Post 10 hormones/osteo

M.K. is a 74 year old woman who has been taking thyroid hormones for 10 years. Which of the following effects of thyroid hormones would be the most dangerous for her?

A. cardiac stimulation
B. constipation
C. insomnia
D. muscle relaxation



F.H. is a 42 year old type 1 diabetic who has been receiving insulin for a long time. He needs a very high dose of insulin to maintain his blood glucose within the target range. Which of the following drugs might be added to his medications to help control his blood glucose?

A. glucagon.
B. bromocriptine.
C. growth hormone.
D. metformin (GLUCOPHAGE).



Which of the following are adverse effects of metformin (GLUCOPHAGE)?

A. hypotension
B. headache
C. blurred vision
D. hyperglycemia



Which of the following would you predict as an effect of insulin administration?

A. Increased blood glucose
B. Decreased white blood cell count
C. Increased serum sodium
D. Decreased serum potassium



After subcutaneous administration of NPH insulin, the peak effect is seen:

A. within 5-10 minutes
B. in 6-12 hours
C. in 18-24 hours
D. after 2 weeks of therapy



Which of the following statements about Repaglinide (PRANDIN)is true?

A. It mimics the normal first phase insulin reaction.
B. It sensitizes cells to the action of insulin.
C. It decreases carbohydrate absorption from the gut.
D. It should be taken 30 minutes after eating.



For many years, women have been prescribed estrogen with or without progesterone at menopause to reduce hotflashes and protect the bones and blood vessels. In 2002 the Women's Health Initiative published findings (JAMA 2002 Jul 17;288(3):366-8) substantiated by other reviews (JAMA 2002 Aug 21;288(7):872-81) that showed the effect of postmenopausal hormone replacement therapy (HRT) to include:

A. Large reduction in risk of breast cancer.
B. NO reduction in risk of heart attack and stroke.
C. Small reduction in risk of gall bladder disease.
D. Large increase in the risk of osteoporotic bone fractures.



A patient is to receive 12 units of regular insulin AND sliding scale insulin as follows: for BS (blood sugar) less than 80: give sugar, for BS 81-140: give no insulin, for BS 141-200 give 2 units regular insulin, for BS 201-250 give 4 units regular insulin, for BS 251-300 give 6 units regular insulin, for BS 301-350 give 8 units regular insulin. For BS over 350 give 10 units regular insulin. This morning the blood sugar was 40. What should you do?

Student Response Correct Answer
A. Give 12 units Humalog insulin with sugar.
B. Give 12 units Humulin-R with sugar.
C. Give 12 units Humulin-N with sugar.
D. Give sugar.



LC is a 33 year old who has been taking oral contraceptives for the past 8 years. To assess her risk of having adverse effects from this medication, the most important question you should ask is:

A. "Are you allergic to eggs?"
B. "Do you smoke?"
C. "Has anyone in your family died of colon cancer?"
D. "Have any family members been diagnosed with osteoporosis?"



When teaching an elderly client how to take calcium supplements to prevent osteoporosis, your best statement would be:

A. Take 240 mg sustained release Calan each morning.
B. Take 1 500 mg calcium carbonate in the morning on an empty
stomach.
C. Take 1 100 mg tablet of calcium citrate with each meal.
D. Take 2 500 mg tablets of calcium carbonate every evening with your
meal.



Which of the following drugs would INCREASE the cardiovascular adverse effects of thyroid hormones?

A. acetominophen
B. beta blockers
C. parasympathomimetic drugs
D. sympathomimetic drugs



H.W. is a 56 year old male who has type 2 diabetes. He is taking glipizide (GLUCOTROL) and acarbose (PRECOSE). He shows evidence of hypoglycemia. How should this be treated?

A. administer insulin
B. give him sugar
C. give him a high protein supplement
D. take his blood pressure and watch carefully



Match the drug to its MAJOR mechanism of aciton.

glipizide (GLUCOTROL) Replaces insulin
acarbose (PRECOSE) Increases insulin release
repaglinide (PRANDIN) Delays absorption of carbohydrate
NPH insulin



LC is a 33 year old who has been taking oral contraceptives for the past 8 years. To assess her risk of having adverse effects from this medication, the most important question you should ask is:

A. "Do you smoke?"
B. "Has anyone in your family died of colon cancer?"
C. "Are you allergic to eggs?"
D. "Have any family members been diagnosed with osteoporosis?"



Which of the following is the least expensive prevention for osteoporosis?

A. Flomax
B. Evista
C. Forteo
D. Calcium supplements with vitamin D



After subcutaneous administration of regular insulin, the peak effect is seen:

A. within 5-10 minutes
B. in 2-4 hours
C. in 8-12 hours
D. after 2 weeks of therapy



Which of the following are adverse effects of glipizide (GLUCOTROL)?

A. hypertension
B. headache
C. chest pain
D. muscle pain


Courtesy of Vanessa Kelly, Thanks!!!


LC is a 33 year old who has been taking oral contraceptives. She reports a recent weight gain and says her right foot is so swollen she can barely get her shoe on. Her left foot is normal. What is the significance of these complaints?


A. She is probably pregnant, and should pick up an over-the-counter kit to check before she takes any more BCPs.
B. These symptoms may eventually require a trip to the doctor, but they are not related to the BCPs.
C. She is showing signs of menopause and could probably safely stop taking the BCPs without getting pregnant.
D. She has probably developed a blood clot in her right leg (thrombophlebitis), and should go to the hospital to have it checked.




H.B. is a 48 year old male who is being treated for type 2 diabetes with oral agents. He reports his usual fasting blood glucose is 168, bedtime glucose is 180, and A1c is 10.2. Which of the following statements is true about H.B.?

A. He should stay on the same medications.
B. He needs additional medicine.
C. He needs lower doses of medicine.
D. His diabetes has resolved.



Your diabetic patient is to receive 8 units of regular insulin AND sliding scale insulin as follows: for BS (blood sugar) less than 80: give sugar, for BS 81-140: give no insulin, for BS 141-200 give 2 units regular insulin, for BS 201-250 give 4 units regular insulin, for BS 251-300 give 6 units regular insulin, for BS 301-350 give 8 units regular insulin. For BS over 350 give 10 units regular insulin. This morning the blood sugar was 145. What should you do?

A. Give 8 units Humalog and 2 units Humulin-R.
B. Give 10 units Humulin-R.
C. Give 8 units Humalog.
D. Give 12 units Humulin-N.