis and peripheral glucose uptake (increases insulin sensitivity
Sulfonylureas - ANSWER ✓ First generation: Tolbutamide (oranase),
chlorpropamide (diabinase), second generation: Glyburide (micronase, diabeta),
glipizide (glucotrol), glimeprode (amaryl); lowers blood sugar by stimulating the
release of insulin by the beta cells of the pancreas + causes tissues to take up and
store glucose more easily; first generation are low potency and short acting; second
generation are high potency and longer acting; adverse reactions: first generations:
hypoglycemia, nausea, heartburn, constipation, anorexia, agranulocytosis, allergic
skin reactions; second generation reactions: weight gain, hypoglycemia; first
generation: responsiveness may decrease over time; once daily with first meal;
monitor blood sugar; hard to detect hypoglycemia; second generation: less likely to
interact with other medications
Thiazolidinediones - ANSWER ✓ Rosiglitazone (avandia), pioglitazone (actos);
lowers BS by decreasing insulin resistance of the tissues; adverse reactions:
hypoglycemia, increased total cholesterol, weight gain, edema, anemia; skip dose
if meal skipped; no known drug interactions; monitor liver function; caution with
use in CAD; may precipitate HF
Bile Acid Sequestrant - ANSWER ✓ Colesevelam (Welchol) reduces hepatic
glucose production and may reduce intestinal absorption of glucose.
, Meglintinide - ANSWER ✓ Repaglinide (prandin) Nateglinide (starlix).
Stimulates release of insulin in response to glucose load (meal) which lowers blood
sugar, can cause hypoglycemia. Indicated for DM2 with posparandial
hyperglycem
ia. NSAIDS - ANSWER ✓ Inhibit prostaglandin and other chemical
mediator syntheses and other chemical mediator synthesis involved in
pain; antipyretic activity through action on the hypothalamic heat-
regulating center to reduce fever Mild/moderate pain, fever, arthritis,
and blood thinner. Take with food will cause GI ulcers, Do not give
this and aspirin together, stop taking 1 week before surgery.
Topical Nasal Decongestants - ANSWER ✓ Oxymetazoline Nasal Spray(Afrin)
Phenylephrine(Neo-Synephrine
Relieve the discomfort of nasal congestion that accompanies the common cold,
sinusitis, and allergic rhinitis
Can cause rebound congestion if used longer than 3 to 4 days.
Antihistamines - ANSWER ✓ Called histamine antagonists or H1 blockers; they
compete for receptor sites, thus preventing a histamine response.
Benadryl avoid with elderly use claritin instead. Zyrtec more potent and long
acting.
Decongestants - ANSWER ✓ pseudoephedrine and pheylephrin
robitussin, sudafed, allegra, afrin, nasonex
constrict blood vessels of nasal passages and limit blood flow, which causes
swollen tissues to shrink so that air can pass more freely through the passageway
CI with HTN, CAD (angina MI). Avoid mixing with stimulants
caffeine causes elevated bp palpitations, anxiety, arrythymias. dont
give within 14 days of MAOI and seligine (eldepryl).
, Aspirin - ANSWER ✓ Irrevesiable supresses platelet function for 7
days.
discontinue if c/o tinnitus (toxicity). 81/day for chronic use. Give post
MI/Stroke considered tertiary prevention. Avoid in children with viral
infections less than 16 years causes Reye's syndrome.
Hypothyroidism - ANSWER ✓ A disorder caused by a thyroid gland
that is slower and less productive than normal
The classic lab finding for hypothyroidism is a high TSH with low
free T4(no not confuse with total T4)
Tx with Levothyroxine (synthroid 25 mcg/day start low dose). Check
TSH levels 6-8 weeks.
Thyroid Cancer - ANSWER ✓ a single large nodule(>2.5 cm)on one
lobe of the thyroid gland. The 24 hour radioactive iodine
uptake(RAIU) test will show a cold nodule
Type 1 Diabetes - ANSWER ✓ form of diabetes mellitus that is an
autoimmune disease; results in the destruction of beta islet cells and a
complete deficiency of insulin on the body; usually occurs before age
30.
Type 2 Diabetes - ANSWER ✓ Diabetes of a form that develops
especially in adults and most often obese individuals and that is
characterized by high blood glucose resulting from impaired insulin
utilization coupled with the body's inability to compensate with
increased insulin production.
fasting glucose 100-125
A1C 5.7-6.4
2 hr ogtt 140-199
Dawn Phenomenon - ANSWER ✓ A nocturnal release of growth hormone, whic
may cause blood glucose level elevations before breakfast in the client with
diabetes mellitus. Treatment includes administering an evening dose of
intermediate acting insulin at 10 pm.
