MTM Chronic Disease Management 2

Question 1

A patient with type 2 diabetes has an HbA1c of 9.2% despite metformin 1000 mg twice daily. Which is the most appropriate next step in therapy?

Accepted Answer

Add a GLP-1 receptor agonist or SGLT-2 inhibitor with cardiovascular benefit if indicated

Answer

Current ADA guidelines recommend adding agents with proven cardiovascular or renal benefit (GLP-1 RA or SGLT-2i) as preferred second-line therapy when HbA1c remains above goal.

Question 2

Which blood pressure target is recommended for most patients with hypertension and established cardiovascular disease according to current guidelines?

Accepted Answer

Less than 130/80 mmHg

Answer

The AHA/ACC 2017 guidelines recommend a BP target of <130/80 mmHg for patients with hypertension and established CVD.

Question 3

A COPD patient uses a short-acting beta-agonist (SABA) more than twice per week for symptom relief. According to GOLD guidelines, this indicates:

Accepted Answer

Inadequately controlled symptoms requiring therapy escalation

Answer

Frequent rescue inhaler use (>2 days/week) signals uncontrolled symptoms and warrants reassessment and escalation of maintenance therapy per GOLD guidelines.

Question 4

Which monitoring parameter is MOST critical when initiating an ACE inhibitor in a patient with chronic kidney disease?

Accepted Answer

Serum creatinine and potassium within 1–2 weeks

Answer

ACE inhibitors can cause acute rises in creatinine and hyperkalemia in CKD patients, so renal function and electrolytes must be rechecked within 1–2 weeks of initiation.

Question 5

A patient with heart failure with reduced ejection fraction (HFrEF) is on optimal medical therapy. Which medication class has demonstrated mortality reduction in this population?

Accepted Answer

Beta-blockers (carvedilol, metoprolol succinate, or bisoprolol)

Answer

Evidence-based beta-blockers (carvedilol, metoprolol succinate, bisoprolol) are proven to reduce mortality in HFrEF and are part of the guideline-directed medical therapy quartet.

(MTM) Medication Therapy Management Board Certification Practice Test

(MTM) Medication Therapy Management Board Certification Practice Test

MTM Chronic Disease Management 2