18.1 Insulin release from pancreatic β cells is augmented by the following except:
A. Ketone bodies
B. Glucagon
C. Vagal stimulation
D. Alfa adrenergic agonists
18.2 Action of Insulin does not include the following:
A. Facilitation of glucose transport into cells
B. Facilitation of glycogen synthesis by liver
C. Facilitation of neoglucogenesis by liver
D. Inhibition of lipolysis in adipose tissue
18.3 The major limitation of the thiazolidinediones in the
treatment of type 2 diabetes mellitus is:
A. Frequent hypoglycaemic episodes
B. Hyperinsulinemia
C. Lactic acidosis
D. Low hypoglycaemic efficacy in moderate to severe cases
18.4 Glucose entry into the cells of the following organ/
tissue is highly dependent on the presence of insulin:
A. Brain
B. Liver
C. Adipose tissue
D. Kidney tubules
18.5 Choose the correct statement(s) about actions of insulin:
A. It favours translocation of glucose transporters
from intracellular site to the plasma
membrane
B. It enhances transcription of lipoprotein lipase in vascular endothelium
C. It increases production of the enzyme glucokinase
D. All of the above
18.6 The insulin receptor is a:
A. Ion channel regulating receptor
B. Tyrosine protein kinase receptor
C. G-protein coupled receptor
D. None of the above
18.7 The primary route of administration of insulin is:
A. Intradermal
B. Subcutaneous
C. Intramuscular
D. Intravenous
18.8 The duration of action of insulin-zinc suspension (lente insulin) is:
A. 2–4 hours
B. 8–10 hours
C. 20–24 hours
D. 30–36 hours
18.9 The most common adverse reaction to insulin is:
A. Hypoglycaemia
B. Lipodystrophy
C. Urticaria
D. Angioedema
18.10 Which of the following is true of counterregulatory
symptoms of insulin hypoglycaemia:
A. They generally appear before neuroglucopenic symptoms
B. They are accentuated after long-term insulin treatment
C. They result from parasympathetic activation
D. They manifest as hunger and fatigue
18.11 Which of the following is a neuroglucopenic symptom of hypoglycaemia:
A. Sweating
B. Palpitation
C. Tremor
D. Abnormal behaviour
18.12 There is no alternative to insulin therapy for:
A. All type 1 diabetes mellitus patients
B. All type 2 diabetes mellitus patients
C. Type 2 diabetes patients not controlled by a sulfonylurea drug
D. Type 2 diabetes patients not controlled by a biguanide drug
18.13 In diabetic patients, round the clock tight control of
hyperglycaemia achieved by multiple daily insulin
injections or insulin pumps:
A. Prevents macrovascular disease more effectively
B. Is recommended in all type 2 diabetes patients
C. Is associated with higher incidence of hypoglycaemic reactions
D. Both A and C are correct
18.14 In a patient of diabetes mellitus maintained on
insulin therapy, administration of the following drug
can vitiate glycaemia control:
A. Prednisolone
B. Prazosin
C. Paracetamol
D. Phenytoin
18.15 Insulin therapy is required for the following category/
categories of type 2 diabetes mellitus patients:
A. Patients with ketoacidosis
B. Patients undergoing surgery
C. Pregnant diabetic
D. All of the above
18.16 The insulin preparation of choice in diabetic ketoacidosis is:
A. Regular insulin
B. Lente insulin
C. Isophane insulin
D. A 30:70 mixture of plain and isophane insulin
18.17 Which of the following measures is not an essential
component of the management of moderately
severe diabetic ketoacidosis:
A. Insulin
B. Intravenous fluids
C. Potassium chloride
D. Sodium bicarbonate
18.18 The monocomponent insulin preparations differ from
the conventional preparations in the following
respects except:
A. They are less allergenic
B. They cause less hypoglycaemic reactions
C. They cause less lipodystrophy
D. They are less liable to induce insulin resistance
18.19 Insulin resistance can be minimised by the use of:
A. Corticosteroids
B. Tolbutamide
C. Protamine
D. Monocomponent/human insulin
18.20 Human insulins are obtained by the following
sources/methods except:
A. Cadaver pancreas
B. Proinsulin recombinant bacterial
C. Precursor yeast recombinant
D. Enzyme modification of pork insulin
18.21 Compared to pork/beef insulins, the human insulins:
A. Are more potent
B. Have a faster kinetics of absorption and elimination
C. Have longer biological action half life
D. Penetrate blood-brain barrier more efficiently
18.22 Which of the following is not a specific indication
for the more expensive monocomponent/human
insulins:
A. Insulin resistance
B. Pregnant diabetic
C. Sulfonylurea maintained diabetic posted for surgery
D. Type 1 diabetes mellitus
18.23 The second generation sulfonylurea hypoglycaemics
differ from the first generation ones in that they:
A. Are more potent
B. Are longer acting
C. Do not lower blood sugar in nondiabetic subjects
D. Are less prone to cause hypoglycaemic reaction
