1.
_____________ is the most important fuel for the brain.
Correct Answer
D. Glucose
Explanation
Glucose is the most important fuel for the brain because it is the primary source of energy for brain cells. The brain relies heavily on glucose to function optimally and carry out its various cognitive processes. Glucose is easily transported across the blood-brain barrier and is metabolized by brain cells to produce ATP, the main energy currency of the cell. Other sugars like fructose, sucrose, and galactose need to be converted into glucose before they can be used by the brain, making glucose the preferred and most efficient fuel source for brain function.
2.
Brain glucose uptake occurs at different rates during absorptive and post-absorptive periods and is not altered in type 2 diabetes.
Correct Answer
B. False
Explanation
Occurs at same rate
3.
What type of cells releases insulin?
Correct Answer
A. Pancreatic β cells
Explanation
Pancreatic β cells are responsible for releasing insulin. Insulin is a hormone that helps regulate blood sugar levels by allowing cells in the body to take in glucose from the bloodstream. These cells are located in the pancreas, specifically in the islets of Langerhans. When blood sugar levels rise, pancreatic β cells release insulin to facilitate the uptake of glucose by cells, thereby lowering blood sugar levels.
4.
Which of the following are specific-defined gene mutations of diabetes Mellitus?
Correct Answer
C. MODY
Explanation
MODY (Maturity-Onset Diabetes of the Young) is a specific-defined gene mutation of diabetes Mellitus. It is a rare form of diabetes that is caused by a mutation in a single gene. Unlike Type 1 and Type 2 diabetes, which have multiple causes and risk factors, MODY is caused by a specific genetic mutation that affects the body's ability to produce insulin. People with MODY often develop diabetes at a younger age and have a strong family history of the disease.
5.
Hyperinsulinemia is a condition in which normal amounts of insulin are ineffective in lowering plasma glucose concentrations.
Correct Answer
A. True
Explanation
Hyperinsulinemia is a condition characterized by elevated levels of insulin in the blood. In this condition, even though there are normal amounts of insulin present, it is unable to effectively lower the concentration of glucose in the blood. This can lead to persistently high blood glucose levels, which is a characteristic feature of hyperinsulinemia. Therefore, the statement that hyperinsulinemia is a condition in which normal amounts of insulin are ineffective in lowering plasma glucose concentrations is true.
6.
Insulin can bind to IGF receptors with high affinity.
Correct Answer
B. False
Explanation
low affinity
7.
Glucose is taken up by pancreatic β cells via _____________.
Correct Answer
B. GLUT2
Explanation
Pancreatic β cells take up glucose via GLUT2. GLUT2 is a glucose transporter protein that is expressed in the plasma membrane of pancreatic β cells. It allows the entry of glucose into the cells, which is necessary for the production and release of insulin. GLUT2 has a high Km value, which means it has a low affinity for glucose and is responsible for facilitating the transport of glucose in and out of the cells depending on the concentration gradient. This allows pancreatic β cells to sense and respond to changes in blood glucose levels.
8.
Glucose is ___________ by glucokinase.
Correct Answer
B. pHospHorylated
Explanation
Glucose is phosphorylated by glucokinase. This means that a phosphate group is added to the glucose molecule, resulting in the formation of glucose-6-phosphate. Phosphorylation is an important process in glucose metabolism as it helps to trap glucose inside the cell and initiate further metabolic reactions.
9.
What is the 1st phase in biphasic insulin secretion?
Correct Answer
A. Fusion
Explanation
The correct answer is Fusion. In biphasic insulin secretion, the first phase involves the fusion of insulin-containing vesicles with the cell membrane of pancreatic beta cells. This fusion allows the release of a rapid and initial burst of insulin into the bloodstream in response to increased blood glucose levels. This first phase is followed by a second phase, which involves a slower and sustained release of insulin.
10.
What is the 2nd phase in biphasic insulin secretion?
Correct Answer
B. Translocation
Explanation
The second phase in biphasic insulin secretion is translocation. This refers to the movement of insulin-containing vesicles from the cytoplasm of beta cells to the cell membrane, allowing the release of insulin into the bloodstream. Translocation is an essential step in the regulation of blood sugar levels, as it enables the timely and controlled release of insulin in response to glucose levels in the body.
11.
What type of cells releases glucagon?
Correct Answer
D. Pancreatic α cells
Explanation
Pancreatic α cells are responsible for releasing glucagon. Glucagon is a hormone that helps regulate blood sugar levels by stimulating the liver to convert stored glycogen into glucose and release it into the bloodstream. These α cells are located in the islets of Langerhans in the pancreas and play a crucial role in maintaining glucose homeostasis in the body.
