PHARMACOLOGY: PRACTICE 4

SINGLE BEST OPTION SERIES

         INSTRUCTION: SELECT THE SINGLE BEST OPTION

1.          Which of the following is incorrect about dipeptidyl peptidase-4 (DPP-4) inhibitors in the management of type 2 diabetes mellitus?
   a.       Their major action is to increase the circulating levels of glucagon-like peptide-1 (GLP-1) like molecules
   b.      They decrease post prandial glucose excursions
   c.       They potentiate glucose mediated insulin secretion
   d.      They increase glucagon levels
   e.      They may be used as monotherapy or in combination with metformin
   2.       It has been observed that when regular insulin is administered at meal time, the blood glucose rises faster than the insulin with resultant early postprandial hyperglycaemia and an increased risk of late postprandial hypoglycaemia. Based on this finding, regular insulin should best be injected...........................before meal to minimize this mismatching.
   a.       30 to 45 minutes or more
   b.      10 to 15 minutes or more
   c.       30 to 45 minutes or less
   d.      10 to 15 minutes or less
   e.      15 to 30 minutes or less
   3.       The following class of oral antidiabetic agents are matched with their predominant mechanism of action except:
   a.       Insulin secretagogues...............................increased insulin secretion from the pancreas
   b.      Biguanides...............................................decreased hepatic glucose production
   c.       Thiazolidinediones..................................reduced insulin resistance
   d.      Alpha glucosidase inhibitors...................increased digestion and absorption of starch
   e.      Amylin analog.........................................decreased post meal glucose excursions
   4.       Which of the following is incorrect about repaglinide?
   a.       Causes increased insulin release from the pancreas
   b.      It is indicated for controlling postprandial glucose excursions because of its rapid onset
   c.       It is contraindicated in patients with type 2 diabetes mellitus who have sulphur allergy
   d.       Hypoglycaemia is a risk if meal is delayed or skipped after taking this drug
   e.      It should be used with caution in patients with renal and/or hepatic impairment
   5.       Metformin is contraindicated in the following conditions except:
   a.       Renal disease
   b.      Alcoholism
   c.       Hepatic disease
   d.      Cardiopulmonary dysfunction predisposing to tissue anoxia
   e.      None of the above
   6.       Which of the following is incorrect about acarbose?
   a.       Gastronintestinal adverse effects usually result from the appearance of undigested carbohydrates in the colon that is then fermented into long chain fatty acids, releasing gas.
   b.      It has effects on all α-glucosidase enzymes attached to the brush border of intestinal cells.
   c.       Monotherapy with this drug in patients with type 2 diabetes mellitus results in modest drop in glycohaemoglobin levels.
   d.      Hypoglycaemia does not usually occur in diabetics even when combined with metformin
   e.      None of the above
   7.       Common adverse effects of sitagliptin include the following except?
   a.       Nasopharyngitis
   b.      Upper respiratory infection
   c.       Headaches
   d.      Allergic reactions
   e.      None of the above
   8.       Which of the following is incorrect about the management of diabetes mellitus?
   a.       Metformin is beneficial for overweight or obese patients
   b.      Sulphonylureas are valuable in the treatment of non-obese patients who fail to respond to dietary measures alone
   c.       Repaglinide is more likely to cause hypoglycaemia than sulphonylureas
   d.      The thiazolidinediones do not usually cause hypoglycaemia
   e.      Sulphonylurea, metformin and thiazolidinediones can be combined and used as ‘triple therapy’.
   9.       Which of the following is incorrect about regular short acting insulins?
   a.       Their effect appears within 30 minutes and peaks between 2 and 3 hours after subcutaneous injection
   b.      Their hexameric nature causes a delayed onset and prolongs the time to peak action
   c.       They are never to be administered intravenously even when treating patients with diabetic ketoacidosis
   d.      After subcutaneous injection, their effects generally lasts 5 to 8 hours
   e.      None of the above
   10.   Inhibitors of insulin release from the beta cells of the pancreas include the following except:
   a.       Vinblastine
   b.      Somatostatin
   c.       Arginine
   d.      Colchicine
   e.      Alpha sympathomimetic effect of catecholamines 
   
   
   
   
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