8.24 Metformin is preferred over phenformin because:
A. It is more potent
B. It is less liable to cause lactic acidosis
C. It does not interfere with vitamin B12 absorption
D. It is not contraindicated in patients with kidney disease
18.25 Sulfonylureas do not lower blood sugar level in:
A. Nondiabetics
B. Type 1 diabetics
C. Type 2 diabetics
D. Obese diabetics
18.26 Sulfonylurea hypoglycaemics act by:
A. Reducing intestinal absorption of glucose
B. Increasing insulin secretion from pancreas
C. Reversing down-regulation of insulin receptors
D. Both ‘B’ and ‘C’ are correct
18.27 Which of the following drugs can precipitate hypoglycaemia
if given to a diabetic controlled with a
sulfonylurea drug:
A. Phenobarbitone
B. Chloramphenicol
C. Rifampicin
D. Oral contraceptive
18.28 The hypoglycaemic action of sulfonylureas is likely
to be attenuated by the concurrent use of:
A. Hydrochlorothiazide
B. Propranolol
C. Theophylline
D. Aspirin
18.29 Chlorpropamide is not a preferred sulfonylurea
because:
A. Hypoglycaemic reaction is more common with it
B. Incidence of alcohol intolerance reaction is higher with it
C. It can produce cholestatic jaundice
D. All of the above
18.30 Metformin causes little lowering of blood sugar level in:
A. Nondiabetics
B. Obese diabetics
C. Type 2 diabetics
D. Diabetics not responding to sulfonylureas
18.31 The 1st phase of insulin release from pancreatic β
cells is augmented by:
A. Glibenclamide
B. Metformin
C. Nateglinide
D. Both 'A' and 'C'
18.32 Choose the correct statement about nateglinide:
A. It is a long acting oral hypoglycaemic drug
B. Taken just before a meal, it limits postprandial
hyperglycaemia in type 2 diabetes
mellitus
C. It lowers blood glucose in both type 1 and type 2 diabetes mellitus
D. It acts by opening K+ channels in myocytes and adipocytes
18.33 Which of the following is not a sulfonylurea but acts
by analogous mechanism to bring about quick and
brief insulin release that is useful for normalizing
meal time glycaemic excursions in type 2 diabetes
mellitus:
A. Glimepiride
B. Miglitol
C. Repaglinide
D. Rosiglitazone
18.34 Metformin acts by:
A. Releasing insulin from pancreas
B. Suppressing gluconeogenesis and glucose output from liver
C. Up regulating insulin receptors
D. Inhibiting degradation of insulin
18.35 Choose the correct statement(s) about pioglitazone:
A. It acts as an agonist on nuclear paroxisome proliferator receptor γ
B. It enhances transcription of insulin responsive genes
C. It lowers blood sugar in type 2 diabetes mellitus without causing hyperinsulinemia
D. All of the above
18.36 The thiazolidinediones are mainly used as:
A. Sole drug in type 1 diabetes mellitus
B. Sole drug in type 2 diabetes mellitus
C. Addon drug to a sulfonylurea and/or a biguanide in type 2 diabetes mellitus
D. Addon drug to insulin in type 1 diabetes mellitus
18.37 The present status of oral hypoglycaemics in diabetes mellitus is:
A. They are the first choice drug in all cases
B. They should be prescribed only if the patient refuses insulin injections
C. They are used only in type I diabetes mellitus
D. They are used first in most uncomplicated mild to moderate type 2 diabetics
18.38 The following feature disfavours use of oral hypoglycaemics in diabetes mellitus:
A. Age at onset of disease over 40 years
B. Insulin requirement more than 40 U/day
C. Fasting blood sugar level between 100–200 mg/dl
D. Associated obesity
18.39 Which of the following is true of acarbose:
A. It reduces absorption of glucose from intestines
B. It produces hypoglycaemia in normal as well as diabetic subjects
C. It limits postprandial hyperglycaemia in diabetics
D. It raises circulating insulin levels
18.40 The following antidiabetic drug inhibits intestinal
brush border α-glucosidase enzymes:
A. Acarbose
B. Pioglitazone
C. Metformin
D. Guargum
18.41 Guargum limits post-prandial glycaemia by:
A. Inhibiting intestinal brush border α-glucosidases
B. Slowing carbohydrate absorption from intestine
C. Releasing incretins from the intestine
D. Promoting uptake of glucose into skeletal muscles
18.42 Select the drug which tends to reverse insulin resistance
by increasing cellular glucose transporters:
A. Glibenclamide
B. Rosiglitazone
C. Acarbose
D. Prednisolone
18.43 Glucagon release from pancreas is stimulated by:
A. High blood glucose level
B. Insulin
C. Somatostatin
D. Adrenaline
Ans:
18.1D 18.2 C 18.3D 18.4 C 18.5 D 18.6 B 18.7 B 18.8 C 18.9 A 18.10 A 18.11 D 18.12 A 18.13 D 18.14 A 18.15D 18.16 A 18.17D 18.18 B 18.19D 18.20 A 18.21 B 18.22D 18.23 A 18.24 B 18.25 B 18.26D 18.27 B 18.28 A 18.29D 18.30 A 18.31 C 18.32 B 18.33 C 18.34 B 18.35D 18.36 C 18.37D 18.38 B 18.39 C 18.40 A 18.41 B 18.42 B 18.43 D
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