Anesthesia Pharmacology: Practice Questions concerning Diabetes

Most common complication insulin therapy:
1. lipodystrophies
2. hypotension
3. gallstones
4. hypoglycemia
5. retinopathy
Effects associated with insulin- induced hypoglycemia:
1. tachycardia
2. palpitations
3. nausea
4. sweating
5. all of the above
Effective in the immediate management of the comatose, hypoglycemic patient.
1. have the patient drink orange juice
2. provide IV infusion of 50% glucose solution
3. glucagon injection -- subcutaneous or intramuscular
4. B & C
5. A,B & C
Causes of hypoglycemia in a diabetic patient:
1. insulin overdosage
2. delay in eating (later than normal)
3. unusual physical activity
4. A & B
5. A,B & C
Blockade of signs of diabetic hypoglycemia:
1. diabetic neuropathy
2. metoprolol (Lopressor)
3. propranolol (Inderal)
4. B & C
5. A, B & C
Insulin allergy:
1. immediate response is IgG mediated
2. anaphylaxis may result
3. change in insulin species(e.g. from pure pork or human from beef)
4. B & C
5. A, B & C
Biguanide-- oral hypoglycemic drug:
1. Tolbutamide (Orinase)
2. acarbose (Precose)
3. metformin (Glucophage)
4. troglitazone (Rezulin)
5. none of the above
Proposed mechanism(s) for hypoglycemic action of sulfonylureas:
1. enhancement of insulin release from pancreatic beta cells
2. increase of serum glucagon levels
3. potentiation of insulin effects at target tissues
4. A & B
5. A & C
Sulfonylurea hypoglycemic drug:receptor sites
1. muscarinic receptor
2. calcium channel
3. potassium channel
4. beta adrenergic receptor
5. alpha adrenergic receptor
Inhibitors of insulin release:
1. somatostatin
2. diazoxide (Hyperstat)
3. phenytoin (Dilantin)
4. vinblastine (Velban)
5. all of the above
Second generation sulfonylurea:
1. chlorpropamide (Diabinese)
2. tolazamide (Tolinase)
3. acetohexamide
4. glipizide (Glucotrol)
5. Tolbutamide (Orinase)
Second-generation sulfonylurea approved for once-daily use as monotherapy in management of Type II diabetes:
1. chlorpropamide (Diabinese)
2. glyburide (Micronase, DiaBeta)
3. glipizide (Glucotrol)
4. glimepiride (Amaryl)
5. metformin (Glucophage)
Oral hypoglycemic agent most likely to be prescribed for patients with refractory obesity and who exhibit insulin resistance syndrome: in
1. acetohexamide
2. chlorpropamide (Diabinese)
3. glyburide (Micronase, DiaBeta)
4. metformin (Glucophage)
5. Tolbutamide (Orinase)
Aldose reductase inhibitor:
1. metformin (Glucophage)
2. acetazolamide (Diamox)
3. Tolbutamide (Orinase)
4. acarbose (Precose)
5. troglitazone (Rezulin)
Cardiac effects of glucagon:
1. positive inotropic; positive chronotropic
2. negative inotropic negative chronotropic
Immediate pharmacologic/metabolic consequence of glucagon infusion:
1. increase hepatic glycogen; decrease blood glucose
2. decrease blood glucose; decrease stored hepatic glycogen
3. increased blood glucose; decreased hepatic glycogen
4. decreased blood glucose; increase stored hepatic glycogen
5. none of the above
Glucagon effect(s)-- at pharmacologic doses:
1. promote insulin release from normal pancreatic B cells
2. promote catecholamine release from pheochromocytoma
3. promote calcitonin release from medullary carcinoma cells
4. A & B
5. A, B & C
Following very significant alpha and beta-adrenergic blocker overdosage; most likely to promote increased inotropic and chronotropic cardiac response
1. isoproterenol (Isuprel)
2. phenylephrine (Neo-Synephrine)
3. glucagon
4. mecamylamine (Inversine)
5. none of the above would be effective