12.
Insulin secretion is biphasic.
Correct Answer
A. True
Explanation
Insulin secretion is biphasic, meaning that it occurs in two distinct phases. The first phase is a rapid and transient release of insulin immediately after a meal, which helps to quickly lower blood glucose levels. The second phase is a slower and sustained release of insulin that occurs over a longer period of time, helping to maintain stable blood glucose levels. This biphasic secretion pattern is important for regulating glucose metabolism in the body.
13.
Glucagon increases gluconeogenesis and glycogenolysis.
Correct Answer
A. True
Explanation
Glucagon is a hormone that is released by the pancreas in response to low blood sugar levels. It acts to increase the production of glucose in the body through a process called gluconeogenesis, where new glucose is synthesized from non-carbohydrate sources such as amino acids. Glucagon also stimulates glycogenolysis, which is the breakdown of stored glycogen into glucose. Therefore, it is correct to say that glucagon increases both gluconeogenesis and glycogenolysis.
14.
Glucagon is an antagonist for G-protein coupled receptor (GPCR) that signals via stimulatory G-protein (Gs).
Correct Answer
B. False
Explanation
agonist
15.
Which of the following are "metabolic effects"?
Correct Answer(s)
A. Glucose uptake
C. Glycogen synthesis
D. Lipogenesis
Explanation
The metabolic effects listed in the answer choices are glucose uptake, glycogen synthesis, and lipogenesis. Glucose uptake refers to the process of cells taking in glucose from the bloodstream to be used as a source of energy. Glycogen synthesis involves the formation of glycogen, which is a stored form of glucose in the liver and muscles. Lipogenesis is the process of synthesizing lipids or fats. These metabolic effects are all involved in the regulation and storage of energy in the body.
16.
_____________ signaling events involved in "metabolic" signaling by insulin.
Correct Answer
C. PI-3 Kinase
Explanation
PI-3 Kinase is the correct answer because it is a key signaling molecule involved in metabolic signaling by insulin. Insulin binds to its receptor on the cell surface, leading to the activation of PI-3 Kinase. This enzyme then phosphorylates specific proteins, initiating a cascade of intracellular events that regulate glucose uptake, glycogen synthesis, and lipid metabolism. PI-3 Kinase plays a crucial role in mediating insulin's metabolic effects, making it a critical component of the insulin signaling pathway.
17.
Dysregulation of insulin signaling pathways is one of the hallmarks of Type I diabetes.
Correct Answer
B. False
Explanation
Type II
18.
Hepatic glucose production is altered in Type 2 diabetes.
Correct Answer
A. True
Explanation
In Type 2 diabetes, hepatic glucose production is indeed altered. The liver plays a crucial role in regulating blood glucose levels by producing glucose through a process called gluconeogenesis. In individuals with Type 2 diabetes, there is an increased production of glucose by the liver, leading to elevated blood sugar levels. This occurs due to insulin resistance, where the body's cells do not respond effectively to insulin, causing the liver to overproduce glucose. Therefore, the statement that hepatic glucose production is altered in Type 2 diabetes is true.
19.
If the liver is insulin-resistant, it will continue to produce glucose leading to marked hyperglycemia.
Correct Answer
A. True
Explanation
Insulin resistance occurs when the liver and other tissues do not respond properly to the hormone insulin, which is responsible for regulating blood sugar levels. When the liver is insulin-resistant, it fails to suppress glucose production, resulting in elevated blood sugar levels, a condition known as hyperglycemia. This is because insulin normally signals the liver to stop producing glucose, but when the liver is resistant to insulin, it continues to produce glucose, leading to marked hyperglycemia. Therefore, the statement is true.
20.
Hypoglycemia is a potent inhibitor of hepatic glucose output (HGO).
Correct Answer
B. False
Explanation
Hyperglycemia
21.
_______________ occurs when the body cannot use glucose as a fuel source because the body has no insulin or not enough insulin, and fat is used instead.
Correct Answer
A. Diabetic ketoacidosis
Explanation
Diabetic ketoacidosis occurs when the body is unable to use glucose as a fuel source due to insufficient insulin. In this condition, fat is used as an alternative source of energy, leading to the production of ketones. This can result in a buildup of ketones in the blood, causing a state of acidosis. Diabetic ketoacidosis is a serious complication of diabetes and requires immediate medical attention.
22.
