CDCES Pharmacology Fundamentals 5

Question 1

A patient with type 2 diabetes and heart failure with reduced ejection fraction (HFrEF) would benefit most from which medication class based on current evidence?

Accepted Answer

SGLT-2 inhibitors

Answer

SGLT-2 inhibitors like empagliflozin and dapagliflozin have demonstrated significant reductions in heart failure hospitalization and are recommended in patients with HFrEF.

Question 2

When converting a patient from twice-daily NPH insulin to once-daily insulin glargine, the typical dose conversion is:

Accepted Answer

80% of total daily NPH dose given as glargine

Answer

When switching to glargine, starting at 80% of the total daily NPH dose reduces hypoglycemia risk while providing similar basal coverage, with subsequent titration as needed.

Question 3

A patient asks about the difference between semaglutide oral and injectable forms. Which statement is accurate?

Accepted Answer

Oral semaglutide requires a specific administration protocol: fasting, with small amount of water, 30 minutes before eating

Answer

Oral semaglutide has very low bioavailability (~1%) and must be taken on an empty stomach with no more than 4 oz of water, waiting 30 minutes before eating or drinking.

Question 4

Which adverse effect is a BLACK BOX WARNING for thiazolidinediones (TZDs) like pioglitazone?

Accepted Answer

Congestive heart failure exacerbation

Answer

TZDs carry a black box warning for causing or worsening congestive heart failure due to fluid retention; they are contraindicated in NYHA Class III-IV heart failure.

Question 5

A patient on insulin develops lipohypertrophy at injection sites. What is the primary clinical consequence the CDCES should address?

Accepted Answer

Unpredictable insulin absorption leading to erratic glucose control

Answer

Lipohypertrophy causes fibrotic tissue that alters insulin absorption rates, leading to unpredictable glucose fluctuations and making diabetes management more difficult.

(CDCES) Certified Diabetes Care and Education Specialist Practice Test

(CDCES) Certified Diabetes Care and Education Specialist Practice Test

CDCES Pharmacology Fundamentals 5