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PHCY 631: EXAM 1 Questions with Correct Answers
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PHCY 631: EXAM 1 Questions with Correct Answers
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PHCY 631: EXAM 1 Questions with Correct AnswersTRUE or FALSE: "Sliding scale" insulin should be avoided in the
inpatient setting Correct Answer-TRUE
TRUE or FALSE: "Sliding scale" insulin alone is commonly used in the
inpatient setting and is guideline sanctioned Correct Answer-FALSE
In the inpatient setting, glucose control measures (i.e insulin) should be
implemented if the blood glucose is >/= to ______ mg/dl, and should be
maintained between ____ and _____ during the duration of
hospitalization Correct Answer-180
140 180
TRUE or FALSE: You should perform an A1C test on all patients with
T2DM or hyperglycemia (BG>140) admitted to the hospital if it has not
been performed in the past 3 months Correct Answer-TRUE
For review give the cutoffs for the different levels of hypoglycemia:
1. Level 1 = BG<___
2.. Level 2 = BG>___ but less than level 1 Correct Answer-70 54
Level ____ hypoglycemia involves a "severe event characterized by
AMS and/or physical status requiring assistance Correct Answer-3 (no
BG cutoff for this)
,The preferred regimens for insulin management in the inpatient setting
are basal insulin alone, basal+bolus, or basal+prandial+correction
depending on the patient's nutritional status (say ok) Correct Answer-ok
I would review insulin dosing: In the case review he recommended using
a couple different techniques during the case debrief Correct Answer-ok
When should BG be monitored in the inpatient setting in patients that
are eating?
Before ____s and ____. With patients that are not eating, they should
receive insulin every ___-___ hours Correct Answer-meals bedtime
4-6
When monitoring BG in the inpatient setting, testing should be done
____ minutes before meals, and then rapid-acting insulin should be
administered ____ minutes before eating Correct Answer-30 10
You may consider a stricter BG goal of between _____ and ______ in
some patients. The following complications/comorbidities may affect
your BG goal (more strict or more lenient)
1. High risk of ______
2. Long-standing disease duration
3. Shorter life expectancy (maybe a higher goal)
4. The presence of important comorbidities, including established
vascular complications
5. Lack of adherence or less motivation
,6. Limited resources and support systems Correct Answer-110-140
hypoglycemia (I would imagine you'd give them a higher goal)
TRUE or FALSE: Mixed insulin is less flexible than having separate
basal/prandial because the dose ratio is fixed Correct Answer-TRUE
TRUE or FALSE: Recent studies have shown that tight glucose control
in the inpatient setting actually might lead to higher mortality/morbidity
Correct Answer-TRUE
You might consider a more lax A1c goal in patients who are older. This
was mentioned the first time we learned T2DM. There's a table in the
guidelines that discuss reasons why you might consider a higher A1c
goal (say ok) Correct Answer-ok
TRUE or FALSE: MSSA is pretty rare in causing nonpurulent cellulitis
Correct Answer-TRUE
TRUE or FALSE: Any antibiotic that covers MSSA will cover beta-
hemolytic strep Correct Answer-TRUE
"Severe" cellulitis usually involves the threat of loss of ____ or ____.
We usually empirically use broad spectrum antibiotics in this case and
have an immediate emergency consult to surgery. Vanc/Zosyn is a
common combo for broad spectrum treatment Correct Answer-life, limb
, TRUE or FALSE: Oral vanc is contraindicated in patients with renal
failure Correct Answer-FALSE (not systemically absorbed)
_______ is an agent that did not perform as well as oral vanc or
fidaxomicin in treating first occurrence CDI. Patients may experience
_____ ___ while on this drug and cannot use ____ while taking this drug
Correct Answer-metronidazole
metallic taste
alcohol
Generally, SIRS criteria are not held in high regard any more. Basically,
if you're screening for sepsis in a patient, then it's probably severe and
will probably throwing the kitchen sink of ABX at them (say ok) Correct
Answer-ok
Beta-hemolytic strep is covered by early-generation and naturally
occurring drugs like penicillin, amoxicillin, or ampicillin. However,
_____ has developed a(n) _____ as a mechanism of resistance against
these drugs. So, we tend to use slightly newer drugs like cephalexin or
cefazolin. Correct Answer-MSSA
penicillinase
What 3 agents are (ideally) reserved for more serious gram positive
infections or for MRSA Correct Answer-vancomycin, daptomycin,
linezolid
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