The following can greatly improve outcomes for diabetic patients:
Correct Answer(s)
A. Early diagnosis
B. Careful glucose monitoring
C. Control
Explanation
Early diagnosis, careful glucose monitoring, and control can greatly improve outcomes for diabetic patients. Early diagnosis allows for prompt intervention and management of the disease, preventing further complications. Careful glucose monitoring helps in maintaining blood sugar levels within the target range, reducing the risk of hyperglycemia or hypoglycemia. Control of diabetes through medication, lifestyle modifications, and adherence to treatment plans can prevent the progression of the disease and minimize the impact on the patient's health. Overall, these measures contribute to better management of diabetes and improved patient outcomes.
23.
Glycosylated hemoglobin is a critical biomarker for glucose control.
Correct Answer
A. True
Explanation
Glycosylated hemoglobin, also known as HbA1c, is indeed a critical biomarker for glucose control. It provides an average measure of a person's blood sugar levels over the past two to three months. By monitoring HbA1c levels, healthcare professionals can assess the effectiveness of diabetes management and make necessary adjustments to treatment plans. This biomarker is commonly used in diagnosing and managing diabetes, making the statement true.
24.
Insulin resistance/Metabolic syndrome is constellation of symptoms most often associated with obesity.
Correct Answer
A. True
Explanation
Insulin resistance/Metabolic syndrome refers to a group of symptoms that are commonly found in individuals who are obese. These symptoms include high blood pressure, high blood sugar levels, excess body fat around the waist, and abnormal cholesterol levels. Therefore, it is true that insulin resistance/Metabolic syndrome is often associated with obesity.
25.
One of the glycemic goals is to maintain fasting blood glucose between ____________.
Correct Answer
A. 70-130 mg/dL
Explanation
The correct answer is 70-130 mg/dL. This range is considered to be the optimal fasting blood glucose level for individuals with diabetes. Maintaining blood glucose within this range helps to prevent complications associated with high or low blood sugar levels.
26.
The following are stimulatory factors in the regulation of insulin secretion, except:
Correct Answer
E. Dopamine
Explanation
Dopamine is not a stimulatory factor in the regulation of insulin secretion. Insulin secretion is primarily regulated by factors such as dietary amino acids, acetylcholine (via the vagus nerve), glucose-dependent insulinotropic peptide (GIP), and fatty acids. Dopamine, on the other hand, is known to inhibit insulin secretion rather than stimulate it. Therefore, it is not considered a stimulatory factor in the regulation of insulin secretion.
27.
Type 1 diabetics have essentially no functional β cells therefore they cannot maintain basal insulin secretion, nor respond to variations in circulating fuels.
Correct Answer
A. True
Explanation
This statement is true because type 1 diabetics have a condition where their β cells, which are responsible for producing insulin in the pancreas, are essentially non-functional. As a result, they are unable to maintain basal insulin secretion, which is necessary for regulating blood glucose levels during periods of fasting. Additionally, they are also unable to respond to variations in circulating fuels, such as glucose, which further contributes to their inability to regulate blood sugar levels.
28.
Oral glucose has less stimulus for insulin secretion than IV due to stimulatory effects of GI hormones.
Correct Answer
B. False
Explanation
greater stimulus
29.
Human insulin is produced by recombinant RNA technology.
Correct Answer
B. False
Explanation
recombinant DNA technology
30.
As insulin is a polypeptide, it can be taken orally.
Correct Answer
B. False
Explanation
Note: As insulin is a polypeptide, it cannot be taken orally due to degradation in GI tract. Therefore typically administered as sc injection.
31.
The following can alter insulin absorption and duration of action:
Correct Answer(s)
A. Injection site
B. Blood flow
C. Temperature
D. pHysical activity
Explanation
Insulin absorption and duration of action can be influenced by various factors. The injection site plays a crucial role as insulin is absorbed differently in different areas of the body. Blood flow is also important as it affects the rate at which insulin is distributed throughout the body. Temperature can impact insulin absorption, with higher temperatures potentially increasing absorption. Physical activity can also affect insulin absorption and action by increasing blood flow and altering the body's metabolism. Overall, all of these factors, including injection site, blood flow, temperature, and physical activity, can have an impact on how insulin is absorbed and how long it remains active in the body.
32.
________________ is the most common adverse event due to insulin Rx.
Correct Answer
B. Hypoglycemia
Explanation
Hypoglycemia is the most common adverse event due to insulin Rx. This is because insulin lowers blood sugar levels, and if too much insulin is administered or if a person's blood sugar levels are already low, it can result in hypoglycemia. Symptoms of hypoglycemia include dizziness, sweating, confusion, and in severe cases, loss of consciousness. It is important for individuals taking insulin to monitor their blood sugar levels regularly and adjust their insulin dosage accordingly to avoid hypoglycemia.
