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Apr 7, 2010 ... Basic & Clinical Pharmacology 10th ed. New York: The. McGraw-Hill Companies. Pelley, J.W., Goljan, E.F. (2007). Rapid Review: Biochemistry ...

Texas Tech MedCast Podcast Episode Fact Sheet

Podcast Series

Reynolds Geriatrics Series • USMLE Step 1 Prep

Episode Title

When Diet and Exercise Aren’t Enough, Question 63

Personnel

Kiersten Andrews, Chase Cawyer, Rajan Gadhia, Thach Huynh, Meagan Jarboe, Matthew Richards, Camille Stephens, Gerrid Warner, Mary Ann Weaver

Group 9 Recording Date USMLE Question Number: 63 Pg #: 35

April 7, 2010 A 52-year-old man with recently diagnosed type 2 diabetes mellitus comes to the physician for a follow-up examination. Physical examination shows no abnormalities. Laboratory studies show an increased hemoglobin A1c despite patient compliance with diet and exercise recommendations. Treatment with a sulfonylurea is started. Which of the following is most likely to occur in this patient? (A) Decreased entry of glucose into the muscle cells (B) Decreased production of glucose from the liver (C) Decreased secretion of insulin from the pancreas (D) Decreased speed of carbohydrate absorption from the intestines (E) Increased entry of glucose into the muscle cells (F) Increased production of glucose from the liver (G) Increased secretion of insulin from the pancreas (H) Increased speed of carbohydrate absorption from the intestines

Learning Objectives

1. Explain the pathogenesis of type 2 diabetes mellitus

The listener should be able to:

3. Know the pharmacological class available for managing type 2 diabetes mellitus including: insulin, biguanides, sulfonylurea, and a-glucosidase inhibitors

2. Know the relationship between hemoglobin A1c level and diabetes control

4. Discuss the mechanism of action of sulfonylurea and potential side effects Texas Tech MedCast Producer: Betsy Goebel Jones, Ed.D., [email protected] Prepared for the MS2 Aging Block at Texas Tech University Health Sciences Center School of Medicine, Andrew Dentino, M.D., Block Director, [email protected] http://www.ttuhsc.edu/som/fammed/ttmedcast/gerseries/gerstep1prep.aspx

Texas Tech MedCast Podcast Episode Fact Sheet

Key Teaching Points

1. Non-insulin dependent diabetes mellitus, also called Type II diabetes mellitus, is a condition most often characterized by insulin resistance resulting in persistent hyperglycemia. 2. Complications of diabetes mellitus are systemic and relate to microvascular disease in organs like the eye, kidney, skin, and nerves. 3. Sulfonylureas are an oral hypoglycemic that can help regulate blood sugar levels by increasing the release of endogenous insulin from the endocrine pancreas. 4. Sulfonylureas should be given with caution as their main complication is the induction of hypoglycemia which can lead to coma. Care should be taken with administration to have patients tightly monitor their blood sugar when beginning the new regimen.

USMLE Test source:

http://www.usmle.org/examinations/step1/2010Step1.pdf

Keywords

Geriatrics, USMLE step exam, diabetes mellitus, sulfonylureas Katzung, B.G. (2007). Basic & Clinical Pharmacology 10th ed. New York: The McGraw-Hill Companies.

References

Pelley, J.W., Goljan, E.F. (2007). Rapid Review: Biochemistry 2nd ed. Mosby Elsevier. Costanzo, L.S. (2006). Physiology 3rd ed. Saunders Elsevier. Harvey, Richard A., Champe, Pamela C. (2009). Lippincott’s Illustrated Reviews Pharmacology 4th ed. Philadelphia: Lippincott Williams & Wilkins. pp295

Texas Tech MedCast Producer: Betsy Goebel Jones, Ed.D., [email protected] Prepared for the MS2 Aging Block at Texas Tech University Health Sciences Center School of Medicine, Andrew Dentino, M.D., Block Director, [email protected] http://www.ttuhsc.edu/som/fammed/ttmedcast/gerseries/gerstep1prep.aspx