NBME 21 Stimulation of the peroxisome proliferator-activated receptor γ (NBME Answers)

NBME 21 Answers

nbme21/Block 1/Question#21 (reveal difficulty score)
A 40-year-old man with type 2 diabetes ...
Stimulation of the peroxisome proliferator-activated receptor γ 🔍 / 📺 / 🌳 / 📖
tags: pharm endo repeat

+11 upvote downvote
submitted by sgarzon15(11)

get full access to all content ⋅ pick a username

Thank you glitter zone of sketchy pharm. I shall never forget you

get full access to all content ⋅ pick a username

cr why not C?. It´s not supose that it improve the efectivity of insulin? +

divya because insulin uptake by adipose and muscle tissue is not limited to thiazolidinediones but also and mainly by metformin. and glitazones' primary MOA is PPAR gamma stimulation which then increases insulin sensitivity to other tissues. +2

+7 upvote downvote
submitted by ∗madojo(212)

get full access to all content ⋅ pick a username

Going over the other answer choices:

Blocking ATP sensitive potassium channels in the pancreatic beta cells to increase insulin secretion would be drugs like Sulfonylureas or Meglitinides for example like Glyburide.
Increasing endogenous GLP1 or GIP levels are drugs like Sitagliptan and Saxagliptan. They have GLP in them
Increasing peripheral glucose uptake would be the biguanides like metformin.
Stimulating transcription regulator PPAR-gamma decreases insulin resistance and is the MOA of thiazolidenediones like Pioglitazone.

get full access to all content ⋅ pick a username

+0 upvote downvote
submitted by cr(5)

get full access to all content ⋅ pick a username

why not C?. It´s not supose that it improve the efectivity of insulin?

get full access to all content ⋅ pick a username

yb_26 thiazolidinediones (pioglitazone) increase insulin sensitivity (in muscles and liver) through activation of peroxisome proliferator-activated receptor-gamma (PPAR) I think they are asking about primarily mechanism of action, that's why it is E +

cienfuegos UW explanation regarding the genes upregulated 1. GLUT4: insulin responsive on adipocytes/skeletal increases G uptake 2. adiponectin: cytokine secreted by adipocytes increases # of insulin responsive adipocytes and stims FA oxidation 3. PPAR family also plays significant role in pathogenesis of metabolic syndrome +2

poisonivy Also, I think the word uptake shouldn't be right when speaking about insulin, it does increase insulin sensitivity and therefore glucose uptake +9

brotherimodu @poisonivy That's why I didn't choose C and went with E since it was more specific +

+0 upvote downvote
submitted by ∗namesthegame22(13)

get full access to all content ⋅ pick a username

Pioglitazone is an oral thiazolidinedione that is used for the treatment of type 2 diabetes mellitus. it binds to peroxisome proliferator-activated receptors (PPARs): act as transcription factors to regulate metabolism and promote insulin sensitivity.

get full access to all content ⋅ pick a username

Must-See Comments from nbme21

nosancuck on Absorption atelectasis
assoplasty on Free T4
seagull on GM2
lnsetick on Apocrine
niboonsh on NMDA receptors are blocked by Mg2+ at the ...
drdoom on Deletion of a hydrophobic amino acid ...
hayayah on HCO3− transported in the plasma
mcl on Aortic
notadoctor on Usual interstitial pneumonitis
madojo on Genital herpes
hungrybox on Obstruction of the bile duct
jambo2222 on Lung
hungrybox on Mismatch repair
hungrybox on Hydrochlorothiazide