33.
The following are oral Rx for Type 2 diabetes mellitus, except:
Correct Answer
B. Insulin desensitizers
Explanation
Insulin desensitizers are not oral medications for Type 2 diabetes mellitus. Insulin secretagogues, α-Glucosidase inhibitors, and Dipeptidyl Peptidase 4 (DPPIV) inhibitors are all oral medications commonly used to treat Type 2 diabetes mellitus. Therefore, the correct answer is "Insulin desensitizers."
34.
Insulin secretagogues promote insulin secretion from β cells.
Correct Answer
A. True
Explanation
Insulin secretagogues are substances that stimulate the release of insulin from β cells in the pancreas. These substances can include certain medications or natural compounds. When insulin secretagogues are present, they enhance the secretion of insulin, leading to increased levels of insulin in the bloodstream. This can help regulate blood sugar levels and promote glucose uptake by cells. Therefore, the statement that insulin secretagogues promote insulin secretion from β cells is true.
35.
Which of the following are sulfonylureas?
Correct Answer(s)
A. Glibenclamide
D. Glipizide
Explanation
Glibenclamide and Glipizide are both sulfonylureas. Sulfonylureas are a class of oral medications commonly used to treat type 2 diabetes. They work by stimulating the pancreas to produce more insulin, which helps lower blood sugar levels. Nateglinide, on the other hand, is a different type of medication called a meglitinide, and Metformin is a biguanide. Both Nateglinide and Metformin also help lower blood sugar levels, but they do so in different ways than sulfonylureas.
36.
Which of the following are Meglitinides?
Correct Answer(s)
B. Nateglinide
C. Replaglinide
Explanation
Nateglinide and Replaglinide are both classified as Meglitinides. These drugs are commonly used to treat type 2 diabetes by stimulating the release of insulin from the pancreas. They work by targeting the beta cells in the pancreas to increase insulin secretion, helping to lower blood sugar levels. Rosiglitazone/Avandia and Metformin, on the other hand, belong to different drug classes and have different mechanisms of action for managing diabetes.
37.
___________ are oral insulin sensitizer, and 1st line therapy for Type 2 Diabetes Mellitus.
Correct Answer
D. Metformin
Explanation
Metformin is the correct answer because it is an oral insulin sensitizer and is widely recognized as the first-line therapy for Type 2 Diabetes Mellitus. It works by reducing glucose production in the liver, increasing insulin sensitivity, and improving glucose uptake in the muscles. Metformin is also beneficial in managing weight and reducing the risk of cardiovascular complications. Actos and Avandia are thiazolidinediones, another class of oral antidiabetic drugs, while Glipizide is a sulfonylurea.
38.
Which of the following are Biguanides?
Correct Answer
A. Metformin
Explanation
Metformin is a biguanide. Biguanides are a class of oral diabetes medications that work by reducing the production of glucose in the liver and improving the body's response to insulin. They are commonly used to treat type 2 diabetes. Glipizide, Actos, and Avandia are not biguanides. Glipizide is a sulfonylurea medication, while Actos and Avandia belong to a class of medications called thiazolidinediones.
39.
Which of the following are Thiazolidinediones?
Correct Answer(s)
A. Rosiglitazone (Avandia)
B. Pioglitazones (Actos)
Explanation
Rosiglitazone (Avandia) and Pioglitazones (Actos) are Thiazolidinediones. Thiazolidinediones are a class of oral medication used to treat type 2 diabetes. They work by increasing the body's sensitivity to insulin, helping to lower blood sugar levels. Nateglinide and Miglitol, on the other hand, are not Thiazolidinediones. Nateglinide is a meglitinide that stimulates the release of insulin from the pancreas, while Miglitol is an alpha-glucosidase inhibitor that slows down the digestion of carbohydrates.
40.
Which of the following are α-Glucosidase inhibitors?
Correct Answer(s)
C. Miglitol
D. Acarbose
Explanation
Miglitol and Acarbose are α-Glucosidase inhibitors. These drugs work by slowing down the digestion and absorption of carbohydrates in the small intestine. By inhibiting the α-Glucosidase enzyme, they prevent the breakdown of complex carbohydrates into simple sugars, thereby reducing the post-meal rise in blood glucose levels. Actos and Avandia, on the other hand, are thiazolidinediones used to treat type 2 diabetes by improving insulin sensitivity.
41.
Which of the following are phases of the menstrual cycle?
