Metformin works by:

Increasing the cells' sensitivity to insulin.

Stimulating the release of insulin from the pancreas.

Stimulating glucose uptake in the skeletal muscles.

Increasing hepatic glucose production.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Metformin primarily increases peripheral insulin sensitivity, particularly in muscle and adipose tissues, facilitating glucose uptake and utilization. It inhibits hepatic glucose production through AMPK activation, reducing gluconeogenesis. Metformin also improves lipid profiles and insulin resistance without promoting insulin secretion, which minimizes the risk of hypoglycemia. Its actions target metabolic pathways, enhancing cellular glucose management for type 2 diabetes control.

Choice B rationale

Metformin does not stimulate pancreatic insulin release. It acts independently of insulin production mechanisms, focusing on improving peripheral sensitivity and reducing hepatic glucose output. Drugs like sulfonylureas target beta cells for insulin release, unlike metformin, which avoids direct engagement with the pancreas, minimizing hypoglycemia risks associated with excessive insulin secretion.

Choice C rationale

Stimulating glucose uptake in skeletal muscles is a partial outcome of improved insulin sensitivity induced by metformin. However, metformin’s mechanism extends beyond this, involving significant hepatic effects. It does not directly stimulate glucose uptake as a sole action; rather, it enhances overall metabolic efficiency and glucose management through multiple pathways.

Choice D rationale

Metformin decreases hepatic glucose production rather than increasing it. It inhibits gluconeogenesis by activating AMPK, suppressing the production of glucose from non-carbohydrate sources. This inhibition aids in reducing fasting glucose levels, which are often elevated in type 2 diabetes. The opposite action described contradicts its therapeutic role in managing hyperglycemia effectively.

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Correct Answer is C

Explanation

Choice A rationale

Glyburide does not stimulate glucose uptake directly in skeletal muscles. Instead, it acts on pancreatic beta cells, affecting insulin release. Enhancing muscular glucose uptake occurs through insulin’s action downstream.

Choice B rationale

Glyburide does not primarily increase insulin sensitivity. Agents like metformin work to sensitize cells to insulin, but Glyburide functions by stimulating endogenous insulin release.

Choice C rationale

Glyburide stimulates insulin release from pancreatic beta cells by closing ATP-sensitive potassium channels, leading to calcium influx and insulin secretion. This increases circulating insulin, aiding glucose uptake and reducing blood glucose levels.

Choice D rationale

Glyburide does not inhibit carbohydrate breakdown in the intestines. Medications like alpha-glucosidase inhibitors target intestinal enzymes to slow carbohydrate digestion, unlike Glyburide’s pancreatic action.

A. An incision into the renal pelvis for stone removal. B. An incision into the kidney to remove a stone. C. A procedure used to break up stones, thus allowing them to pass from the urinary tract. D. A minimally invasive technique using laser technology to fragment stones.

Correct Answer is C

Explanation

Choice A rationale

Incisions into the renal pelvis for stone removal describe open surgical methods, not ultrasonic lithotripsy. This invasive approach is reserved for cases where less invasive techniques fail or stones are inaccessible through standard methods. Lithotripsy avoids direct incisions, utilizing external energy for stone fragmentation.

Choice B rationale

Kidney incisions for stone removal align with nephrolithotomy procedures rather than ultrasonic lithotripsy. This alternative represents open surgical intervention, distinct from non-invasive lithotripsy technologies. Lithotripsy eliminates stones using sound waves or lasers, reducing surgical risks and recovery times.

Choice C rationale

Ultrasonic lithotripsy employs high-frequency sound waves to break stones into small fragments. This minimally invasive method allows natural passage through the urinary tract or facilitates removal via catheterization. It reduces complications compared to invasive surgeries and is highly effective for calculi management.

Choice D rationale

Laser fragmentation techniques differ from ultrasonic lithotripsy, involving concentrated light energy to break stones. While both are minimally invasive, ultrasonic methods utilize sound waves rather than light energy for disintegration. This technical distinction outlines lithotripsy's use of external sound waves for stone management.

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Metformin works by:

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Naxlex Comprehensive Predictor Exams

Glyburide works by which of the following mechanisms?

Correct Answer is C

Explanation

The MD schedules an ultrasonic lithotripsy.Choose the correct description of this procedure.

Correct Answer is C

Explanation

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