Correct Answer(s)
B. Follicular development and endometrial development
C. Mid-cycle / ovulation
D. Luteal pHase
Explanation
The phases of the menstrual cycle include follicular development and endometrial development, mid-cycle/ovulation, and the luteal phase. During the follicular phase, follicles in the ovaries mature and prepare to release an egg. The endometrial phase involves the thickening of the uterine lining in preparation for potential implantation of a fertilized egg. Mid-cycle/ovulation is when the mature egg is released from the ovary. The luteal phase occurs after ovulation and is characterized by the production of progesterone to support a potential pregnancy.
42.
In the follicular phase, a "pulse generator" in the basal hypothalamus produces a large burst of neuronal activity.
Correct Answer
B. False
Explanation
small burst of neuronal activity
43.
In the follicular phase, GnRH binds its receptors in the pituitary and causes lutienizing hormone (LH) and follicle stimulating hormone (FSH) to be released from the pituitary.
Correct Answer
A. True
Explanation
During the follicular phase of the menstrual cycle, the hypothalamus releases gonadotropin-releasing hormone (GnRH), which binds to its receptors in the pituitary gland. This binding stimulates the pituitary gland to release luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These hormones play a crucial role in the development and maturation of ovarian follicles and the release of an egg during ovulation. Therefore, the statement is true as it accurately describes the hormonal changes that occur during the follicular phase.
44.
In the follicular phase, __________ and __________ feedback to the pituitary and hypothalamus to inhibit LH and FSH release.
Correct Answer
A. Estrogen (E2); inhibin
Explanation
During the follicular phase, estrogen (E2) and inhibin feedback to the pituitary and hypothalamus to inhibit LH and FSH release. Estrogen acts as a negative feedback signal to prevent excessive production of LH and FSH, while inhibin specifically inhibits FSH release. This feedback mechanism helps regulate the levels of these hormones and ensure proper follicular development and ovulation. Progesterone and estradiol are not involved in inhibiting LH and FSH release during the follicular phase.
45.
The _________________ produces estrogen (E2) and inhibin.
Correct Answer
D. Graafian follicle
Explanation
The graafian follicle is responsible for producing estrogen (E2) and inhibin. The graafian follicle is a mature ovarian follicle that contains the developing egg. As it grows, it secretes estrogen, which plays a crucial role in the regulation of the menstrual cycle and the development of secondary sexual characteristics. Additionally, the graafian follicle also produces inhibin, a hormone that helps regulate the production of follicle-stimulating hormone (FSH) from the pituitary gland.
46.
The gonads (ovaries) secretes the following, except:
Correct Answer
C. GnRH
Explanation
The gonads, specifically the ovaries, secrete estradiol (E2) and progesterone (P4), which are important hormones involved in the menstrual cycle and reproductive processes. However, gonadotropin-releasing hormone (GnRH) is not secreted by the ovaries. GnRH is actually produced and released by the hypothalamus, and it plays a crucial role in regulating the secretion of other hormones, such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which in turn stimulate the ovaries to produce estradiol and progesterone. Therefore, GnRH is not secreted by the ovaries.
47.
At most times during the menstrual cycle, estrogen and/or progesterone provide positive feedback to GnRH and LH release.
Correct Answer
B. False
Explanation
negative feedback
48.
Just prior to the preovulatory GnRH/LH/FSH surges, estradiol (E2) and progesterone (P4) are stimulatory to GnRH release.
Correct Answer
A. True
Explanation
Prior to the preovulatory GnRH/LH/FSH surges, estradiol (E2) and progesterone (P4) are stimulatory to GnRH release. This means that the levels of E2 and P4 increase and signal the release of GnRH, LH, and FSH. These hormones are essential for the ovulation process and the preparation of the uterus for potential pregnancy. Therefore, the statement "True" is correct as it accurately reflects the relationship between E2, P4, and GnRH release.
49.
Deactivated cAMP triggers protein kinase activity and the subsequent phosphorylation of proteins necessary for steroidogenesis.
Correct Answer
B. False
Explanation
activated cAMP
50.
In the early proliferative phase of the menstrual cycle, the uterine is relatively thin compared to the late proliferative phase where the endometrium thickens.
Correct Answer
A. True
Explanation
During the early proliferative phase of the menstrual cycle, the uterine lining is indeed relatively thin compared to the late proliferative phase. This is because in the early proliferative phase, the hormones estrogen and progesterone are low, causing the endometrium to shed and the uterine lining to be thin. As the menstrual cycle progresses and estrogen levels rise, the endometrium begins to thicken in preparation for possible pregnancy. Therefore, it is true that the uterine lining is thinner in the early proliferative phase compared to the late proliferative phase.